Daily Vehicle Inspection Form

Vehicle:*

Vehicle Driver:*

Starting Mileage:*

Ending Mileage*

Inspected By:*

First NameLast Name

Date Inspected:*

Date

Report required. Every driver and every motor carrier that operates more then one motor vehicle shall require its drivers to prepare a Daily Vehicle Inspection Report (DVIR), in writing for each vehicle operated by a driver on that day and the report should always cover the following parts and accessories. Please check anything that needs repair.

Item Checklist:

Rows	✘	✔	N/A	Action Required
Fluids – radiator, oil, transmission, brake, steering, wiper
Lights – headlights, driving, tail, signal, hazard,
Tires – pressure, tread, wheel nuts, spare
Brakes – function, emergency, warnings,
Electrical – battery, gauges, warnings
Defrost/heater – functioning, windows clear
Exhaust – noise, secure, leaks
Safety – seatbelts, first aid kit, fire extinguisher (insp. Date)
Accessories – wipers, horn, mirrors, cab clean
Windshield – clean, no chips or cracks
PPE –, hardhat, safety glasses, gloves, footwear
Tools – condition, inspected
Emergency items – bucket evac, beacon, signs, cones, etc.

If damaged, upload a photo of the damages.

Report content. The report should identify the vehicle and list any defects or deficiencies discovered by or reported by the driver which would affect the safety of operation of the vehicle or result in mechanical breakdown. If there is no defect or deficiency the report should indicate so in all instances the driver should sign the report on two driver operations only one driver needs to sign DVIR if it is agreed there are no defects or deficiencies. A separate report is needed, if multiple vehicles are operated by the same driver.

Corrective action. Prior to requiring or permitting a driver to operate a vehicle, every motor carrier or its agent shall repair and defect or deficiency listed on the DVIR which would be likely to affect the safety of operation of the vehicle(1) Every motor vehicle carrier or its agent shall certify on the original DVIR which lists any defect or deficiency that the defect or deficiency has been repaired or that repair was not needed before the vehicle is operated again.(2) Every motor carrier shall maintain the original DVIR the certification of repairs and the certification of the drivers review for three months from the date the written report was prepared.

Notes

Signature*