PRE TRIP INSPECTION FORM

Pre-Trip Inspection Form:

Date: [MM/DD/YYYY]

Driver Name: [First Name] [Last Name]

VIN: [Vehicle Identification Number]

Vehicle Mileage: [Mileage]

License Plate Number: [Number]

Company Name: [Company Name]

General Vehicle Condition:

Cleanliness: [Describe Vehicle Cleanliness]

Damage: [Describe any Exterior Damage]

Leaks: [Describe any Noticeable Leaks]

Engine Compartment:
Fluid Level (Oil, Coolant,
[Describe Fluid Levels]
Washer Fluid):

Belts and Hoses: [Describe Condition of Belts and Hoses]

Battery: [Describe Condition of the Battery]

Brakes:
Brake Pedal: [Describe Condition of Brake Pedal]

Parking Brake: [Describe Condition of Parking Brake]

Brake Lights: [Describe Condition of Brake Lights]

Tires and Wheels:

Tire Condition: [Describe Condition of Tires]

Tire Pressure: [Describe Tire Pressure]

Lug Nuts: [Describe Condition of Lug Nuts]

Lights and Reflectors:

Headlights: [Describe Condition of Headlights]

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Tail Lights: [Describe Condition of Tail Lights]

Turn Signals: [Describe Condition of Turn Signals]

Reflectors: [Describe Condition of Reflectors]

Steering and Horn:

Steering Movement: [Describe Condition of Steering]

Horn: [Describe Condition of Horn]

Windshield and Mirrors:

Windshield: [Describe Condition of Windshield]

Wipers: [Describe Condition of Wipers]

Mirrors: [Describe Condition of Mirrors]

Safety Equipment:
Seat Belts: [Describe Condition of Seatbelts]

Fire Extinguisher: [Describe Condition of Fire Extinguisher]

First Aid Kit: [Describe Condition of First Aid Kit]

Cargo Securement (If Applicable):

Load Securement: [Describe Condition of Load Securement]

Tarps and Straps: [Describe Condition of Tarps and Straps]

Comments:
[Additional Comments about the inspection]

Driver Signature: [Signature]

Time: [HH:MM AM/PM]

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