Dot Inspection Form
Inspector's Name
First Name
Last Name
Motor Carrier Operator Name
First Name
Last Name
Vehicle Type
Tractor
Trailer
Truck
Other
Please Specify
1. BRAKE SYSTEM
Rows
Needs Repair
Repaired
Notes
Service Brakes
1
2
Parking Brake System
3
4
Brake Drums or Rotors
5
6
Brake Hose
7
8
Brake Tubing
9
10
Low Pressure Warning
Device
11
12
Tractor Protection Valve
13
14
Air Compressor
15
16
Electric Brakes
17
18
Hydraulic Brakes
19
20
Vacuum Systems
21
22
2. COUPLING DEVICES
Rows
Needs Repair
Repaired
Notes
Fifth Wheels
23
24
Pintle Hooks
25
26
Drawbar/Towbar Eye
27
28
Drawbar/Towbar Tongue
29
30
Safety Devices
31
32
Saddle-Mounts
33
34
3. EXHAUST SYSTEM
Rows
Needs Repair
Repaired
Notes
Any exhaust system
determined to be leaking at
a point forward of or directly
below the driver/sleeper
compartment.
35
36
A bus exhaust system
leaking or discharging to
the atmosphere in violation
of standards (1), (2) or (3).
37
38
No part of the exhaust
system of any motor vehicle
shall be so located as
would be likely to result in
burning, charring, or
damaging the electrical
wiring, the fuel supply, or
any combustible part of the
motor vehicle.
39
40
4. FUEL SYSTEM
Rows
Needs Repair
Repaired
Notes
Visible leak
41
42
Fuel tank filler cap missing
43
44
Fuel tank securely
attached
45
46
5. LIGHTING DEVICES
Rows
Needs Repair
Repaired
Notes
All lighting devices and
reflectors shall be operable.
47
48
6. SAFE LOADING
Rows
Needs Repair
Repaired
Notes
Part(s) of vehicle or
condition of loading such
that the spare tire or any
part of the load or dunnage
can fall onto the roadway.
49
50
Protection against shifting
cargo
51
52
7. STEERING MECHANISM
Rows
Needs Repair
Repaired
Notes
Steering Wheel Free Play
53
54
Steering Column
55
56
Front Axle Beam and All
Steering Components
Other Than Steering
Column
57
58
Steering Gear Box
59
60
Pitman Arm
61
62
Power Steering
63
64
Ball and Socket Joints
65
66
Tie Rods and Drag Links
67
68
Nuts
69
70
Steering System
71
72
8. SUSPENSION
Rows
Needs Repair
Repaired
Notes
Any U-bolt(s), spring
hanger(s), or other axle
positioning part(s) cracked,
broken, loose or missing
resulting in shifting of an
axle from its normal position.
73
74
Spring Assembly
75
76
Torque, Radius or Tracking
Components.
77
78
9. FRAME
Rows
Needs Repair
Repaired
Notes
Frame Members
79
80
Tire and Wheel Clearance
81
82
Adjustable Axle
Assemblies (Sliding
Subframes)
83
84
10. TIRES
Rows
Needs Repair
Repaired
Notes
Tires on any steering axle
of a power unit.
85
86
All other tires
87
88
11. WHEELS AND RIMS
Rows
Needs Repair
Repaired
Notes
Lock or Side Ring
89
90
Wheels and Rims
91
92
Fasteners
93
94
Welds
95
96
12. WINDSHIELD GLAZING
Rows
Needs Repair
Repaired
Notes
Requirements and exceptions
as stated pertaining to any
crack, discoloration or vision
reducing matter
97
98
13. WINDSHIELD WIPERS
Rows
Needs Repair
Repaired
Notes
Any power unit that has an
inoperative wiper, or missing
or damaged parts that render
it ineffective.
99
100
Please specify any other condition which may prevent safe operation of this vehicle.
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