Pre-Trip Vehicle Inspection Daily Form
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1NAVY CHILD AND YOUTH PROGRAMS
PRE-TRIP VEHICLE INSPECTION
DAILY FORM
For the Week of: ___________________________________________________________________________
REQUIRING DIRECTIVE OPNAV 1700.9
VEHICLE NUMBER:
ODOMETER READING:
(Recorded on Monday)
Please use the LEGEND below to complete this form:
Y = YES
N = NO
N/A = For Contracted Vehicles
ITEMS FOR SCHOOL PICK UP/TRIP:
M
T
W
TH
F
S
Cell Phone or Two Way Radios
Children’s Emergency Information
(CNICCYP1700/04 CYP Registration Form)
Children’s Pick up Lists
(if applicable)
Gas Card
(if applicable)
Statement of Government Vehicle Insurance
OUTSIDE WALK AROUND INSPECTION
M
T
W
TH
F
S
Tires
(check for proper inflation and wear)
Mirrors Adjusted Properly
Exterior Lights
(Turn Signals, Brake Lights, Headlights, Hazard Lights)
Outside Body of Vehicle
(check for damages)
Doors
(check to ensure all open/close)
BEFORE STARTING ENGINE:
M
T
W
TH
F
S
Seats/Seatbelts
(Ripped, Frayed, or Broken)
Complete First Aid Kit
(Checklist maintained in the kit)
Emergency Equipment
(Flares, Reflective Triangles, Cones, etc)
Emergency Procedures in Vehicle
Vehicle Log Book
(if applicable)
Fire Extinguisher Charged
AFTER STARTING ENGINE:
M
T
W
TH
F
S
Interior Lights – Exit Signs
Gas Levels
Heating and Air Conditioning
Horn Works
Windshield Wipers
(Work, Blades not Worn, Fluid
Full)
TRIP DESTINATION
M
T
W
TH
F
S
Vehicle is Clean and Free of Trash
Complete Walk Through Vehicle Before Securing
Driver’s Initials Every Day
Explanation of problems noted during pre-inspection and/or travel:
(Please report problems to Supervisor)
CNICCYP 1700/26 (Rev 09-08)
FOR OFFICIAL USE ONLY
PAGE 1 OF 1
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