Date: ______ Vehicle Plate#: ________ Odo: _______ TripTicket#: _____

DEPARTURE VEHICLE INSPECTION

Driver (Printed Name with Signature): _____________________________
Date: ______ Vehicle Plate#: ________ Odo: _______ TripTicket#: _____
Guard on Duty (Printed Name with Signature): ______________________
Driver (Printed Name with Signature): _____________________________
VEHICLE PARTS GOOD MAY REQUIRE REMARKS
Guard on Duty (Printed Name with Signature): ______________________ ATTENTION
Windshield
VEHICLE PARTS GOOD MAY REQUIRE REMARKS
ATTENTION Windshield Wiper
Windshield Door Locks
Windshield Wiper Window Condition
Door Locks Rearview Mirror
Window Condition Sideview Mirrors
Rearview Mirror Horn
Sideview Mirrors High Beam Headlights
Horn Low Beam Headlights
High Beam Headlights Tail Lights
Low Beam Headlights Brake Lights
Tail Lights Seat Belt
Brake Lights Coolant Level
Seat Belt Hand Break
Coolant Level Spare Tire
Hand Break Physical Appearance
Spare Tire Dents
Physical Appearance
Dents
ARRIVAL VEHICLE INSPECTION