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Vehicle Inspection Form
Vehicle Safety Inspection
Overview
Facility Name
*
Vehicle (Year/Make/Model)
*
Mileage:
*
Next Due Oil/Filter/Lube Service (Date & Mileage)
*
Inspected by:
*
Date:
*
Accident Forms, Proof of Insurance, and Registration expiration:
*
License plate tags expiration:
*
Oil/filter and lube intervals recorded and on schedule:
Yes
Engine
Engine Oil Level
*
Select
OK
High
Low
Engine Oil Amount Added (N/A if none)
*
Coolant Fluid Level
*
Select
OK
High
Low
Coolant Fluid Amount Added (N/A if none)
*
Power Steering Fluid Level
*
Select
OK
High
Low
Power Steering Fluid Amount Added (N/A if none)
*
Transmission Fluid Level
*
Select
OK
High
Low
Transmission Fluid Amount Added (N/A if none)
*
Brake Fluid Level
*
Select
OK
High
Low
Brake Fluid Amount Added (N/A if none)
*
Windshield Washer Fluid Level
*
Select
OK
High
Low
Windshield Washer Fluid Amount Added (N/A if none)
*
Cab
Safety Belts Operational
*
Select
OK
Faulty
Windshield Glass and Wipers
*
Select
OK
Faulty
Horn Operational
*
Select
OK
Faulty
All Control Levels Operational (wipers, washer, fan, etc)
*
Select
OK
Faulty
Interior Clean & Seats in Good Condition
*
Select
OK
Faulty
Interior Dash Gauges Operational
*
Select
OK
Faulty
First Aid Kit
*
Select
OK
Faulty
Fire Extinguisher
*
Select
OK
Faulty
Snow Brush/Ice Scraper
*
Select
OK
Faulty
Comments (required regarding any marked "faulty" above)
Chassis & Body
Exterior Body Condition
*
Select
OK
Faulty
Brake - Backup - Tail Lights
*
Select
OK
Faulty
Head Lights
*
Select
OK
Faulty
Tire Pressure & Tread Depth
*
Select
OK
Faulty
Turn Signals
*
Select
OK
Faulty
Mirrors (Rearview and Side)
*
Select
OK
Faulty
Spare Tire, Jack, & Lug Wrench
*
Select
OK
Faulty
Comments (required regarding any marked "faulty" above)
Road Test
Speedometer/Odometer Operational
*
Select
OK
Faulty
Brakes (Foot & Parking) Operational
*
Select
OK
Faulty
Vehicle Handling
*
Select
OK
Faulty
Comments (required regarding any marked "faulty" above)
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