WEEKLY INSPECTION CHECKLIST

WEEKLY INSPECTION CHECKLIST
Date*

MonthDayYear
Van/Vehicle Nu.*
Vehicle Identification Number (VIN)*
Driver Name*

First NameLast Name
Current Mileage*
Service Mileage*
VEHICLE CHECKLIST
Van Cleanliness*

CleanDirty
Oil Level*

GoodLow
Headlights*

GoodLight Out
Brake Lights*

GoodLight Out
Running Lights*

GoodLight Out
Tire Pressure (Mark if it is good)*

Driver FrontPassenger FrontDriver RearPassenger Rear
Check Engine Lights*

Check EngineTire PressureOilBatteryABSNone
REQUIRED DOCUMENTS*

Insurance CardRegistration
INTERIOR PHOTOS: You must include pictures of the interior by opening the drivers door, passenger door, both rear side doors, and the back hatch.*

Cancelof
EXTERIOR PHOTOS: You must include photos of all four sides of the vehicle. Driver & Passenger side, as well as front and back.*

Cancelof
SUPPLIES/EQUIPMENT
Check your vehicle to ensure you have the following supplies and minimum levels, if applicable.*

White Bags (4)Black Bags (1)Large Black Bags (1)Coveralls (4)GlovesRed Bags (4)Infant Removal Bag (1)Sheets (6)Pillow (1)Cleaning Supplies
Cot *

GoodNeeds Attention
Any needed repairs or supplies:
Comments or concerns:
Signature*

Clear
Should be Empty:

VEHICLE CHECKLIST