VEHICLE INSPECTION Date of inspection Re-inspection Equipment data: Operator / Driver data Registration Number Name Manufacture Sex (malerfemale) Year Age Type / Model License (Class) Police Number Expired Certicate-STNK Exp. Subject 1 Dump truck [J] truck erane (] Truck [7] tr. mixer [1] trailer [] Light vehicle Result column: [7] Yes/good, Acceptable [XX] NotBad, Not To Use [NA] Not Applicable Copy of driving license and vehicle certificate (SINK) must be attached inthis form 4_| Carrier Body / Frame Damage, Deformation 2 | Wneets / Spare whee! Tite pressure, Abrasion 3_| Handle / Power stering (Operabilty, Play, Breakage 4 | Foot / Hand brakes Operating check, play 5 | Clutch / Lever / Pedais (Operating check 6 | Engine Starting, Sound, Vibration 7_ | Battery / Wiring Liquid vol, Aging, Terminal &_| Engine oil/fiter / piping Oli vol, Smudge, Leakage 9 | Fuel tank /Pump /Filter/ Piping | Leakage, Breakage, Plugging 410 | Radiator / Pump / Fan belt Water vol, Leakage, Damage 14 | Transmission Oli vol, Leakage, Smudge 12 | Muffler / Flame arrestor Exhaust color, Sound, Missing 13 | Hom Function check 14 | Reverse alarm Function check 45 | Lightings * Head light (High / Low) Breakage / Missing / Function * Signal light (left & right side) Breakage / Missing / Function * Inside / Door light Breakage / Missing / Function * Brake ight Breakage / Missing / Function * Reverse light Breakage / Missing / Function 416 | indicators * Speed indicator Function check * Fuel indicator Function check * Temperatur indicator Function check * Head / Tail ight indicator Function check * Brake light indicator Function check Page : 1 of2Wind shield Breakage, Crack ‘Wiper / Washer Function, Breakage Mirrors (inside ‘Left & right side) | Function, Breakage Door latches / Locks Detect, Missing Seats Breakage, Missing ‘Seat belts Missing, function Miscellaneous + First Aid Kit + Fire Extinguisher * Operator Cabin * Safe guard for moving part | Comments Page: 2of2