Vehicle Inspection Form
Department:
*
Site Name and address:
Vehicle Locations
*
Please Select
Goulburn
Registration no:
*
Vehicle Make and Model:
*
Odometre Reading:
*
Date Inspected:
*
/
Day
/
Month
Year
Date
Service Due Date:
*
-
Day
-
Month
Year
Date
Service Due Kilometres
*
Item Checklist:
*
Rows
Ok
Not Ok
N/A
Action Required
Fluids – radiator, oil, transmission, brake, steering, wiper
Lights – headlights, driving, tail, signal, hazard,
Tyres – pressure, tread, wheel nuts, spare
Brakes – function, emergency, warnings,
Aircon– functioning, windows clear
Safety – seatbelts, first aid kit, fire extinguisher (insp. Date)
Accessories – wipers, mirrors, hubcaps clean
Windshield – clean, no chips or cracks
PPE – gloves
Other
*
Please circle the area where damage is noted and indicate type of damage:
Notes
Upload any documents related to vehicle
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Vehicle Photo 1 - from front left corner, covers "Left" side of the vehicle and front.
*
Vehicle Photo 2 - from rear left corner, covers "Left" side of the vehicle and back.
*
Vehicle Photo 3 - Inside front
*
Vehicle Photo 3 - Inside back
*
Inspected By:
*
First Name
Last Name
Signature
*
Submit
Should be Empty: