MO-IA Vehicle PM / Inspection
VEHICLE TYPE
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ENGINE
TRUCK
UTV
VEHICLE NUMBER
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Please Select
CMD 1
CMD 2
CMD 3
T-687
T-694
E-861 Type 6
E-862 Type 6
UTV-1
UTV-2
UTV-3
UTV OTHER
Date
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/
Month
/
Day
Year
Date
Mileage
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Already completed the inspection on this EXACT vehicle in the last 24hrs?
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Yes (Vehicle Not Moved)
Yes (Vehicle Moved)
No
Name and Vehicle Number
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Lights
Exterior Lights
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
OTHER
Headlamps
Tail Lamps
R Turn Signal
L Turn Signal
Emergency
Battery Check
Battery
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Condition
Cables & Connectors
Tire Check
Tires
*
Rows
8/32 or Greater
4/32 to 7/32
3/32 or Less
PSI at
Set to...PSI
Weather Pattern / Damage
Left Front
Right Front
Left Rear
Right Rear
Brakes
Brake System
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Lines
Hoses
Parking Brake
Firmness
Wiper/Windows
Blades
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Left Front
Right Front
Rear (if applicable)
Windshield Condition
Cracks
Chips
Check Fluids
Levels
*
Rows
Okay
Filled
Requires Attention
Engine Oil
Brake Fluid Reservoir
Transmission (if equipped w/dipstick)
Coolant Recovery Reservoir
Power Steering
Windshield Washer
Additional Checks
Inspect for Visible Leaks, Operation, and Visual Condition
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Fuel System (includes gas cap seating)
Belts: Engine, Accessory, Serpentine, and / or V-drive
Hoses: Engine, Power Steering and HVAC
Engine Air Filter
Mirrors
Steering Components and Steering Linkage
All Body and Frame Components
Restraint System Component Check
Drive Axle (Leak / Other)
FIRE ENGINE (EXTERIOR)
Fire Engine Pump
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
PRIMER
DOES PUMP PRIME
INSPECT PUMPS, PIPING, AND DISCHARGE VALVES FOR OPERATION/LEAKS/CORROSION
IGNITION SWITCH
HARD REEL LINE OPERATES
TANK FULL OF WATER
100 PSI CHECK
GAUGES (DURING OPERATION)
HOSES (EXTERNAL)
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Hoses Condition
Hardline Rolled
WENCH (EXTERNAL)
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Operates
Wench Cable
Wench Controller
FIRE ENGINE (INTERIOR)
CAB
*
Rows
Checked and OKAY
Replaced
Need to Order
Fireline Handbook
ERG/HAZMAT
Binoculars
Logbook with Forms
Owners Manual
Mobile Radio
FUSES (CASE)
Fencing Pliers
Interagency Standards for Fire
Vehicle Card Binder
AA Batts (Box)
Duct Tape (roll)
Cloning Cable
Grage Door Opener
Nice to have
Rows
Checked and OKAY
Replaced
Need to Order
Toilet Paper
Kestrel
Flagging
P-Cord
Flashlight
Glove Box
*
Rows
Checked and OKAY
Replaced
Need to Order
Wench Remote
FIRE ENGINE COMPARTMENTS
Gear Compartment (medical)
*
Rows
Checked and OKAY
Replaced
Need to Order
Backboard
Trauma Bag (Blue Bag)
Cervical Collar
Gear Compartment (D1)
*
Rows
Checked and OKAY
Replaced
Need to Order
Fussee Box (1)
Hand Primer (1)
