MOTOR VEHICLE WEEKLY SAFETY CHECKLIST
[Pages:1]MOTOR VEHICLE WEEKLY SAFETY CHECKLIST
Department: ____________________
Vehicle Make: ______________ Model: ________________ V.I.N.#__________________________
Do not operate any vehicle if an unsafe
condition exists.
Inspection Date: / /
Inspected By:
Inspection Date: / /
Inspected By:
Inspection Date: / /
Inspected By:
Inspection Date: / /
Inspected By:
Inspection Date: / /
Inspected By:
Windshield wipers and washers Directional Signals
Lights
Horn and Mirrors
Inspection sticker current Tag current
Check for 4000 mile maintenance Tire inflation and safe tread depth Power steering fluid
Antifreeze / Coolant
Motor oil level
Brake fluid & Brake operation Exterior and Interior condition acceptable Transmission Fluid & Hydraulics (if applic.)
Any item not passing inspection shall immediately be brought to the attention of the department head, a garage work order issued, and the vehicle repaired and returned to service as soon as possible.
Comments: ________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________
***SUBMIT CHECKLIST TO HUMAN RESOURCES ON THE 5TH DAY OF EACH MONTH***
Revised 8-06-08 BG
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