Supervisor Monthly Inspection Form
Date
*
/
Month
/
Day
Year
Date
Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Branch
*
Andrews-PC
Artesia-CTS
Artesia-PC
Artesia-PR
Bossier City
Charlotte-CTS
Charlotte-PR
Cleburne-CRF
Clinton-OK
Dickinson-PR
Douglas-PR
Greeley-PR
Fort Collins-PR
Fort Stockton-PC
Frierson-CTS
Frierson-PR
Midland Tubulars
Midland-FR
Midland-FS
Monahans-FS
Oakdale-PR
Odessa-CM
Odessa-CTS
Odessa-FS
Odessa-PC
Odessa-PR
Odessa-Shop
Oklahoma City-CTS
Oklahoma City-PC
Oklahoma City-PR
Pecos-CTS
Pecos-PC
Pecos-PR
Ponca City-PC
Shreveport-PR
Snyder CTS
Snyder-FR
Snyder-FS
Snyder-Perm
Sonora-PC
Truck/Tractor #:
Annual Inspection Expiration Date:
-
Month
-
Day
Year
Date
Tractor
Seat Belt
*
Satisfactory
Unsatisfactory
NA
Mirrors/ Windshield
*
Satisfactory
UnSatisfactory
NA
Defrosting Device
*
Satisfactory
UnSatisfactory
NA
Cab Card Book
*
Satisfactory
UnSatisfactory
NA
Fire Extinguisher
*
Satisfactory
UnSatisfactory
NA
Warning Triangles
*
Satisfactory
UnSatisfactory
NA
Spare Electrical Fuses
*
Satisfactory
UnSatisfactory
NA
Horn
*
Satisfactory
UnSatisfactory
NA
Electronic Logging Device
*
Satisfactory
UnSatisfactory
NA
Dashboard/Gauges
*
Satisfactory
UnSatisfactory
NA
Annual Inspections
*
Satisfactory
UnSatisfactory
NA
Head Lamps/High & Low
*
Satisfactory
UnSatisfactory
NA
Turn Lamps/Front & Rear
*
Satisfactory
UnSatisfactory
NA
Hazard Signals/Front & Rear
*
Satisfactory
UnSatisfactory
NA
Windshield/ Windows
*
Satisfactory
UnSatisfactory
NA
ID Lamps
*
Satisfactory
UnSatisfactory
NA
Suspension/Axle
*
Satisfactory
UnSatisfactory
NA
Hood Securement
*
Satisfactory
UnSatisfactory
NA
Brake Lamps
*
Satisfactory
UnSatisfactory
NA
Tail Lamps
*
Satisfactory
UnSatisfactory
NA
Reverse Lamps
*
Satisfactory
UnSatisfactory
NA
Clearance Lamps
*
Satisfactory
Unsatisfactory
NA
Battery Cover
*
Satisfactory
UnSatisfactory
NA
Axle 1/2/3 Tires
*
Satisfactory
UnSatisfactory
NA
Fuel Tanks
*
Satisfactory
UnSatisfactory
NA
Lug Bolts/Wheel Checks
*
Satisfactory
UnSatisfactory
NA
Hubs/ Oil Level
*
Satisfactory
UnSatisfactory
NA
Fifth Wheel/Gooseneck
*
Satisfactory
UnSatisfactory
NA
Brake Adjustments
*
Satisfactory
UnSatisfactory
NA
Airlines
*
Satisfactory
UnSatisfactory
NA
Brake Indicator
*
Satisfactory
UnSatisfactory
NA
Mud Flaps
*
Satisfactory
UnSatisfactory
NA
Exhaust System
*
Satisfactory
UnSatisfactory
NA
Trailer
Trailer #
Trailer Type
Vacuum
Float
Drop Deck
DOT Spec/Hazmat
Frac Tank
Annual Inspection Expiration Date:
-
Month
-
Day
Year
Date
Brake Adjustments
Satisfactory
UnSatisfactory
NA
Reflective Tape
Satisfactory
UnSatisfactory
NA
Tail Lamps
Satisfactory
UnSatisfactory
NA
Stop Lamps
Satisfactory
UnSatisfactory
NA
Turn Lamps
Satisfactory
UnSatisfactory
NA
License Plate Lamp
Satisfactory
UnSatisfactory
NA
Hazard Signals
Satisfactory
UnSatisfactory
NA
ID Lamps
Satisfactory
UnSatisfactory
NA
Side Marker Lamps
*
Satisfactory
UnSatisfactory
NA
Hatches
*
Satisfactory
UnSatisfactory
NA
Mud Flaps
Satisfactory
UnSatisfactory
NA
Axle 4/5 Tires
*
Satisfactory
UnSatisfactory
NA
Lugs/Wheel Checks
*
Satisfactory
UnSatisfactory
NA
Wheels/ Tires
*
Satisfactory
UnSatisfactory
NA
Brake Indicator
*
Satisfactory
UnSatisfactory
NA
Tools/ Equipment
*
Satisfactory
UnSatisfactory
NA
Misc.
Cargo Securement
*
Satisfactory
UnSatisfactory
NA
Ladder/ Catwalks
*
Satisfactory
UnSatisfactory
NA
Placards/Markings
*
Satisfactory
UnSatisfactory
NA
Shipping papers
*
Satisfactory
UnSatisfactory
NA
Cab Book
*
Available
Unavailable
ELD Documentation:
*
Available
Unavailable
Blank Log
*
Available
Unavailable
DOT log instructions sheet
*
Available
Unavailable
ELD Manual
*
Available
Unavailable
Corrective Actions:
Inspector:
First Name
Last Name
Inspector Signature:
Driver:
First Name
Last Name
Driver Signature:
Submit
Should be Empty: