EQUIPMENT INSPECTION FORM
EQUIPMENT DETAILS
Name of Registered Owner
Base Plate Number
Registered State
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Equipment VIN
Equipment Make
Equipment Color
Equipment Model
EQUIPMENT RETURN INSPECTION
Inspector’s Name
Location of Inspection
Phone Number
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Area Code
Phone Number
Mark:
N/A: Not Applicable | S: Satisfactory | D: Defective | M: Correction Made
1. Fuel (if applicable)
2. Speedometer Mileage
3. Hubodometer Mileage
Check Parking Brakes
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
One Way Check Valve
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check for Excessive Fuel, Oil, Air, and Exhaust Leaks
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Inspect Airhoses
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check all Lights, Reflectors, Signals
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Gauges for Proper Operation
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Inspect Trailer Light Cord (Pig Tail)
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Windshield Wipers
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Inspect All Glass
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Spring, Hangers, Equalizers & U-Bolts
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Mirrors
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Wheels & Seal Leakage
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Inspect Emergency Equipment
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check 5th Wheel
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Batteries, Secure Cover in Place
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Check Low Air Warning Must Operate 55 psi Minimum
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Inspect Emergency Equipment
N/A: Not Applicable
S: Satisfactory
D: Defective
M: Correction Made
Record Tire Tread Depth (32nds)
L Steer
R Steer
LFO
LFI
RFO
RFI
LRO
LRI
RRO
RRI
I hereby certify that I am a qualified to inspect the Equipment, with full knowledge of applicable regulations, and that on
I hereby certify that I am qualified to inspect the Equipment, with full knowledge of applicable regulations and that on the date below, I inspected the Equipment described above, that this is a true and correct report of the Equipment of such inspection.
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Month
-
Day
Year
Date
Name
First Name
Last Name
Sign
Rental End-Date
-
Month
-
Day
Year
Date
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