Annual Inspection Form
Inspection Report ID
Inspector Name
First Name
Last Name
Inspection Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Start Time
Hour Minutes
AM
PM
AM/PM Option
End Time
Hour Minutes
AM
PM
AM/PM Option
License Plate Number and Issuing State
Type of Inspection
Daily routine
Weekly routine
Monthly routine
Yearly routine
Brake System
Rows
Passed Inspection
Needs Repair
N/A
Service Brakes
1
2
3
Parking Brake
4
5
6
Brake Drums/Rotors
7
8
9
Brake Hose
10
11
12
Tubing
13
14
15
Low Pressure Warning Device
16
17
18
Air Compressor
19
20
21
Tractor Protection Valve
22
23
24
Electric Brakes
25
26
27
Hydraulic Brakes
28
29
30
Vacuum Systems
31
32
33
Coupling Devices
Rows
Passed Inspection
Needs Repair
N/A
Fifth Wheels
34
35
36
Pintle Hooks
37
38
39
Drawbar/Towbar Eye
40
41
42
Drawbar/Towbar Tongue
43
44
45
Safety Devices
46
47
48
Saddle-Mounts
49
50
51
Exhaust System
Rows
Passed Inspection
Needs Repair
N/A
Any exhaust system determined to be leaking at a point forward of or directly below the driver/sleeper compartment.
52
53
54
A bus exhaust system leaking or discharging to the atmosphere in violation of standards (1), (2) or (3).
55
56
57
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 explosive part of the motor vehicle.
58
59
60
Fuel System
Rows
Passed Inspection
Needs Repair
N/A
Visible leak
61
62
63
Fuel tank filler cap missing
64
65
66
Fuel tank securely attached
67
68
69
Lighting Devices
Rows
Passed Inspection
Needs Repair
N/A
All lighting devices and reflectors required by Section 393 shall be operable.
70
71
72
Self Loading
Rows
Passed Inspection
Needs Repair
N/A
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.
73
74
75
Protection against shifting cargo
76
77
78
Steering Mechanism
Rows
Passed Inspection
Needs Repair
N/A
Steering Wheel Free Play
79
80
81
Steering Column
82
83
84
Front Axle Beam and All Steering Components Other Than the Steering Column
85
86
87
Steering Gear Box
88
89
90
Pitman Arm
91
92
93
Power Steering
94
95
96
Ball and Socket Joints
97
98
99
Tie Rods and Drag Links
100
101
102
Nuts
103
104
105
Steering System
106
107
108
Suspension
Rows
Passed Inspection
Needs Repair
N/A
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.
109
110
111
Spring Assembly
112
113
114
Torque, Radius or Tracking Components
115
116
117
Frame
Rows
Passed Inspection
Needs Repair
N/A
Frame Members
118
119
120
Tire and Wheel Clearance
121
122
123
Adjustable Axle Assemblies (Sliding Subframes)
124
125
126
Tires
Rows
Passed Inspection
Needs Repair
N/A
Tires on any steering axle of a power unit.
127
128
129
All other tires
130
131
132
Wheels & Rims
Rows
Passed Inspection
Needs Repair
N/A
Lock or Side Ring
133
134
135
Wheels and Rims
136
137
138
Fasteners
139
140
141
Welds
142
143
144
Windshield Glazing
Rows
Passed Inspection
Needs Repair
N/A
Requirements and exceptions as stated pertaining to any crack, discoloration or vision reducing matter (reference 393.60 for exceptions)
145
146
147
Windshield Wipers
Rows
Passed Inspection
Needs Repair
N/A
Any power unit that has an inoperative wiper, or missing or damaged parts that render it ineffective.
148
149
150
Other Observations/Issues to Address
Inspector Signature
Submit
Should be Empty: