WC-Weekly Maintenance Inspection

Weekly Maintenance Inspection

Please complete by close of business each Friday.
Employee/Volunteer Name*

First NameLast Name
Date*

MonthDayYear
Date
Agency Vehicle*
Oil Change Due*

MonthDayYear
Date
NYS Inspection Due*

MonthDayYear
Date
Registration Due*

MonthDayYear
Date
Starting Odometer*
Ending Odometer*
Total Miles Driven During Inspection*

Checklist*

Rows	Working	Needs Repair	Missing
All interior lights
All exterior lights
Heat/AC working
Fire Extinguisher
Ramp
Doors (all doors open and close?)
Wiper Blades
Safety Triangles
Battery
Brakes
Seat Belts & Restraints working/present
PPE (masks, gloves, wipes, etc...)
Wheelchair (is there a spare in the van?)

Date vehicle last detailed*

MonthDayYear
Should be no less than 1 time every 14 days.
Date ramp was last oiled*

MonthDayYear
Tire Pressure*
(list like this 34, 34, 34, 34)
Window wash topped off*
Additional Notes
Should be Empty: