Fuel Gauge Inspection Report Form
Complete this form to record the results of a vehicle fuel gauge inspection. Please ensure all information is accurate and relevant.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Vehicle Make and Model
*
Vehicle License Plate Number
*
Current Fuel Level (e.g., Full, 3/4, 1/2, 1/4, Empty)
*
Please Select
Full
3/4
1/2
1/4
Empty
Other
Fuel Gauge Reading Matches Actual Fuel Level
*
Yes
No
Is the Fuel Gauge Functioning Properly?
*
Yes
No
Notes or Observations
Recommended Actions (if any)
Submit Inspection Report
Should be Empty: