VEHICLE INSPECTION

TO BE COMPLETED BY VEHICLE OPERATOR

FULL NAME

EMAIL ADDRESS

SIGNATURE

INSPECTION POINT

PHONE NUMBER

PASS

FAIL

DATE

INSPECTION POINT

HEADLIGHTS

FRONT SEAT ADJUSTMENT

TAIL LIGHTS

DOORS (Open/Close/Lock)

TURN INDICATOR LIGHTS

HORN

STOP LIGHTS

SPEEDOMETER

BRAKE PADS/SHOES THICKNESS

BUMPERS

Min. per Manufacturer

MUFFLER AND EXHAUST SYSTEM

Right Front Measurements

TIRES, INCL. TREAD DEPTH

PASS

Left Front Measurements

Right Front

(32nds/in)

Right Rear Measurements

Left Front

(32nds/in)

Left Rear Measurements

Right Rear

(32nds/in)

EMERGENCY/PARKING BRAKE

Left Rear

(32nds/in)

FAIL

INTERIOR AND EXTERIOR REAR VIEW MIRRORS

STEERING MECHANISM

SAFETY BELTS FOR DRIVER AND EACH PASSENGER

Ball Joints
Tie Rods

VEHICLE INSPECTION RESULT

Rack & Pinion

Inspector To Circle

Bushings

PASS

WINDSHIELD
Large Crack

FAIL

Small Crack
REAR WINDOW AND OTHER GLASS

I NSP ECTI ON D ATE :

WINDSHIELD WIPERS

An y mar ki ng s o n the FAIL si de wi ll auto matica lly fai l i nspectio n.

THIS CERTIFICATION EXP IRE S 1 Y EA R FROM IN SPE CTIO N DA TE

TO BE COMPLETED BY INSPECTOR

COMPANY

VEHICLE MILEAGE

LICENSE PLATE STATE AND #

VIN#

VEHICLE MAKE

VEHICLE MODEL

INSPECTOR NAME

INSPECTION ADDRESS

INSPECTOR SIGNATURE

MODEL YEAR

# OF DOORS

STATE CERTFICATION #