Driver'S Daily Vehicle Inspection Report
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1DRIVER’S DAILY VEHICLE INSPECTION REPORT
VAN#________
MM/YY:__________
ENDING MILEAGE:___________________________________
Brakes
Steering Mechanism
Lighting Devices/Reflectors
Horn
Instrument Panel
Wheels/Rims
Tires
Windshield Wipers
Emergency/Safety Equipment
Mirrors
IF NO DEFICIENCIES ARE NOTED, INITIAL UNDER DATE INSPECTION PERFORMED
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If no defect or deficiency is discovered or reported to the driver, the report shall so indicate by initialing the corresponding date block below. If a deficiency is
noted, indicate the date, mileage, and nature of the deficiency below. If this is a SAFETY ISSUE or one that may CAUSE THE VAN TO HAVE A
MECHANICAL BREAKDOWN, call your Project Director IMMEDIATELY to arrange for a spare so your van can go in for repairs. If it is not an emergency, call
and make arrangements for the repairs to be completed as soon as possible. (Albuquerque-based vans, call Ken Thom at 833-1167 or 263-2123; all other
vans, call Cecil Stark at 982-0413, 667-6486, or 670-2107.) These inspections MUST BE PERFORMED DAILY and turned in to the SECA office with the
monthly report.
DEFICIENCIES NOTED:
Date:___________
Mileage:____________ Problem Found:________________________________________________________________________
Date:___________
Mileage:____________ Problem Found: ________________________________________________________________________
Date:___________
Mileage:____________ Problem Found: ________________________________________________________________________
SCHEDULED AND EMERGENCY MAINTENANCE SERVICES COMPLETED DURING MONTH: (attach receipts to this form)
Type of Service:__________________________________________________
Date Performed:___________
Mileage:________________________
Type of Service:__________________________________________________
Date Performed:___________
Mileage:________________________
SECA Form DDVI May 2000
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