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Vehicle Daily Inspection Report Template

The document is a vehicle inspection report template for operators to inspect vehicles daily and submit weekly to supervisors. It includes sections to document vehicle and operator information, check vehicle condition and equipment, and includes signature lines for the operator, inspector, and supervisor.

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eliza87785
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30 views1 page

Vehicle Daily Inspection Report Template

The document is a vehicle inspection report template for operators to inspect vehicles daily and submit weekly to supervisors. It includes sections to document vehicle and operator information, check vehicle condition and equipment, and includes signature lines for the operator, inspector, and supervisor.

Uploaded by

eliza87785
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

(OH&S Regulation 17.01 to 17.

14) Vehicle Inspection Report

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

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