Brake Pad Inspection Checklist Form
Complete this Brake Pad Inspection Checklist Form to document the condition and safety of vehicle brake pads. Please ensure all items are checked thoroughly before submitting.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Vehicle Make and Model
*
Vehicle License Plate Number
*
Current Odometer Reading (miles)
*
Brake Pad Thickness (mm)
*
Brake Pad Wear Indicator Light On?
*
Yes
No
Brake Pads Evenly Worn?
*
Yes
No
Brake Pad Surface Condition
*
Please Select
Good
Cracked
Glazed
Contaminated
Additional Notes or Recommendations
Submit Inspection
Should be Empty: