Vehicle Inspection Form (Updated 5/25/17)

Vehicle Inspection
Date of Inspection:

MonthDayYear
Vehicle/Driver Information
Total Points :
(Add all the points from Checklist, Fluids & PPE Sections. 28 = Perfect Score)
Driver Name:
Manager Name:
Vehicle Unit #
License Plate #
License Plate State:
(What state is vehicle tagged in?)
Maint. Card Number: (if Under Enterprise Maintenance)
(Under "Unit No.")
Fuel Card Number:
(Bottom Left of Card Under Quench USA)
Fuel Card Expiration:
(mm/yyyy)
Current Odometer Reading:
Current Mileage
Date of Last Oil Change:
(mm/yyyy)
Mileage at Last Oil Change:
*SEE BELOW EXAMPLE OF CORRECT CARD NUMBERS TO ENTER ABOVE*
* Ensure Your Fuel Card and Maintenance Card #'s MATCH Your Enterprise Unit #, if they do not, please notify Fleet Manager immediately*

REMEMBER - Fuel Cards and Maintenance Cards STAY with the Vehicle, they are not assigned to drivers. Each card should only be used for the vehicle of the same #.
Registration Expiration:
(mm/yyyy)
Does Registration Expiration Match License Plate Decal?
Valid Insurance Card?
Insurance Exp. Date:
(mm/yyyy)
Checklist

You receive 1 Point per YES below, if response is NO, then no point, remember to total entire form when complete at the top.
Clean Inside:
Clean Outside:
Current Insurance Card:
Current Fuel Card:
Current Enterprise Fleet Maint. Card:
Spare Tire Inflated & at Least 2/32nd's Tread Depth:
Turn Signals Operational:
Geotab is Functional:
Vehicle Graphics Legible & Up to Date:
Does Vehicle Have a Ladder Rack?
Does Vehicle Have a Liftgate?
Yellow GPS Indication Sticker Affixed to Rear Of Vehicle:
Parts/Materials Organized:
Brake Lights Operational:
Head Lights Operational:
Tires @ 2/32nd's Tread Depth: (use penny method)
Glass of Vehicle in good condition:
PPE On Vehicle/Person?
Hard Hat:
SDS Binder On Truck:
Back Brace:
Gloves:
First-Aid Kit:
Steel Toed Boots:
Knee Pads:
Fluids At Proper Levels?
Oil:
Brake Fluid:
Coolant:
Transmission Fluid:
Washer Fluid:
GeoTab Serial Number:
(GPS Found Under Dash Plugged in OBD Port)
Toll Provider:
Toll Transponder #
STATE/# If Applicable, if not enter N/A
State Inspection Date:
(mm/yyyy) If Applicable, if not enter N/A
Emissions Inspection Date: (if applicable for state vehicle is registered in)
(mm/yyyy), if Applicable, if not enter N/A
Vehicle Damage

Identify all areas of cosmetic damage using the diagram below and descride the damage in the space provided below.
Please upload vehicle photos:

Upload a File

Cancelof
Damage Description:
ACTION ITEMS NEEDED: (Required By Either FST or FLEET MANAGER)
Driver Signature:
Manager Signature:
Should be Empty:

Vehicle Inspection

Checklist

PPE On Vehicle/Person?

Fluids At Proper Levels?