Box Truck Inspection Form
Driver's Name
First Name
Last Name
Driver's Signature
VIN (Vehicle Identification Number)
Vehicle Type
Please Select
Truck
Tractor
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
1
Mileage
Part 1 : Box Truck Inspection
Equipments
Rows
Fail
Pass
N/A
Notes
1. Air Compressor.
2
3
4
2. Air Couplings.
5
6
7
3. Air Lines.
8
9
10
4. Air Tanks.
11
12
13
5. Batteries.
14
15
16
6. Brake Accessories.
17
18
19
7. Brakes.
20
21
22
8. Carburetor.
23
24
25
9. Clutch.
26
27
28
10. Defroster.
29
30
31
11. Drive Belts.
32
33
34
12. Drive Line.
35
36
37
13. Engine.
38
39
40
14. Exhaust System.
41
42
43
15. Fifth Wheel.
44
45
46
16. Front Axle.
47
48
49
17. Fuel Tanks.
50
51
52
18. Heater.
53
54
55
19. Horn.
56
57
58
20. Leaks.
59
60
61
21. Lights.
62
63
64
22. Mirrors.
65
66
67
23. Muffler.
68
69
70
24. Oil Pressure.
71
72
73
25. On-Board Recorder.
74
75
76
26. Radiator.
77
78
79
27. Rear End.
80
81
82
28. Reflectors.
83
84
85
29. Safety Equipment.
86
87
88
30. Springs.
89
90
91
31. Starter.
92
93
94
32. Steerings.
95
96
97
33. Tachograph.
98
99
100
34. Tires.
101
102
103
35. Transmission.
104
105
106
36. Wheels.
107
108
109
37. Windows.
110
111
112
38. Windshield Wipers.
113
114
115
39. Vehicle Clean.
116
117
118
40. Other.
119
120
121
Findings & Comments
Part 2 : Trailer Inspection
Equipments
Rows
qFail
Pass
N/A
Notes
1. Breakaway Battery.
122
123
124
2. Brakes.
125
126
127
3. Brake Connections.
128
129
130
4. Brake pads.
131
132
133
5. Brake Rotors.
134
135
136
6. Coupler.
137
138
139
7. Coupling Pin.
140
141
142
8. Coupling Chains.
143
144
145
9. Doors.
146
147
148
10. Equipment Secure.
149
150
151
11. Fire Extinguisher.
152
153
154
12. Floor Secure.
155
156
157
13. Hitch Secure.
158
159
160
14. Landing Gear.
161
162
163
15. Latches Secure.
164
165
166
16. License Plate & Light.
167
168
169
17. Lugs Secure.
170
171
172
18. Left Turn.
173
174
175
19. Right Turn.
176
177
178
20. Marker Lights Operative.
179
180
181
21. Roof.
182
183
184
22. Reflectors Intact.
185
186
187
23. Safety Chains.
188
189
190
24. Spare Bulbs.
191
192
193
25. Tarpaulin.
194
195
196
26. Tires.
197
198
199
27. Wheels.
200
201
202
Findings & Comments
Inspection Agency
Inspection Agency Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Inspector's Name
First Name
Last Name
Inspector's Signature
Submit
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