Pre-trip Inspection Form
Organization Name: ______________________________________________________________
Date: ________________ Time: ________________ Place: __________________________
Make: ________________ Model: _______________ License #: ______________________
VIN: ________________________________________ Odo: _________________________
Inspection Checklist
Pass Fail Comments Pass Fail Comments
Break Lights Wiper Blades
Hazard Lights Windshield Washer
Indicator Lights Windshield Fluid
Head Lights Dents/Scratches
Tail Lights Engine Oil
Fog Lights Coolant
Tires Power Steering Fluid
Tire Tread Fuel Guage
Tire Pressure Oil Guage
Spare Tire Horn
Lug Nuts Fuel Level
Brake Drums Ignition
Brake Chambers All Seat Belts
Air Brake Ac/Heater
Parking Brake Fire Extinguisher
Side Mirrors Cargo Area
Rear View Mirror Exhaust
Windshield Axel Leaks
Any other comments: _____________________________________________________________
______________________________________________________________________________
Operator Signature: ________________________