Vehicle Entry Safety Checklist
Use this form to record the vehicle, complete the pre-entry safety checklist, and note any issues before the vehicle is used.
Vehicle and Inspection Details
Vehicle / Unit Identifier
*
Date of Inspection
*
-
Month
-
Day
Year
Date
Time of Inspection
*
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
Vehicle Type
*
Car
Van
Truck
Bus
SUV
Other
Safety Checklist Items
Doors and latches secure
*
Yes
No
Needs attention
Windows clear and intact
*
Yes
No
Needs attention
Mirrors adjusted and undamaged
*
Yes
No
Needs attention
Tires in safe condition
*
Yes
No
Needs attention
Lights and indicators functioning
*
Yes
No
Needs attention
Brakes responsive
*
Yes
No
Needs attention
Seatbelts functional
*
Yes
No
Needs attention
Dashboard warning lights reviewed
*
Yes
No
Needs attention
Interior free of hazards
*
Yes
No
Needs attention
Emergency equipment present if applicable
Yes
No
Not applicable
Inspection Outcome and Notes
Overall inspection result
*
Safe to enter
Needs attention before entry
Do not enter
Notes / corrective actions required
Follow-up / reinspection date
-
Month
-
Day
Year
Date
Submit
Should be Empty: