Pretrip Inspection Form
Vehicle Plate ID:
Driver's Name:
First Name
Last Name
Trip Starts:
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Trip Ends:
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Starting Mileage:
Ending Mileage:
Check the Interior and Exterior of the vehicle for the following items.
1. Under Hood
Rows
PASS
FAIL
N/A
COMMENTS
Water Level
1
2
3
Oil Level
4
5
6
Belts & Hoses
7
8
9
Fluid Leaks
10
11
12
2. Start Engine
Rows
PASS
FAIL
N/A
COMMENTS
Oil Pressure
13
14
15
Air Pressure
16
17
18
Fuel Level
19
20
21
Air Conditioning
22
23
24
Wipers & Washer
25
26
27
Service Door
28
29
30
Signal Indicators
31
32
33
Warning Lights
34
35
36
Emergency Exit & Buzzer
37
38
39
3. Inside Vehicle
Rows
PASS
FAIL
N/A
COMMENTS
Cleanliness
40
41
42
Seats & Windows
43
44
45
Emergency Equipment
46
47
48
Low Beam Indicator
49
50
51
Signal Indicators
52
53
54
Red Warning Lights
55
56
57
Service Brakes
58
59
60
Parking Brakes
61
62
63
4. Outside Vehicle
Rows
PASS
FAIL
N/A
COMMENTS
Rear Clear Lights
64
65
66
Amber Warning Lights
67
68
69
Signals
70
71
72
Brakes
73
74
75
Exhaust System
76
77
78
Tires & Wheels, Rear
79
80
81
Headlights, High Beam
82
83
84
Clear Lights
85
86
87
Warning Lights
88
89
90
Signal Indicators
91
92
93
Crossover Mirror
94
95
96
Both Rear View Mirrors
97
98
99
Any Comments:
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Driver's Signature
Submit
Should be Empty: