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Time
:

Truck

Air Compressor
Air Lines
Battery
Belts and Hoses
Body
Brake Accessories
Brakes, Parking
Brakes, Service
Carburetor
Clutch
Coupling Devices
Defroster / Heater
Drive Lines
Engine
Exhaust
Fifth Wheel
Fluid Levels
Frame and Assembly
Front Axle
Fuel Tanks
Heater
Horn
Lights - Head / Stop
Lights - Tail / Dash
Lights - Turn Indicators
Lights - Clearance / Marker
Mirrors
Muffler
Oil Pressure
Radiator
Rear End
Reflectors
Safety Equipment - Fire Extinguisher
Safety Eqiupment - Flags / Flares / Fuses
Safety Equipment - Reflective Triangles
Safety Equipment - Spare Bulbs and Fuses
Safety Equipment - Spare Seal Beam
Starter
Steering
Suspension System
Tachograph
Tire Chains
Transmission
Trip Recorder
Wheels and Rims
Windows
Windshield Wipers
Other

Trailers

Trailer(s) Number(s)
Brake Connection
Brakes
Coupling Devices
Coupling (King) Pin
Doors
Hitch
Landing Gear
Lights - All
Reflectors / Reflective Tape
Roof
Suspension System
Tarpaulin
Tires
Wheels
Other
The condition of the above vehicle is satisfactory
Clear Signature

Corrections

Above Defects Corrected
Above Defects Need Not Be Corrected For Safe Operation Of Vehicle
Clear Signature
MM slash DD slash YYYY
Clear Signature
MM slash DD slash YYYY