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ANNUAL VEHICLE INSPECTION REPORT

The ANNUAL VEHICLE INSPECTION REPORT Form is used to bring notice to any faults or defects the driver observed in the vehicle and its equipment. The report allows repairs to be done in a timely manner so that vehicles can maintain high operating efficiency.
MaintainX
04/26/2021

ANNUAL VEHICLE INSPECTION REPORT

62 steps
The ANNUAL VEHICLE INSPECTION REPORT Form is used to bring notice to any faults or defects the driver observed in the vehicle and its equipment. The report allows repairs to be done in a timely manner so that vehicles can maintain high operating efficiency.
  • VEHICLE HISTORY RECORD

  • REPORT NUMBER

  • FLEET UNIT NUMBER

  • DATE

  • MOTOR CARRIER OPERATOR

  • INSPECTOR'S NAME (PRINT OR TYPE)

  • ADDRESS

  • THIS INSPECTOR MEETS THE QUALIFICATION REQUIREMENTS IN SECTION 396.19.

  • CITY, STATE, ZIP CODE

  • VEHICLE IDENTIFICATION () AND COMPLETE

  • VEHICLE TYPE

  • INSPECTION AGENCY/LOCATION (OPTIONAL)

  • VEHICLE COMPONENTS INSPECTED

  • BRAKE SYSTEM

  • Service Brakes

    • Yes
    • No
    • N / A
  • Parking Brake System

    • Yes
    • No
    • N / A
  • Brake Drums or Rotors

    • Yes
    • No
    • N / A
  • Brake Hose

    • Yes
    • No
    • N / A
  • Brake Tubing

    • Yes
    • No
    • N / A
  • Low Pressure Warning Device

    • Yes
    • No
    • N / A
  • Tractor Protection Valve

    • Yes
    • No
    • N / A
  • Air Compressor

    • Yes
    • No
    • N / A
  • Electric Brakes

    • Yes
    • No
    • N / A
  • Hydraulic Brakes

    • Yes
    • No
    • N / A
  • Vacuum Systems

    • Yes
    • No
    • N / A
  • COUPLING DEVICES

  • Fifth Wheels

    • Yes
    • No
    • N / A
  • Pintle Hooks

    • Yes
    • No
    • N / A
  • Drawbar/Towbar Eye

    • Yes
    • No
    • N / A
  • Drawbar/Towbar Tongue

    • Yes
    • No
    • N / A
  • Safety Devices

    • Yes
    • No
    • N / A
  • Saddle-Mounts

    • Yes
    • No
    • N / A
  • EXHAUST SYSTEM

  • Any exhaust system determined to be leaking ata point forward of or directlybelow the driver/sleepercompartment.

    • Yes
    • No
    • N / A
  • A bus exhaust systemleaking or discharging tothe atmosphere in violationof standards (1), (2) or (3).

    • Yes
    • No
    • N / A
  • No part of the exhaust system of any motor vehicleshall be so located aswould be likely to result inburning, charring, ordamaging the electricalwiring, the fuel supply, orany combustible part of themotor vehicle

    • Yes
    • No
    • N / A
  • FUEL SYSTEM

  • Visible leak

    • Yes
    • No
    • N / A
  • Fuel tank filler cap missing

    • Yes
    • No
    • N / A
  • Fuel tank securelyattached

    • Yes
    • No
    • N / A
  • LIGHTING DEVICES

  • All lighting devices andreflectors required by Section393 shall be operable

    • Yes
    • No
    • N / A
  • SAFE LOADING

  • Part(s) of vehicle orcondition of loading suchthat the spare tire or anypart of the load or dunnagecan fall onto the roadway

    • Yes
    • No
    • N / A
  • Protection against shifting cargo

    • Yes
    • No
    • N / A
  • STEERING MECHANISM

  • Steering Wheel Free Play

    • Yes
    • No
    • N / A
  • Steering Column

    • Yes
    • No
    • N / A
  • Front Axle Beam and All Steering Components Other Than SteeringColumn

    • Yes
    • No
    • N / A
  • Steering Gear Box

    • Yes
    • No
    • N / A
  • Pitman Arm

    • Yes
    • No
    • N / A
  • Power Steering

    • Yes
    • No
    • N / A
  • Ball and Socket Joints

    • Yes
    • No
    • N / A
  • Tie Rods and Drag Links

    • Yes
    • No
    • N / A
  • Nuts

    • Yes
    • No
    • N / A
  • Steering System

    • Yes
    • No
    • N / A
  • SUSPENSION

  • Any U-bolt(s), springhanger(s), or other axlepositioning part(s) cracked,broken, loose or missingresulting in shifting of anaxle from its normal position

    • Yes
    • No
    • N / A
  • Spring Assembly

    • Yes
    • No
    • N / A
  • Torque, Radius or Tracking Components.

    • Yes
    • No
    • N / A
  • FRAME

  • Frame Members

    • Yes
    • No
    • N / A
  • Tire and Wheel Clearance

    • Yes
    • No
    • N / A
  • Adjustable Axle Assemblies (Subfreezing)

    • Yes
    • No
    • N / A
  • TIRES

  • Tires on any steering axleof a power unit.

    • Yes
    • No
    • N / A
  • All other tires.

    • Yes
    • No
    • N / A
  • WHEELS AND RIMS

  • Lock or Side Ring

    • Yes
    • No
    • N / A
  • Wheels and Rims

    • Yes
    • No
    • N / A
  • Fasteners

    • Yes
    • No
    • N / A
  • Welds

    • Yes
    • No
    • N / A
  • WINDSHIELD GLAZING

  • Requirements and exceptionsas stated pertaining to anycrack, discoloration or visionreducing matter (reference393.60 for exceptions)

    • Yes
    • No
    • N / A
  • WINDSHIELD WIPERS

  • Any power unit that has aninoperative wiper, or missingor damaged parts that renderit ineffective.

    • Yes
    • No
    • N / A
  • List any other condition which may prevent safe operation of this vehicle.

  • CERTIFICATION: THIS VEHICLE HAS PASSED ALL THE INSPECTION ITEMS FOR THE ANNUAL VEHICLE INSPECTION REPORT INACCORDANCE WITH 49 CFR 396

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