OBD Inspection Checklist Form
Use this form to record vehicle details, OBD findings, inspection results, and follow-up actions for an OBD inspection.
Vehicle and Inspection Details
Vehicle Year
*
Vehicle Make
*
Vehicle Model
*
Vehicle Identifier
Odometer Reading
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Location / Branch
Inspector Name
*
OBD Check Results
OBD connection status
*
Connected
Not Connected
Intermittent
Malfunction indicator lamp status
*
Off
On
Flashing
Diagnostic trouble code status
*
None Found
Pending Codes
Stored Codes Present
Emissions readiness summary
*
Pass
Needs Review
Not Available
Overall inspection result
*
Pass
Fail
Needs Reinspection
Inspector notes or findings
Corrective action recommended
Attachments and Follow-up
Upload inspection evidence or supporting files
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Follow-up action
*
Please Select
Retest Scheduled
Service Required
No Further Action
Awaiting Parts
Other
Preferred contact method for follow-up
Submit
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