Vehicle Inspection Report Form - Liberty
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1VEHICLE FOR HIRE INSPECTION REPORT
CITY OF YANKTON
PO Box 176, Yankton, SD 57078
605-668-5243
VEHICLE INSPECTION REPORT
Vehicle Owner’s Name:
Telephone #:
Vehicle Year:
Make:
VIN #:
License Plate:
R = NEEDS REPAIR
P - PASS
1. BELTS, HOSES, LUBRICANTS
R P 7. STEERING
R P 11. BODY
R P
BELTS (P/S, AIR PUMP, ALT, A/C)
STEERING LINKAGES/COMPONENTS
LOOSE BODY PARTS
PULLEYS & WATER PUMP
BALL JOINTS
WINDSHIELD/WINDOW GLASS
COOLANT LEVEL
PINION SEALS
DOORS AND TRUNK/HATCH
TRANS FLUID LEVEL
TIRE WEAR
DOOR HANDLES
RADIATOR & PRESSURE CAP
TIRE WEAR/RIM CONDITION
FENDERS-FRONT
ENGINE OIL LEVEL
WHEEL ALIGNMENT-TEST/VISUAL
QUARTER PANELS-REAR
POWER STEERING FLUID LEVEL
PS PUMP AND LEAKS
BUMPER COVERS
BATTERY POSTS & CABLES
MIRRORS
LF
INTERIOR
RF
8. INSTRUMENTS
R P DECAL/COMPANY MARKING
OIL PRESSURE LIGHT
2. POLLUTION CTRL/FUEL SYS
R P ENGINE TEMP LIGHT
12. GENERAL
R P
FUEL LEADS (VISUAL)
BATTERY CHARGING SYSTEM LIGHT
HORN
GAS TANK
SRS AIRBAGS LIGHT
AIR CONDITIONER/HEATER
GAS GAUGE
CHECK ENGINE LIGHT
FAN SPEED
OIL LEAKS
TIRE PRESSURE LIGHT
WINDSHIELD WIPERS/WASHER
ODOMETER
HEADLIGHTS (HI/LOW BEAMS)
3. ENGINE/POWER ANALYSIS
R P TAXI METER (if used) OPERATIONAL
PARKING LIGHTS
ENGINE PERFORMANCE
RIGHT TURN LIGHTS
TEST
ENGINE NOISE
9. BRAKING SYSTEM
R P LEFT TURN LIGHTS
DRIVE
GENERAL BRAKE FUNCTION
GENERAL BRAKING FUNCTIONS
BRAKE LIGHTS
ENGINE MOUNTS
MECHANICAL COMPONENTS
PARKING BRAKE
13. TRUNK
R P
4. TRANSMISSION
R P FLUID LEVEL
SPARE TIRE
N/A
NORMAL TRAN OPERATION
DRUM/ROTOR CONDITION
TRUNK UPHOLSTERY CONDITION
TEST
SPEEDOMETER OPERATION
ABNORMAL EXHAUST/FUEL SMELLS
DRIVE
GEAR SHIFT INDICATOR
10. SUSPENSION FRAME (Driving Test)
R P
FRAME/ENERGY ABSORB BUMPER
14. INTERIOR
R P
5. DRIVE TRAIN
R P FRAME/CROSS BARS
UNCLEAN/DIRTY/SOIL/ODORS
DRIVE LINE:
STABILIZER BARS & LINKS
SEAT UPHOLSTERY CONDITION
TEST
NOISE
STRUT/SHOCKS
DASHBOARD CONDITION
DRIVE
VIBRATION
SPRINGS/BRUSHINGS
HEADLINER CONDITION
UNIVERSAL & CV JOINTS
SEATBELTS CONDITION
FLOORS (Excluding carpet stains)
6. EXHAUST SYSTEM
R P
EXHAUST PIPE/TAIL PIPE PLACEMENT
MUFFLER PLACEMENT
HANGARS/CLAMPS
LEAKS
COMMENTS:
Date of
Inspection
Technician Name (Print)
Technician Signature
Employee #
Inspection:
Results
Repair Pass
*******AUTO MECHANIC—ATTACH ASE A SERIES CERTIFICATION*******
I
swear under oath that I have thoroughly inspected the motor vehicle identified in
this application on
(Printed name)
and as of this date, the vehicle is in road worthy mechanical condition and free
of any reasonable
ascertainable mechanical defects that would endanger the safe operation of the vehicle for use in a taxicab
business,
.
(Signature)
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