ANNUAL VEHICLE INSPECTION REPORT

REPORT # FLEET UNIT NUMBER

DATE

MOTOR CARRIER OPERATOR INSPECTOR'S NAME (Print or Type)

ADDRESS

VEHICLE TYPE (Circle One) VEHICLE IDENTIFICATION

LIC. PLATE NO.
Tractor Trailer Truck
VIN

VEHICLE COMPONENTS INSPECTED

Needs Repaired Needs Repaired Needs Repaired
OK Repair Date ITEM OK Repair Date ITEM OK Repair Date ITEM
BRAKE SYSTEM FUEL SYSTEM FRAME
a. Service Brakes a. Visible leak a. Frame Members
b. Parking Brake System b. Fuel tank filler cap missing b. Wheel Clearance
c. Brake Drums or Rotors c. Fuel tank securely attached c. Adjustable Axle
d. Brake Hose LIGHTING DEVICES Assemblies (Sliding
e. Brake Tubing All lighting devices and Subframes)
f. Low Pressure Warning reflectors required by Section TIRES
g. Tractor Protection Valve 393 shall be operable. a. Tires on any
h. Air Compressor SAFE LOADING steering axle of a
i. Electric Brakes power unit.
a. Part(s) of vehicle or
j. Hydraulic Brakes b. All other tires.
condition of loading such
k. Vacuum Systems that the spare tire or any WHEELS & RIMS
COUPLING DEVICES part of the load or dunnage a. Lock or Side Ring
a. Fifth Wheels can fall onto the roadway. b. Wheels & Rims
b. Pintle Hooks b. Protection against c. Fasteners
c. Drawbar/Towbar Eye
shifting cargo d. Welds
d. Drawbar/Towbar Tongue
STEERING MECHANISM WINDSHIELD GLAZING
e. Safety Devices a. Steering Wheel Free Play
f. Saddle-Mounts b. Steering Column Requirements and
c. Front Axle Beam and exceptions as
EXHAUST SYSTEM All Steering Components stated pertaining to
Other Than Steering any crack,
a. Any exhaust system
Column discoloration or
determined to be leaking at
a point forward of or d. Steering Gear Box vision reducing
directly below the e. Pitman Arm matter
driver/sleeper f. Power Steering Any powerWIPERS
WINDSHIELD unit
compartment. g. Ball and Socket Joints that has an
inoperative wiper,
b. A bus exhaust system h. Tie Rods & Drag Links
or missing or
leaking or discharting to the i. Nuts damaged parts that
atmosphere in violation of j. Steering System render it
standards (1), (2), (3). SUSPENSION ineffective.
a. Any U-bolt(s), spring
c. No part of the exhaust hanger(s), or other axle List any other
system of any motor positioning part(s) condition which
vehicle shall be so located cracked, broken, loose or may prevent safe
missing resulting in operation of this
as would be likely to result
shifting of an axle from its vehicle.
in burning, charring, or
damaging the electrical normal position.
wiring, the fuel supply, or b. Spring Assembly
any combustible part of the c. Torque, Radius or
motor vehicle. Tracking Components.
CERTIFICATION: THIS VEHICLE HAS PASSED ALL THE INSPECTION ITEMS FOR THE ANNUAL VEHICLE
INSPECTION REPORT IN ACCORDANCE WITH 49 CFR 396.