Car Air Conditioning Inspection Form
Complete this form to assess and record the condition of a vehicle’s air conditioning system.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Customer Name
*
Vehicle Make and Model
*
Vehicle Year
*
License Plate Number
AC System Visual Inspection
*
Belts and hoses in good condition
No visible leaks
Compressor functioning
Condenser free of debris
Other (describe below)
AC Performance Observations
*
Cold air output
Adequate airflow
Unusual noises
Unusual odors
Other (describe below)
Refrigerant Level Status
*
Normal
Low
High
Recommended Service Actions
*
Additional Comments
Submit Inspection
Should be Empty: