Daily Vehicle Inspections
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Daily Vehicle Inspections as PDF for free.
More details
- Words: 436
- Pages: 2
Pre-Trip
Daily Vehicle inspection Sat
overall Cleanliness Pre Trip Mileage Fuel Level Fluids Oil Transmission Break Antifreeze Power Steering Leakeage General Head Lights Parking Lights Break Lights Back up Lights Turn Signals Registration Insurance Card Vehicle Tags Tires/Pressure Windshield Wipers Lugs/Rims Interior Seats Seat Belts Interior lights Gauges Sanizide Gloves Bedding Safety Equipment Fire Extinguisher Maps
Sun
Mon.
Tue.
Wed.
Thur.
Fri.
From Sat ____/____/____ to Fri ___/___/___ Vehicle: ___________
Notes:
Pre -Tip Employee signature: Sat: Sun: Mon: Tue: Wed: thur: Fri:
Post -Trip Post-Trip Mileage Fuel Level Clean windshield Clean Windows Clean tires Clean Interior Stocked Gloves Maps Sanizide Stretcher Ready Wheelchair Ready Equipment Box
Post-Trip Employee Signature: Sat: Sun: Mon: Tue: Wed: Thur: Fri: Supervisor Signature:
From Sat ____/____/____ to Fri ___/___/___ Vehicle 1- The undersigned, fully aknowledge that I am signing out the specified company equipment that is to be used for official business only. Official business is defined as the following: 1- Any pre-scheduled or non-scheduled livery tranpsortation that brings revenue to this company. 2- Transportation to and from company affiliated vendors or partners for business purposes only. 3- General transportation that is either instructed or approved by a company officer or manager or for transportation that is necessary to accomplish the company mission. I accept full responsability for the condition and the welfare of the equipment that I am signing out. This equipment includes a company vehicle, corresponding cell phone, company cell phone charger, and all pertinent company and literature. By signing this document I acknowledge that I have personally reviewed and recieved these issued pieces of equipment. I understand that should I loose or damage any of these pieces of equipment or information beyond expected wear and tear that I am liable and responsible for replacing the item (s) at my expense. I agree that I will comply with AZDOT rules and regulations and will ensure that I will conduct a pre-trip inspections of the company vehicle in my possesion. I agree to comply with any and all traffic laws while operating this company vehicle. Additionally, the undersigned accepts and agrees to any action that is taken on behalf of the company in response to any violation of the terms and agreements set forth within this document to include fines, suspension, and/or termination. This Document will be filled out on a daily basis and turned in to dispatch every Monday morning for review and supervisor approval.
Item Company vehicle Vehicle Keys Company Cell Ph. Cell ph. Charger Equipment box Fuel Card
Sat
Sun
Mon.
Tue.
Wed.
Thur.
Fri.
Comments:
Employee Signature: Sat: Sun: Mon: Tue: Wed: Thur: Fri:
Supervisor Signature:
Daily Vehicle inspection Sat
overall Cleanliness Pre Trip Mileage Fuel Level Fluids Oil Transmission Break Antifreeze Power Steering Leakeage General Head Lights Parking Lights Break Lights Back up Lights Turn Signals Registration Insurance Card Vehicle Tags Tires/Pressure Windshield Wipers Lugs/Rims Interior Seats Seat Belts Interior lights Gauges Sanizide Gloves Bedding Safety Equipment Fire Extinguisher Maps
Sun
Mon.
Tue.
Wed.
Thur.
Fri.
From Sat ____/____/____ to Fri ___/___/___ Vehicle: ___________
Notes:
Pre -Tip Employee signature: Sat: Sun: Mon: Tue: Wed: thur: Fri:
Post -Trip Post-Trip Mileage Fuel Level Clean windshield Clean Windows Clean tires Clean Interior Stocked Gloves Maps Sanizide Stretcher Ready Wheelchair Ready Equipment Box
Post-Trip Employee Signature: Sat: Sun: Mon: Tue: Wed: Thur: Fri: Supervisor Signature:
From Sat ____/____/____ to Fri ___/___/___ Vehicle 1- The undersigned, fully aknowledge that I am signing out the specified company equipment that is to be used for official business only. Official business is defined as the following: 1- Any pre-scheduled or non-scheduled livery tranpsortation that brings revenue to this company. 2- Transportation to and from company affiliated vendors or partners for business purposes only. 3- General transportation that is either instructed or approved by a company officer or manager or for transportation that is necessary to accomplish the company mission. I accept full responsability for the condition and the welfare of the equipment that I am signing out. This equipment includes a company vehicle, corresponding cell phone, company cell phone charger, and all pertinent company and literature. By signing this document I acknowledge that I have personally reviewed and recieved these issued pieces of equipment. I understand that should I loose or damage any of these pieces of equipment or information beyond expected wear and tear that I am liable and responsible for replacing the item (s) at my expense. I agree that I will comply with AZDOT rules and regulations and will ensure that I will conduct a pre-trip inspections of the company vehicle in my possesion. I agree to comply with any and all traffic laws while operating this company vehicle. Additionally, the undersigned accepts and agrees to any action that is taken on behalf of the company in response to any violation of the terms and agreements set forth within this document to include fines, suspension, and/or termination. This Document will be filled out on a daily basis and turned in to dispatch every Monday morning for review and supervisor approval.
Item Company vehicle Vehicle Keys Company Cell Ph. Cell ph. Charger Equipment box Fuel Card
Sat
Sun
Mon.
Tue.
Wed.
Thur.
Fri.
Comments:
Employee Signature: Sat: Sun: Mon: Tue: Wed: Thur: Fri:
Supervisor Signature:
Related Documents
Daily Vehicle Inspections
May 2020 11
Vehicle Inspections
May 2020 7
Vehicle
November 2019 40
Full Inspections
October 2019 30
Vehicle To Vehicle Services
June 2020 12