Collision Avoidance System Checklist
Complete this checklist to verify the readiness and operational status of the collision avoidance system before or during use.
Date and Time of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Last Name
System Power Status
*
Powered On
Powered Off
Intermittent
Sensor Functionality Check
*
Front Sensors Operational
Rear Sensors Operational
Side Sensors Operational
No Sensor Issues Detected
Warning/Alert System Status
*
Fully Functional
Partial Functionality
Non-Functional
Communication Link Status
*
Stable
Unstable
Disconnected
Software/Firmware Version
*
Environmental Calibration Status
*
Calibrated
Calibration Required
Calibration in Progress
Operational Test Result
*
Rows
Pass
Fail
N/A
Automatic Braking
1
2
3
Obstacle Detection
4
5
6
Warning Alerts
7
8
9
Manual Override
10
11
12
Comments or Issues Noted
Submit Checklist
Should be Empty: