Fleet Management News & Business Info | Commercial Carrier Journal
Issue link: http://read.dmtmag.com/i/284466
MID
TRIP
INSPECTION
STANDARD
SERVICE
CODE
(DOMT)
COMPANY
NAME
_______________________________________
DRIVER
NAME
_______________________________________________
TRACTOR
NUMBER
______________________________________
TRAILER
NUMBER
____________________________________________
LOCATION
NAME
_____________________________________
LOCATION
NO.
___________
BRAND
__________________
WORK
ORDER
NO.
_____________________________________
TIRES
(Minimum
Tread
Depth
Requirement
Inspection)
BRAKES
(Brake
Shoe
Minimum
Thickness
/
Condition)
LIGHTS
/
CONSPICUITY
TAPE
/
OTHER
COMMENTS:
___________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
CHECKLIST
PASS
FAIL
Flaps
Air
Leaks
Wheel
Seals
Fluid
Leaks
Exhaust
Windshield
Mirrors
Fire
Extinguisher
Triangles
DATE
OF
LAST
DOT
INSPECTIONS
TRAILER
/
/
TRACTOR
/
/
TECH'S
FIRST
NAME
TODAY'S
DATE
/
/
ADDITIONAL
COMMENTS:
__________________________________________________
_____________________________________________________________________
_____________________________________________________________________
THIS
INSPECTION
IS
PERFORMED
IN
AN
EFFORT
TO
HELP
YOU
PREPARE
FOR
YOUR
NEXT
LEVEL
1
INSPECTION.
IT
IS
RECOMMENDED
THAT
A
WALK
AROUND
AND
PRE-TRIP
INSPECTION
IS
PERFORMED
DAILY.
WE
HAVE
DOCUMENTED
THE
ITEMS
NOTED
ABOVE
THAT
WERE
FOUND
DURING
THIS
INSPECTION.
THIS
IS
NOT
A
COMPLETE
DOT
LEVEL
1
MEASURED
INSPECTION
AND
WE
MAKE
NO
CLAIMS,
WRITTEN
OR
IMPLIED,
AS
TO
THE
SAFETY
OF
YOUR
VEHICLE.
CIRCLE
ANY
MAJOR
OUT
OF
SERVICE
SAFETY
ITEMS
AND
DOCUMENT
IN
COMMENTS
SECTION.
1-800-824-7467
YOU
BREAK
DOWN.
WE
SHOW
UP.
COMMENTS:
______________________________________________________
______________________________________________________________
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
COMMENTS:
______________________________________________________
______________________________________________________________
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PASS
FAIL
PLU
815062
V.1
With our Mid-Trip Inspection, you can avoid these letters
and keep your trucks Rolling Safely and On Time.
Let us help you prepare for your next Level 1 inspection.
The Mid-Trip Inspection Form
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