Driver's Vehicle Inspection Report

[ Exit Form ] REFERENCE: DVIR-sheet.jpg

DRIVER'S VEHICLE INSPECTION REPORT

CARRIER:

ADDRESS:

DATE:

TIME:

AM PM

Check any defective item and give details under "Remarks"

TRACTOR/TRUCK NO.

ODOMETER READING:

Air Compressor Air Lines Battery Belts and Hoses Body Brake Accessories Brakes/Parking Brakes/Service Carburetor Clutch Coupling Devices Defroster/Heater Drive Line Engine Exhaust Fifth Wheel Fluid Levels

Frame and Assembly Front Axle Fuel Tanks Horn

Lights Head/Stop Tail/Dash Turn Indicators Clearance/Marker

Mirrors Muffler Oil Pressure Radiator Rear End Reflectors

Safety Equipment Fire Extinguisher Flags/Flares/Fusees Reflective Triangles Spare Bulbs & Fuses Spare Seal Beam

Starter Steering Suspension System Tire Chains Tires Transmission Trip Recorder Wheels and Rims Windows Windshield Wipers Other

TRAILER(S) NO.(S)

Brake Connections Brakes Coupling Devices Coupling (King) Pin Doors

Hitch Landing Gear Lights - All Reflectors/Reflective Tape Roof

Suspension System Tarpaulin Tires Wheels and Rims Other

REMARKS:

[X] CONDITION OF THE ABOVE VEHICLE IS SATISFACTORY

DRIVER'S SIGNATURE:

Draw inside box using stylus or finger

PRINT NAME:

[ ] ABOVE DEFECTS CORRECTED [ ] ABOVE DEFECTS NEED NOT BE CORRECTED FOR SAFE OPERATION OF VEHICLE

MECHANIC'S SIGNATURE:

Optional (For repair sign-offs only)

DATE:

DRIVER'S SIGNATURE (POST-REPAIR REVIEW):

Only required if repairs were performed

DATE:

Cancel & Return

REPORT SUBMITTED

Your Driver Vehicle Inspection Report has been successfully compiled and sent directly to the Salt City Constructors fleet supervisor.

Report Reference: DVIR-#####

Filing Status: DIGITALLY ARCHIVED

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