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Daily Vehicle Inspection Report Form

This vehicle inspection report requires vehicle operators to inspect their vehicles daily and submit a weekly report to their supervisor. The report collects information on the vehicle, operator, and checks the condition and equipment of the vehicle, noting any items that are good, fair, or poor. Operators must sign and date the report, which is then reviewed and signed by the supervisor.

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Polycarp Danson Sigai
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995 views1 page

Daily Vehicle Inspection Report Form

This vehicle inspection report requires vehicle operators to inspect their vehicles daily and submit a weekly report to their supervisor. The report collects information on the vehicle, operator, and checks the condition and equipment of the vehicle, noting any items that are good, fair, or poor. Operators must sign and date the report, which is then reviewed and signed by the supervisor.

Uploaded by

Polycarp Danson Sigai
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • Vehicle Inspection Report

Vehicle Inspection Report

(OH&S Regulation 17.01 to 17.14)

Vehicle operators are to inspect & document daily and submit this report weekly to their supervisor
PLEASE PRINT CLEARLY

VEHICLE AND OPERATOR INFORMATION


Operator Name Vehicle description

License number Mileage (km’s) Date of Day 1 Day 2 Day 3 Day 4 Day 5
inspection
(D/M/Y)

VEHICLE CONDITION CHECK 


Item Day 1 Day 2 Day 3 Day 4 Day 5
Status Good Fair Poor Good Fair Poor Good Fair Poor Good Fair Poor Good Fair Poor
Motor Oil
Coolant / Anti-Freeze
Brakes (Foot/Hand)
Exhaust/mufflers
General (body)
General (mechanical)
Mirrors
Seat belts
Steering
Tires (incl. spare)
Windshield, wipers condition
Washer fluid level
Lights OK Replace OK Replace OK Replace OK Replace OK Replace
Brake
Head
Signal

VEHICLE EQUIPMENT CHECK 


Item Day 1 Day 2 Day 3 Day 4 Day 5 Comments (from all sections)
Emergency response numbers posted
Radio/Cel/Sat Phone
Tools, equip. secured
Axe, Shovel, Pulaski, Water Can
Fire Extinguisher
First Aid, Survival Kits
Flares/Triangles/Cones
Flashlight
Tire Jack/Wrench
Jumper Cables
Cargo Netting/Restraint
Environmental Spill Kit
Tow Rope, Chains
OPERATOR / INSPECTOR SUPERVISOR
Signature Date Signature Date

Rev 12/23/09

(OH&S Regulation 17.01 to 17.14) Vehicle operators are to inspect

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