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Fill Out a Valid Dot Vehicle Inspection Template

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Content Overview

Guide to Writing Dot Vehicle Inspection

Filling out the DOT Vehicle Inspection form is an important task that ensures your vehicle meets safety standards. To make the process easier, follow these straightforward steps. You’ll need to gather some basic information about the vehicle and the inspection company before you start.

  1. At the top of the form, fill in the Name and Address of the inspecting company or agency.
  2. Enter the Registered Owner’s Name.
  3. Write the Date and Time of the inspection.
  4. Provide the Street, City, State, Zip Code of the registered owner.
  5. Print or type the name of the Certified Inspector.
  6. If different from the owner, fill in the Motor Carrier Operating Vehicle details, including the Street, City, State, Zip Code.
  7. Complete the Technician’s Signature section.
  8. Fill in the License Plate Number/State and the Vehicle Identification Number.
  9. Enter the Vehicle Make, Vehicle Model, and Model Year.
  10. Inspect the vehicle components listed and mark each item as follows: x for OK, o for Needs repair, and NA for Does not apply.
  11. For any items needing repair, fill in the Repair Date next to each relevant component.
  12. Certify the inspection by signing and dating in the Certified Inspector’s Signature section.
  13. Complete the Inspector Qualifications section by checking the appropriate boxes and providing any necessary details.
  14. Finally, ensure that the evidence of inspector qualification is on file.

Once you have completed the form, keep it on board the vehicle or display it as a decal. Remember to retain this report for at least fourteen months from the date of completion. This helps ensure compliance with federal regulations and promotes safety on the road.

Document Breakdown

Fact Name Details
Purpose of the Form The DOT Vehicle Inspection form is designed to ensure that commercial vehicles are thoroughly inspected for safety and compliance with federal regulations. This includes checking various vehicle components to maintain road safety.
Governing Laws This inspection must comply with 49 CFR §396.17, which outlines the requirements for annual vehicle inspections, as well as relevant state regulations that may apply.
Inspector Qualifications Inspectors must meet specific qualifications, including understanding inspection criteria and having the necessary training or experience, as stipulated in 49 CFR §396.19.
Record Keeping The inspection report must be kept on file for a minimum of fourteen months from the date of completion. This ensures that there is a record of compliance available for review.

FAQ

  1. What is the purpose of the DOT Vehicle Inspection form?

    The DOT Vehicle Inspection form is designed to ensure that commercial vehicles meet safety standards. It serves as a record of the annual inspection required by federal regulations. By documenting the condition of various vehicle components, the form helps identify any issues that may affect safe operation on the road.

  2. Who is qualified to perform the inspections outlined in the form?

    Inspectors must meet specific qualifications as set forth by federal regulations. They should understand the inspection criteria and be knowledgeable about the tools and procedures used during inspections. Acceptable qualifications include completion of a state or federal training program, or a combination of experience and training totaling at least one year in related fields. This ensures that only skilled technicians carry out inspections.

  3. What components are inspected using the DOT Vehicle Inspection form?

    The form covers a wide range of vehicle components, including:

    • Brake system
    • Steering system
    • Lighting devices
    • Exhaust system
    • Tires and wheels
    • Wipers and windshields
    • Coupling devices
    • Safe loading securement

    Each component is marked as either "OK," "Needs Repair," or "Does Not Apply" to provide a clear overview of the vehicle's condition.

  4. How long must the inspection report be kept?

    According to federal regulations, the inspection report must be retained for a minimum of fourteen months from the date of completion. This ensures that there is a record available for review, which can be important for compliance and safety purposes.

  5. What happens if a vehicle needs repairs after inspection?

    If any components are marked as "Needs Repair," it is essential for the vehicle owner or operator to address these issues promptly. The form allows for recording the repair dates next to the respective items. Once repairs are completed, the vehicle should be re-inspected to ensure compliance with safety standards before returning to service.

