PREVENTIVE MAINTENANCE Agency________________________________________

Address_______________________________________
INSPECTION REPORT City___________________________________________
State______ Zip____________
Bus ID #:____________________________________ Date: _________________________________ Miles ________________

Inspector's Signature___________________________________Printed Name _____________________________________Employee # _________

Inspection Type: A Inspection B Inspection C Inspection

Condition Indicators:  O = Follow up required N/A = Not Applicable

= Okay X = Item was repaired or adjusted
# Interior A B C # Exterior (cont.) A B C # Chassis/Drive Line (cont.) A B C
Passenger Door/Check Operation
1 of All Interlocks and/or Starter 36 Check Operation of All Lights 71 Air Tank Mounting/Lines &
Interrupt Valves
2 Standee Line & Warning 37 Condensor Fan Operation 72 Check Exhaust System for

Mounting/Leaks/Restriction

3 Flooring/ Steps/All Interior Panels 38 All Access Doors/Engine Cover & Latch 73 Underbody/Mounts & Frame
Operation
4 39 74 Fuel Tank Mounting & Fuel
Wheelchair Belts/Floor Anchors Tire Damage & Wear Leaks
5 Passenger Seat Condition/ 40 Check Wheels/Lug Nuts/Valve Stems Wheel Chair Lift
Foldaway Seat Operation
Lift Manufacturer Tag/Month
6 Passenger Seat Belts 41 Fuel Cap and Door 75 and year of Manufacture/
State of FL Certificate
7 Stanchions & Hand Rails 42 Leveling 76 Check Lift Wiring for Routing/

Chafing & Loose Connections

8 Roof Hatches/Operation Engine Compartment 77 Check Lift for Damage/

Inspect Lift Anchor Bolts
9 Emergency Door and Window 43 Clean Batteries and Terminal Ends/Check 78 Cycle Lift -Check all Safety
Operation Electrolyte Level Systems Including Barriers
10 Fire Extinguisher/First Aid Kit 44 Check Battery/Hold Downs/Cables/Ground 79 Record Lift Cycle Count
Emergency Triangles/Spill Kit Straps
11 Fire Suppression System 45 Record Voltage Output______V 80 Check for Hydraulic Leaks/
Level
12 Interior Lights 46 Check Belts/Tensioners & Hoses/ 81 Clean, Lubricate and Adjust
Air Compressor Mounting Lift As Needed
13 Vehicle Registration/Plates 47 Check All Fluids Brake Inspection
82 BrakeFoundation/
Drivers Compartment 48 Inspect for Leaks Lines/Rotors/Drums
14 Brake & Accelerator Pedals 49 Test Anti-Freeze Protection 83 L/Front % Worn:
15 Drivers Seat & Belt 50 Check Radiator Core/Mounts 84 R/Front % Worn:
16 Horn Operation 51 Check Wiring for Routing/Chafing & Loose 85
Connections L/Rear % Worn:
17 Service Brake Operation 52 Check Engine Mounts 86 R/Rear % Worn:
18 Ignition System (Start Engine) 53 Replace Engine Oil & Filter Tire Tread Depth/Inflation
19 Check All Gauges/Switches 54 Check Air Filter 87 L/Front /32
20 Check Fast Idle 55 Check Fuel Filter 88 R/Front /32
21 Check Air Sytem 56 Check/Clean A/C Filters & Cores/Lines for R/R Inside /32
Pressures/Perform Leak Down Test Routing/Chafing 89

22 Shift Lever Operation 57 A/C Compressor Mounting/Clutch 90 R/R Outside /32

23 Parking Brake Operation 58 A/C Pressure Check 91 L/R Inside /32
24 Back-Up Alarm Chassis/Drive Line 92 L/R Outside /32
25 Driver's & Panel Lamps 59 Shocks/Springs/MOR/ryde 93 L/Front PSI
26 Interior Mirrors/Sun Visor 60 Torque Rods 94 R/Front PSI
27 Windshield Wipers & Washers 61 Check Ball Joints 95 R/R Inside PSI
28 Climate Control System/Fans 62 Steering Gear/Linkage & Arms 96 R/R Outside PSI
29 Fare Collection System 63 Steering Shaft & Freeplay 97 L/R Inside PSI
30 Cleanliness 64 Lube Chassis 98 L/R Outside PSI
Exterior 65 Check Drive Shaft & U-Joints Test Drive
Check for Damage Check Differential Oil Level/Clean
31 /Corrosion/Bumpers & 66 99
Breather/Check Axle Seals
Mounts/Decals Check Engine Performance
32 Condition of All Glass 67 Drain & Refill Differential O E M 100 Check Shift Points
33 Wiper Blades & Arms 68 Replace Transmission Fluid/Filter O E M 101 Steering
34 Exterior Mirrors 69 Check Front Wheel Bearings 102 Suspension
35 Check Light Lenses & Reflectors 70 Check Brakes (Pull Wheels) 103 Brakes

104 Speedometer
Notes

v071117