Hose Clamp (2)
Hose Gaskets (5 ea) 3/4, 1,1½ 2½
Hose Real Crank (1)
Forester 1" NPSH (3)
Adjustable 1" NPSH (3)
Adjustable 1½" NH (3)
Adjustable ¾" NH (3)
Foam ¾" NH (1)
Foam 1½" NH (1)
Forester Fog Tip (3)
Forester Straight Stream Tip (4)
1" NPSH 2-way gated wye (2)
1½ NH 2-way gated wye (3)
1" NH-F to 1" NPSH-M (1)
¾" NH-F to 1"NPSH-M (1)
1" NPSH to 1½" NH-M (1)
1" NPSH Double Female (1)
1" Double Male (1)
1½ NH Double Female (3)
1½ NH Double Male (1)
1" NPSH-F to ¾" NH-M
1½" NH-F to 1" NPSH-M (5)
2½" NPSH-F to 1½" NH-M (1)
1½" NH-F to 1" NH-M (1)
2 ½" NH-F to 1½" NH-M (1)
1" NPSH-Fx1" NPSH-Mx1" NSPH-M w/cap (2)
1½" NH-Fx1½" NH-Mx1" NPSH-M w/cap (2)
1½" NH-F Check and Bleeder Valve (1)
¾" NH Shut Off Valve (7)
1" NPSH Shut Off Valve (2)
1½ NH Shut Off Valve (2)
Foot Valve with Strainer (2)
1" NPSH x 1½" NH Jet Refill (1)
8" Hydrant Wrench (1)
5" Spanner Wrench (4)
11" Spanner Wrench (1)
14" Pipe Wrench (1)
20" Pipe Wrench (1)
Vary Pistol +Ammo Box = Box of Flares (1)
Hose and Pump Compartment (D2)
*
Rows
Checked and OKAY
Replaced
Need to Order
Portable Pump (1)
Collapsible Pail (1)
¾" P-Hose (300ft)
1" NPSH Hose (300ft)
1½" NH Hose (700 ft)
1½" NH Refill Hose (20ft))
1½" NPSH-F to 1½" NH-M (1)
Spare Hose Bag (2)
Fuel Compartment (D3)
*
Rows
Checked and OKAY
Replaced
Need to Order
Drip torch fuel 5 gal.
Drip torch (2)
50:1 Mixed Gas 5 Gal
5W-40 Oil quart (x2).
WD-40 Can
Trans Fluid qt (X1)
Brake Fluid (Pint)
2 stroke Mix (x6)
Antifreeze/coolant 1 gal (1)
Bug Spray
Funnel
Pump Coolant 1gal (x1)
Radiator Cap (1)
Foam Bottle Wrench (1)
Gas Can Nozzle (1)
Sig Bottle (2)
Simple Green Bottle (1)
Foam Concentrate 5gal (1)
Other Stuff Compartment (D4)
*
Rows
Checked and OKAY
Replaced
Need to Order
Backpack Pump (2)
MRE (box) (1)
10x20 Plastic Sheet (1)
Head Lamp (1).
Hard Hat (1)
Eye Protection (1)
Gloves (1)
Indvidual 1st aid kit (1)
Nomex Shirt (1)
Fire Shelter w/case (2)
Nomex Pants (1)
Line Gear (1)
¼" NH Garden Hose (300ft)
Mop-Up Wand (1)
Mop-Up Wand Tip (3)
¾" NH w/Gated Ball Valve (6)
¾" NH Shut Off Valve (6)
¾" NH Nozzle (6)
Hose Bag (1)
Accessory Bag (1)
Gravity Feed Sock (1)
1½ Suction Hose w/strainer (1)
Mountain House (1box)
Other Stuff Compartment (P1)
*
Rows
Checked and OKAY
Replaced
Need to Order
First Aid Kit (10 Person))
Burn Treatment Kit (1)
Body Fluids Barrier Kit (1)
Rope/Chord (100ft)
Duct Tape (1 roll)
Fiber Tape (1 roll)
Toilet Paper (1 maybe 2 rolls)
Pink Flagging (1 roll)
Yellow, Black Flagging (2 roll)
Escape Route Flagging (1 roll))
Air Compressor w/Accessories
Tire Pressure Guage (1)
Electrical Tape (1 roll)
Teflon Tape (1 roll)
AA Batts box (3)
Ear Plugs pairs (10)
Belt Weather Kit (1)
Eye Protection (3)
Garbage Bags roll (1)
Spare Radio (1)
Battery Booster (1)
Jet Boil (1)
Leather Gloves Pair (2)
Tool Compartments (P2)
*
Rows
Checked and OKAY
Replaced
Need to Order
Pulaski (2)
Shovel (1)
Rouge (2)
Combi (1)
McLeod (2)
Flapper (2)
Tool Files (3)
Bolt cutters
Silky Saw (1)
Hammer (1)
Crowbar
Tow Chain
Rakes (2 Leaf and 2 Council)
Breaker Bar (36")
Breaker Bar Extension
13/64 Lug Nut Socket (1)
Pounder (2)
MISC Compartment (P3)
*
Rows
Checked and OKAY
Replaced
Need to Order
Reflector Triangle Kit (1).