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Dot Vehicle Inspection Example

Annual Periodic Vehicle Inspection Report

Name and Address of Inspecting Company or Agency

Registered Owner’s Name

 

Date

 

 

Time

 

 

 

 

 

 

Street

 

Certified Inspector’s Name (Print or Type)

 

 

 

 

 

 

 

City, State, Zip Code

 

The signing of this inspection report certifies that the technician

 

 

meets and exceeds all requirements of 49 CFR §396.17 and

Motor Carrier Operating Vehicle (If different from Owner)

compatible state regulations and that the technician has the

 

 

 

 

necessary tools, and is skilled in completion of the annual

Street

 

inspection, as listed in 49 CFR §396.17

 

 

 

 

 

 

 

 

 

 

 

 

City, State, Zip Code

 

 

 

 

 

 

 

Technician’s Signature______________________________

 

 

 

 

 

License Plate Number/State

Vehicle Identification Number

Vehicle Make

Vehicle Model

Model Year

 

 

 

 

 

 

Vehicle Components Inspected

OK

Need

Repair

Item

OK

Need

Repair

Item

OK

Need

Repair

Item

 

Repair

Date

Repair

Date

Repair

Date

 

 

 

 

1. BRAKE SYSTEM

 

 

 

5. FUEL SYSTEM

 

 

 

10. SUSPENSION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjustment

 

 

 

Visible Leaks

 

 

 

Springs (cracked/broken/shifted)

 

 

 

 

Drums or Rotors

 

 

 

Fill Caps in place/intact

 

 

 

U-bolts. Hangers, etc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hoses and/or Tubing

 

 

 

Tank(s) securely attached

 

 

 

Torque, Radius, Tracking Arms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lining

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. LIGHTING DEVICES

 

 

 

11. FRAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Warning (Low Pressure)

 

 

 

Headlamps

 

 

 

Frame Members

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tractor Protection Valve

 

 

 

Front Turn Signals

 

 

 

Tire & Wheel Clearance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Air Compressor

 

 

 

Front ID/Clearance Lamps

 

 

 

Sliding Subframe (adj. axle)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Service Brakes

 

 

 

Side Marker Lamps – Left

 

 

 

12. TIRES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Parking Brakes

 

 

 

Side Marker Lamps -Right

 

 

 

Steering Axle Tires -Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Electric Brakes

 

 

 

Rear Turn Signals

 

 

 

Steering Tires - over 4/32” tread

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hydraulic Brakes

 

 

 

Stop Lamps

 

 

 

Other Tires – Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vacuum Brakes

 

 

 

Tail Lamps

 

 

 

Other Tires – over 2/32” tread

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Warning (Sys Failure)

 

 

 

Rear ID/Clearance Lamps

 

 

 

 

 

 

 

 

 

 

 

 

 

13. WHEELS & RIMS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reflectors / Ref Tape

 

 

 

Lock/Slide Ring

 

 

 

 

2. STEERING SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Free Play (Lash)

 

 

 

 

 

 

 

Fasteners

 

 

 

 

 

 

 

7. COUPLING DEVICES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Steering Column

 

 

 

5T H Wheel

 

 

 

Disk/Spoke Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Front Axle Beam

 

 

 

Pintle Hooks

 

 

 

Welds

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Steering Gear Box

 

 

 

Drawbar Eye

 

 

 

 

 

 

 

 

 

 

 

 

 

List any other condition

 

 

 

 

 

 

 

 

 

 

 

 

which may affect safe

 

 

 

 

Pittman Arm

 

 

 

Drawbar Tongue

 

 

 

 

 

 

 

 

 

 

 

 

 

 

vehicle operation

 

 

 

 

Ball & Socket Joints

 

 

 

Safety Devices

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tie Rods & Drag Links

 

 

 

8. EXHAUST SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nuts, Bolts, Fasteners

 

 

 

Leaks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Power Steering Fluid

 

 

 

Placement

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. WINDSHIELDS

 

 

 

9. SAFE LOADING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Securement Devices

 

 

 

 

 

 

 

 

4. WIPERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MARK COLUMNS AS FOLLOWS: x = OK; o = Needs repair; NA = Does not apply; Fill in Repair date as appropriate

I CERTIFY THE ANNUAL VEHICLE INSPECTION HAS BEEN DONE ACCURATELY AND COMPLETELY. I FURTHER CERTIFY THAT THIS INSPECTION COMPLIES WITH THE REQUIREMENTS OF 49 CFR §396.21.

