Vehicle Inspection Form
Type of Vehicle
*
Pickup Truck
Bucket Truck
Car/SUV
Other
Last 4 of the VIN - Vehicle ID#
*
Inspector's email
*
example@example.com
Driver's email
*
example@example.com
Inspection Date
*
-
Month
-
Day
Year
Date
Make/Model/Year
*
Located in
*
Please Select
AZ
NY
NJ
FL
NM
WV
MS
OK
Not Listed
If your State is not on this list, put it in the comments
City/Office
*
City/Office
State registered in
*
Please Select
AZ
TX
NM
FL
NJ
NY
WV
OK
MS
IL
IN
WI
SC
OH
MI
Complete VIN
*
TAG
*
VerTek Asset ID or License Tag #
Tag Expires
*
-
Month
-
Day
Year
if just month/year on sticker enter month-01-year
Last Maintenance Date
*
-
Month
-
Day
Year
Date
Mileage
*
LIGHTS
Rows
PASS
FAIL
N/A
COMMENTS
1. Flashers (Hazard)
2. Headlights
3. Brakes/Taillights
4. Turn signals
ESSENTIALS
Rows
PASS
FAIL
N/A
COMMENTS
1. Brakes
2. Tire Pressure
3. Seat belts
4. Wipers
5. Horn
6. Spare tire
7. Body
8. Battery
9. Check Fluids
BUCKET SYSTEM
Rows
PASS
FAIL
N/A
COMMENTS
1. Lift condition
2. Hydraulic fluid (reservoir)
3. Date of last safety inspection
4. Wheel chocks
5. Safety lanyard & harness
6. General condition
7. Safety decals
SAFETY EQUIPMENT
Rows
PASS
FAIL
N/A
COMMENTS
1. First Aid kit
2. Cones
3. Strobe
4. Ice scraper
DOCUMENTATION
Rows
PASS
FAIL
N/A
COMMENTS
1. Driver’s License up to date
2. Employee ID
3. Insurance card
4. Vehicle Registration
5. Gas Card
Is there Windshield Damage?
*
Yes
No
INTERIOR PHOTOS
Show that you are keeping it clean.
PHOTOS OF CAB INTERIOR
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
EXTERIOR PHOTOS
Exterior Photos & Videos
*
Browse Files
Drag and drop files here
Choose a file
Photos or a narrated video of vehicle (FRONT, REAR, SIDES, BED, LADDERS, TIRES, AND STORAGE). Note damage, condition, paperwork, etc.
Cancel
of
THIS INSPECTION
*
PASSED
FAILED
Comments
Send report to Supervisor
*
example@example.com
Signature
*
Submit
Should be Empty: