California Vehicle Inspection Form
Driver Info:
Drivers Full Name:
Drivers Phone #:
Inspection Date:
Visual Vehicle Inspection:
Visual Systems & Structures:
Pass Fail
Lights:
Pass Fail
Axles & Wheels
Headlights
Tail Lights
Drivetrain, Including Transmission &
Universal Joints for Leaks
Turn Signal Lights
Muffler & Exhaust System for Leaks
Break Lights
Breaks, Steering, Speed, Safety: Pass Fail
Interior & Doors:
Pass Fail
Visual Break Inspec0on
All Doors (Open, Close, Lock)
Parking Break Opera0on
Front Seat Adjustment
Steering Mechanism
Seatbelts (Driver & Passenger)
Speedometer
AC/Heat
Horn
Tires
Pass Fail
Bumpers
Tread
PSI
Windows/Mirrors
Pass Fail
/32
______________
Right Front
/32
LeV Front
______________
Windshield (No Cracks)
/32
______________
LeV Back
Rear Window & Other Glass
/32
Right Front
______________
Windshield Wipers
______________
Tire Pressure
Interior Rearview Mirror
Appearance & Cleanliness
Pass Fail
External Rearview Mirrors
Interior Cleanliness & Smell
Body Damage
Vehicle must pass all items in order to pass inspection.
To be Completed by Inspector
Check one:
PASS
FAIL
License Plate #: _________________________________
Vehicle Make: _________________________________
License State: _________________________________
Vehicle Model: _________________________________
Vehicle Mileage: _________________________________
Total # of Doors: _________________________________
Vehicle Year: _________________________________
VIN Last 8 Digits: _________________________________
Inspector Name: _________________________________
Inspector Company: _______________________________
Inspector Signature: ______________________________
State Bar Cer0ficate #: _____________________________
This inspec0on form reflects a 28 point inspec0on only on the date of the inspec0on listed above. For purpose of this inspec0on,
the wheels were not removed from the vehicle, and the vehicle was not put on a liV, nor was it checked for emissions, or test driven.