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Daily Vehicle Inspection Form






Business Network Members
  1. Dunn Avenue Health and Welln
  2. Cordoves & Gulizio, LLC
  3. BrightStar Healthcare
  4. Amselhaus






Vehicle Inspection Template

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Vehicle Daily Inspection


Date: ____/____/______ Vehicle #: _____________ Mileage: _________________________

Driver Name: _______________________________________________________

Please place an X next to any item that needs attention and place a check next to the rest.


[____] Ignition Key

[____] Fuel Key

[____] Check Radio

[____] Visual Inspection for Exterior Damage / Leaks under the vehicle

[____] Check inside the Engine compartment for any leaks and loose items

[____] Oil Level

[____] Washer Fluid Level

[____] Coolant Level

[____] Power Steering Fluid Level

[____] Start Engine and Check Transmission Fluid

[____] Check for Air Gauge

[____] Check Tires for Wear and Pressure (70 PSI COLD) LF ___ LR ___ RF ___ RR ___

[____] Check Horn

[____] Check Heater / Defroster

[____] Check Windshield Wipers / Washers

[____] Check Highlight / Signal Lights / 4way Flashes / Tail Lights / Reverse Lights

[____] Check Lift; Run on complete up and down cycle

[____] Check Interior Lights

[____] Check Mirrors for Damage and Adjustments

[____] Check Fuel Level

[____] Check First Aide Kit

[____] Check Fire Extinguisher

[____] Check Adequate Tie-Downs

[____] Check Bio-Hazard Kit

Comments: _____________________________________________________



_______________________________________________________________
Driverís Signature










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