DRIVER'S VEHICLE INSPECTION REPORT

DRIVER'S VEHICLE INSPECTION REPORT

AS REQUIRED BY THE D.O.T. FEDERAL MOTOR CARRIER SAFETY REGULATIONS
Date*

MonthDayYear
PRE-TRIPPOST-TRIP
CARRIER*
ADDRESS: 40 LOWELL ROAD, SALEM NH 03079
Tractor/ Truck No.*
If Other - Plate # or Describe
Time*

:HourMinutesAM/PM Option
ODOMETER READING*
HOUR READING
Check DEF FluidCheck Oil LevelCheck Fuel LevelCheck Anti Freeze Level
Air CompressorAir LinesBatteryBelts and HosesBodyBrake AccessoriesBrakes, ParkingBrakes, ServiceClutchCoupling DevicesDefroster/HeaterDrive LineEngineExhaustFifth WheelFrame and AssemblyFront AxleFuel TanksHornLightsHead/StopTail/DashTurn IndicatorsClearance/ MarkerMirrorsMufflerOil PressureRadiatorRear EndReflectorsSafety EquipmentFire ExtinguisherFlags/Flares/FusesReflective TrianglesSpare Bulbs and FusesSpare Seal BeamStarterSteeringSuspension SystemTarpTire ChainsTiresTransmissionTrip RecorderWheels and RimsWindowsWindshield WipersOther
12354679810Drop Axle DriverDrop Axle PassengerOther
TRAILER(S) NO.(S)
Brake ConnectionsBrakesCoupling DevicesCoupling (King) PinDoorsHitchLanding GearLights - AllReflectors/Reflective TapeRoofSuspension SystemTarpTiresWheels and RimsOther
REMARKS
Driver Name*

First NameLast Name
Driver Email (for reply)*
example@example.com
SATISFACTORYNOT SATISFACTORY
DRIVER SIGNATURE
LOOKED AT DATE

MonthDayYear
MECHANIC NAME

First NameLast Name
What was done?
CORRECTEDNEED NOT BE CORRECTED FOR SAFE OPERATION OF VEHICLE
MECHANIC SIGNATURE
Should be Empty: