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Vehicle Safety Inspection Form

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Vehicle Safety Inspection Form

Audit

INSPECTION INFORMATION

Inspectors Name:
Date/Time:

VEHICLE INFORMATION

Vehicle Fleet Number:
Make:
Model:

TIRES

Are tire properly inflated?
Tread in acceptable condition?
Any bulges, cuts, or unusual wear.

LIGHTING

Headlights:

Do the brights work (both lamps)?
Do the dims work (both lamps)?
Do the fogs lamps work (if applicable)?
Do the rear tail lights work (both lamps)?

Parking/Turn Signals:

Are Hazard/Flashers operational (front & back)?
Does right turn signal work (front & back)?
Does left turn signal work (front & back)?

Break Lights:

Are both break lights operational?
Is the third break light operational (if applicable)?
Are all covers intact?

VISABILITY

Windshield:

Is the windshield is good condition (no cracks)?
Is the windshield clean (inside & outside)?
Are the windshield wipers operational & in good condition?
Does the windshield washer fluid work properly?

External/Sideview Mirrors:

Are the external/sideview mirrors clean?
Are the external/sideview adjustable?

Rearview Mirror:

Is the rear view mirror clean?
Is the rear view mirror adjustable?

INTERNAL CONTROLS & GAUGES

Vehicle Gauges:

Is there a clear line of sight to the dashboard gauges?
Does the speedometer work correctly?
Does the temperature gauge work correctly?
Does the fuel gauge work correctly?
Does the battery indicator light work correctly?

Seat Belts:

Are all seat belts fully operational (latch, unlatch, and lock on hard break)?
Are all seat belts in good condition (no tears)?

Horn:

Does the horn work?
Is the horn sound at a reasonable volume?

MAINTENANCE

Fluids:

Engine fluids will be checked weekly unless dashboard gauges suggest a problem. Check with safety manager to see when fluids were last checked.
Is the oil level in the acceptable range?
Is the break fluid in the acceptable range?
Is the anti-freeze/coolant topped off?
Is the transmission fluid in the acceptable range?
Is the windshield washer fluid topped off?

Vehicle Operations:

Does the vehicle break properly?
Is the turning/steering responsive and working properly?
Does the vehicle accelerate properly?
Does the vehicle idle within a an acceptable range (650-1,000 RPM)?

Towing/Coupling:

This section should only apply if you will be towing anything during use. If a trailer is being use please inspect the trailer for all applicable items on is checklist. Only mark "YES" if BOTH the vehicle and trailer are in compliance. If EITHER are not in compliance mark "NO" and note the issue in the details.
Does the tow hitch work properly?
Are all of the lights on the trailer fully functioning (break lights, right/left turn signals, hazards/flashers)?

EMERGENCY/WEATHER EQUIPMENT

Are safety chains in good, working condition?
If the First-Aid kit fully stocked?
Is the Fire extinguisher fully charged?

OTHER ISSUES

Please described any major issues in detail below:
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