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As required by the Federal Motor Carrier Safety Regulations for Commercial Drivers
Location:_______________________________________________________________________________
Date:_________________
Time:______________ AM PM
Vehicle #:_______________________
Speedometer Reading:_______________
Horn
*Lights
*Head
*Tail
*Stop
*Dash
*Turn Indicators
*Emergency Flasher
*Mirrors
Muffler-Exhaust System
*Oil Pressure
Placards
*Radiator
*Rear End
*Reflectors
*Safety Equipment
*Fire Extinguisher (if applicable)
*Reflective Triangles (if applicable)
*Spare Bulbs
*Spare Fuses
*Back-up Alarm (if applicable)
*Seatbelts
Springs
Starter
*Steering
Tachograph
*Wheels and Lugnuts
Transmission
*Windows
*Windshield Wipers
Other __________________________
Hitch
Landing Gear
LightsAll
Placards
Reflectors
Roof
Springs
Tarpaulin
Tires
Wheels and Lugnuts
Other_________________
Remarks:_______________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_____________________________________________
Condition of above vehicle(s) is/are satisfactory
YES
NO
YES
NO
YES
NO