Reflective Vests (3)
General Tool Kit (1)
Engine Air Filter (1)
Pump Air Filter (1)
Jumper Cables (1)
Tow Chain (1)
Rachet Straps (2)
Def Nozzle (1)
Clevis D-Shackle (2)
Engine Rear Compartments (R)
*
Rows
Checked and OKAY
Replaced
Need to Order
Chainsaw 28" Bar (1).
Chainsaw Chaps (2)
Dolmar (1)
Misc Saw Parts (kit)
Pounder (1)
Wedges Various Sizes (3)
Spare Chain (91 Driver) (1)
Spare Tire
Bottle Jack
Lug Wrench (2)
Tow Strap (2)
Suction Hose w/strainer (3)
Fire Extinguisher 5lbs (1)
1½" NH Engine Protection Hose (1)
Engine Top Compartments (T)
*
Rows
Checked and OKAY
Replaced
Need to Order
Tire Chocks (2).
Drinking Water Bottles (50)
Cooler (Yeti 75)
Hardline Hose w/Reel (1)
Forester Nozzle (1)
Leaf Blower (2)
NWCG REQUIRED (VERIFY ON-BOARD)
Fitting Box Secured and Dated?
*
Please Select
Yes (Zip tied/Locked)
Nope
Minimum Engine Inventory Fittings (NWCG)
*
Rows
Checked and OKAY
Replaced
Need to Order
1- Double Male 1 ½” NH
1- Double Female 1 ½” NH
1 – Double Male 1” NPSH
1 – Double Female 1” NPSH
2 – Gated Wyes, 1 ½” NH
2 – Gated Wyes 1” NPSH
1 – Gated Wye ¾” Garden Hose
4 – Reducers, 1 ½” NH Female to 1” NPSH Male
1 – Reducer 1” NPSH to ¾” Garden Hose
2 – Adapters 1 ½” NH Female to 1 ½” NPSH Male
2 – Adapters 1 ½” NPSH Female to 1 ½” NH Male
1 – Mop-Up Wand ¾” Receptor w/ ¾” Nozzle Tip
5 – Inline Ball Valves ¾”
Minimum Engine Inventory (NWCG)
*
Rows
Checked and OKAY
Replaced
Need to Order
1 - Live Hose Reel w/ minimum of 100’ of 1” hose non-collapsible 3/4” inside Diameter
1 ½” Hose (300 feet)
1” Hose (300 feet)
¾” Hose (300 feet)
2 – Nozzles, comb fog/straight stream, 1 ½” NH Female
2– Nozzle, comb fog/straight stream, 1” NPSH Female
2 – Nozzle, Adjustable ¾” Garden Hose
20’ Suction hose with strainer or screened foot valve
1- Forestry, Fire Hose Clamp
4 – Spanner wrenches, combination, 2 ea 1” & 1 ½”
2 – Backpack pumps
Container for drinking water (Min 1 Gallon)
1 – First Aid Kit (5 person)
3 – Headlamps w/Batteries and Hardhat Attachment
10 – Fusee’s (fire starter)
3 – Mill Bastard Files
Reflective Triangles, bi-directional, set of 3
Fire Extinguisher, 1 rated at 10 B:C or better
Chock Blocks 2
Is this vehicle GTG ( 1 or 2 Star = It should not be in service, 3 Star = Its ok but there needs to be service and or corrections made in the next 30 days, 4 Star = GTG but improve items as needed, 5 Star = The vehicle is 100% GTG)
1
2
3
4
5
Your Name
*
Last name
Comments (If on Incident please list Incident Name and Fire Account Code)
Please Sign Below for Engine
*
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UTV INSPECTION
TIRES
TIRES TCLOC
*
Rows
Checked and OKAY
Replaced
Need to Order
1. Air pressure – Always maintain the recommended tire pressure. Incorrect pressure can cause poor handling and tire or wheel damage. To measure pressure (usually 2 to 6 psi), you’ll need a low-pressure gauge; automotive tire gauges are not accurate for use on UTVs.
2. Condition – Check for cuts or gouges that could cause air leakage.
3. To avoid loss of control or injury, make sure axle nuts are tight and secured by cotter pins, and make sure wheel nuts are torqued properly.
Controls and Cables
Controls & Cables TCLOC
*
Rows
Checked and OKAY
Replaced
Need to Order
1. Controls – Ensure all controls work smoothly.
2. Throttle and other cables – Ensure the throttle moves smoothly and snaps closed with the handlebars in any position. Ensure the throttle limiter (if equipped) is adjusted appropriately for the rider.
