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Vehicle Safety Inspection Checklist

The vehicle safety inspection checklist provides a comprehensive list to inspect the lights, interior, gauges, exterior, and fluid levels of a vehicle. The inspector is to check off items that are in good working condition and note items that need repair or replacement. Any other findings or observations should also be included. Upon completion of the inspection, the operator signs and dates the form to certify that all checked items are in working order. Damage observed during the inspection should also be marked on a diagram.

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ALMEDA INC
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20K views2 pages

Vehicle Safety Inspection Checklist

The vehicle safety inspection checklist provides a comprehensive list to inspect the lights, interior, gauges, exterior, and fluid levels of a vehicle. The inspector is to check off items that are in good working condition and note items that need repair or replacement. Any other findings or observations should also be included. Upon completion of the inspection, the operator signs and dates the form to certify that all checked items are in working order. Damage observed during the inspection should also be marked on a diagram.

Uploaded by

ALMEDA INC
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

DATE:

VEHICLE SAFETY
INSPECTION CHECKLIST
Inspected by:
Vehicle Make: Model: Year:
Plate Number Color: Mileage:
Instructions: Put () if the item is in good working condition, and
(×) if the item needs replacement or repair

LIGHTS Low Beam Left Turn Signal


High Beam Right Turn Signal
Brake Lights Tail Lights
Back Up Lights Emergency Flashers

INTERIOR Wiper Operation Door Locks Operable


Washer Operation Window Condition/Operable
Seats Horn
Rear View Mirror Seat Belts
Parking Brake Brakes
Air-Condition Car Stereo

GAUGES Fuel Volt/ Amps


Oil Pressure Temperature

EXTERIOR Tire Tread Body Damage/ Loose Parts


Tire Air Pressure Side Mirrors
Windshield Condition Wiper Blades

FLUID Oil Belts not frayed/cracked/loose


LEVELS Coolant Battery Connection
Brake Fluid Hoses (No cracks or leaks)
Power Steering Steering
No leaks Shock Absorbers/ Struts

Other findings or observation:

As operator/ driver of the above-indicated vehicle. I certify that I have


completed this Vehicle Safety Inspection Checklist and that all items checked
are in good working order.

______________________________ ______________________________
Signature over printed name Date

Vehicle Safety Inspection Checklist pg. 1


PLC VSIC Form2022
Please mark on the appropriate diagram any damage observed during
your inspection.

______________________________ ______________________________
Signature over printed name Date

Vehicle Safety Inspection Checklist pg. 2


PLC VSIC Form2022

VEHICLE SAFETY INSPECTION CHECKLIST DATE: Inspected by: Vehicle Make: Model: Year: Plate Number Color: Mileage: Instruction
Please mark on the appropriate diagram any damage observed during your inspection. ______________________________ ___________

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