This information must be available on board the vehicle, either as a copy of this report, or on a decal that complies with 49 CFR §396.17(c)(2). This report must be kept a minimum of fourteen months from date of completion

Certified Inspector’s Signature:

 

Date:

 

 

 

INSPECTOR QUALIFICATIONS

Certification — 49 CFR §396.19

Motor carriers are responsible for ensuring that individual(s) performing an annual inspection under §396.17 are qualified as follows:

•Understands the inspection criteria set forth in Part 393 and Appendix G and can identify defective components

•Is knowledgeable of and has mastered the methods, procedures, tools and equipment used when performing an inspection

•Is capable of performing an inspection by reason of experience, training, or both, and qualifies in one of the following categories (check all that apply):

I.___ Successfully completed a State or Federal training program or has certificate from a State or Canadian Province which qualifies the person to perform commercial vehicle safety inspections.

Specify: _______________________________________

II.___ Have a combination of training or experience totaling at least one year as follows (check all that apply):

a.___ Participation in a truck manufacturer-sponsored training program or similar commercial training program designed to train students in truck operation and maintenance.

Where and Date: _____________________________________________________

b.___ (years) experience as a mechanic or inspector in a motor carrier maintenance program.

Name and Date: _____________________________________________________

c.___ (years) experience as a mechanic or inspector in truck maintenance at a commercial garage, fleet leasing company, or similar facility.

Name of Facility and Dates: ____________________________________________

d.___ (years) experience as a commercial vehicle inspector for a State, Provincial, or Federal Government.

Where and Dates: ____________________________________________________

I certify the above information is true and accurate to the best of my knowledge.

Employee ______________________________________

________________

Signature of Mechanic/Inspector

Date

Motor Carrier/Company ____________________________________

________________

Signature of Employer/Supervisor

Date

Evidence of Inspector Qualification is on file at:

_______________________________

BRAKE INSPECTOR QUALIFICATIONS

Certification — 49 CPR §396.25

“Brake Inspector” means any employee of a motor carrier who is responsible for ensuring all brake inspections, maintenance, service, or repairs to any commercial motor vehicle, subject to the motor carrier’s control, meet the applicable Federal standards.

No motor carrier shall require or permit any employee who does not meet minimum brake inspector qualifications to be responsible for the inspection, maintenance, service or repairs of any brakes on its commercial motor vehicles.

Minimum Qualifications

•Understands and can perform brake service and inspection

•Is knowledgeable of and has mastered the methods, procedures, tools and equipment necessary to perform brake service and inspection

•Is capable of performing brake service or inspection by reason of experience, training, or both, and qualifies in one of the following categories (check all that apply):

I.___Has successfully completed an apprenticeship program sponsored or approved

by a State, Canadian Province, a Federal agency or labor union, or has a certificate from a State or Canadian Province which qualifies the person to perform brake service or inspections.

Specify: ________________________________________________________________

II.___ Has brake-related training or experience or a combination thereof totaling at least one year as follows (check all that apply):

a.___Participation in a brake maintenance or inspection training program sponsored by a brake or vehicle manufacturer or similar commercial training program.

Where and Date:_______________________________________________

b.___ (years) experience performing brake maintenance or inspection in a motor carrier maintenance program.

Name and Date:_______________________________________________

c.___ (years) experience performing brake maintenance or inspection at a commercial garage, fleet leasing company, or similar facility.

Name of Facility and Dates:______________________________________

I certify the above information is true and accurate to the best of my knowledge.

Employee ______________________________________

________________

Signature of Mechanic/Inspector

Date

Motor Carrier/Company ____________________________________

________________

Signature of Employer/Supervisor

Date

Evidence of Inspector Qualification is on file at:

_______________________________