3. Brakes – Ensure the controls operate smoothly and are adjusted (engagement point and position of controls) according to the owner’s manual. Your brakes are a crucial safety feature and must always be excellent working condition.
Lights and Electrics
Lights and Electrics TCLOC
*
Rows
Checked and OKAY
Replaced
Need to Order
1. Ignition switch – Check the condition of the switch and make sure it works properly by switching it off and on during your warm-up period.
2. Engine stop switch – Ensure it turns off the engine.
3. Headlight and taillight (if equipped) – Check operation and condition of the lights. You could be caught out after dark.
Oil and Fuel
Oil and Fuel TCLOC
*
Rows
Checked and OKAY
Replaced
Need to Order
1. Do not get stranded because you are out of oil or fuel. Know your UTV’s cruising range. Start your ride with a full tank of gas.
2. Check oil level with dipstick or sight glass while the engine is off. Check your owner’s manual for procedure.
3. Check for fuel or oil leaks.
4. Take off the air filter cover and check the condition of the filter element. Be sure it is clean and not torn or blocked.
Chain/ Driveshaft and Chassis
Chain/ Driveshaft and Chassis TCLOC
*
Rows
Checked and OKAY
Replaced
Need to Order
2. Drive shaft – If your UTV is equipped with a drive shaft rather than a drive chain, check for oil leaks. Maintain its oil supply as outlined in your owner’s manual.
3. Nuts & bolts – Riding in rough terrain will loosen parts. Look and feel for loose parts while the engine is off. Shake handlebars, footrests, etc., before each ride and periodically check fasteners.
Fire Fighting Equipment
UTV Tank & Pump
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
PRIMER
DOES PUMP PRIME
INSPECT PUMPS, PIPING, AND DISCHARGE VALVES FOR OPERATION/LEAKS/CORROSION
IGNITION SWITCH
HARD REEL LINE OPERATES
TANK FULL OF WATER
PSI CHECK
GAUGES (DURING OPERATION)
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Is this vehicle GTG ( 1 or 2 Star = It should not be in service, 3 Star = Its ok but there needs to be service and or corrections made in the next 30 days, 4 Star = GTG but improve items as needed, 5 Star = The vehicle is 100% GTG)
1
2
3
4
5
Your Name
*
Last name
Comments (If on Incident please list Incident Name and Fire Account Code)
Please Sign Below UTV
*
Save and Come Back Later
Submit
Clear Form
Print Form
Back
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Save and Come Back Later
Lights
Exterior Lights
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
OTHER
Headlamps
Tail Lamps
R Turn Signal
L Turn Signal
Emergency
Battery Check
Battery
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Condition
Cables & Connectors
Tire Check
Tires
*
Rows
8/32 or Greater
4/32 to 7/32
3/32 or Less
PSI at
Set to...PSI
Weather Pattern / Damage
Left Front
Right Front
Left Rear
Right Rear
Brakes
Brake System
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Lines
Hoses
Parking Brake
Friendliness
Wiper/Windows
Blades
*
Rows
Checked and OKAY
May require attention SOON
Requires IMMEDIATE attention
Left Front
Right Front
Rear (if applicable)
Windshield Condition
Cracks
Chips
Check Fluids
Levels
*
Rows
Okay
Filled
Requires Attention
Engine Oil
Brake Fluid Reservoir
Transmission (if equipped w/dipstick)
Coolant Recovery Reservoir
Power Steering
Windshield Washer
(INTERIOR)
Vehicle Interior Items
*
Rows
Checked and OKAY
Replaced
Need to Order
Binoculars
Range finder
clamshell
Power inverter
Accident Forms
Interior Items Continued
*
Rows
Checked and OKAY
Replaced
Need to Order
Fireline Handbook
ERG/HAZMAT
Owners Manual
2.0 Medkit
Chem light
Back Seat or under seat
*
Rows
Checked and OKAY
Replaced
Need to Order
Jumper Cables
Rope
AA BATTERY BOX
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Is this vehicle GTG ( 1 or 2 Star = It should not be in service, 3 Star = Its ok but there needs to be service and or corrections made in the next 30 days, 4 Star = GTG but improve items as needed, 5 Star = The vehicle is 100% GTG)
1
2
3
4
5
Your Name
*
Last name
Comments (If on Incident please list Incident Name and Fire Account Code)
Please Sign Below for Truck.
*
Save and Come Back Later
Submit
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Print Form
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