DRIVER’S VEHICLE INSPECTION REPORT

Name of Driver: ______Date: ______

Vehicle Number: ______Vehicle Type ( ex: Ford F-250): ______

Current Mileage: ______Mileage for Next Oil Change (not the date): ______

Instructions: Please inspect all applicable items to your type of vehicle/trailer combination from the lists below. In the applicable items, Put a check mark in the box if the item is O.K. Put an X if it needs attention. Leave blank if it does not apply. Describe in detail in the Driver’s Comments below.

Due by the 10th of every month.

FLUIDS LIGHTS Engine Oil Headlights Turn Signals Break lights Power Steering Running/License plate Transmission Fluid Diesel Exhaust Fluid DEF Washer Fluid Tread Air Pressure GENERAL A/C Heater/Defroster SAFETY Engine Air Filter Accident Kit (Fire Extinguisher, First Aid, SDS) Cabin Air Filter (behind glove comp) Cones (5 for crew trucks,3 vans,1 mgr.) Trailer Lights Connector Mower Straps Mirrors Chains/Binders for Heavy Equipment Seatbelts Pipe Racks Straps Windows (cracks) Toolbox that Locks for Chemicals and Tools Horn Locks, Cable with Lock for Truck Beds, racks, cages Engine Belts & Hoses Labels for , Chemicals, Water Jugs Battery

DOCUMENTATION TRAILER No. ______Vehicle Gas Card Lights: break lights, running lights, markers Equipment Gas Card Pins, Chains, Breakaway Cable, Connections, Hitch Insurance Tires Truck Registration Trailer Brake Controller Trailer integrity: floorboards, tail gate, mud Trailer Registration guards, jack,2 cycle racks Valid License plate stickers

Driver’s Comments: ______

______

New damage to vehicle/trailer: Yes No Describe if Yes: ______

Driver’s Signature: ______