Inspection Report – C. M. High, Inc.

+1-888-123-1234 info@company.com

Menu

We Employ Level III
IMSA Certified Technicians

As Required By The D.O.T. Federal Motor Carrier Safety Regulations

Carrier: C. M. High, Inc.
Address: 341 King Street, Myerstown, PA 17067
Date: 01/16/2021
Check Any Defective Item And Give Details Under "Remarks"
Tractor / Truck No.*
Odometer Reading*
- Air Compressor
- Air Lines
- Battery
- Belts and Hoses
- Body
- Brake Accessories
- Brakes, Parking
- Brakes, Service
- Clutch
- Coupling Devices
- Defroster / Heater
- Drive Line
- Engine
- Exhaust
- Fifth Wheel
- Fluid Levels
- Frame and Assembly
- Front Axle
- Fuel Tanks
- Horn
- Lights:
  Head / Stop
  Tail / Dash
  Turn Indicators
  Clearance / Marker
- Mirrors
- Muffler
- Oil Pressure
- Radiator
- Rear End
- Reflectors
- Safety Equipment:
  Fire Extinguisher
  Flags/Flares/Fuses
  Reflective Triangles
  Spare Bulbs and Fuses
  Spare Seal Beam
- Starter
- Steering
- Suspension System
- Tire Chains
- Tires
- Transmission
- Trip Recorder
- Wheels and Rims
- Windows
- Windshield Wipers
- Other
Trailer(s) No.(s)
- Brake Connections
- Brakes
- Coupling Devices
- Coupling (King) Pin
- Doors
- Hitch
- Landing Gear
- Lights - All
- Reflectors / Reflective Tape
- Roof
- Suspension System
- Tarpaulin
- Tires
- Wheels and Rims
- Other
Remarks:
*
- Condition Of The Above Vehicle Is Satisfactory
Signature*
Email Copy To:*