FHWA-WFLHD Equipment Inspection Report.pdf

Inspector:___________________________ Location:____________________________ Contractor:__________________________ Date/Time:__________________________

FHWA-WFLHD -Equipment Inspection Report Inspections must occur during environmental conditions supporting good light and visibility.

Inspections must occur in conditions allowing full visibility of the equipment.

There should be no mud, dirt, soil, organic debris, sand, gravel, or plant parts on equipment.

Use flashlights and mirrors to inspect dark and hard-to-access portions of equipment.

WEATHER CONDITIONS: ________________________________________________________________

INSPECTION EQUIPMENT USED:

☐ Flashlight

☐ Undercarriage Mirror

WHAT INSPECTORS WILL NEED THE CONTRACTOR TO FACILITATE DURING INSPECTION:

☐ Turn on machines and move extensions as needed

☐ Drop belly pans/undercover

☐ Open side panels

☐ Spin track or wheels

☐ Open cab for interior inspection

☐ If inspection identifies soil and/or plant material on the vehicle, remove and dispose appropriately

☐ If soil or vegetative matter is removed, dispose at the locations below using described method:

REQUIRED CONTRACTOR-PROVIDED INFORMATION FOR EACH PIECE OF EQUIPMENT

☐ Previous Location ____ ______________________________________________________________

☐ Make, Model, Serial # _______________________________________________________________

INSPECT THE FOLLOWING ITEMS. CHECK BOX IF CLEAN. IF NOT APPLICABLE NOTE “NA”.

All Cracks Crevices, Panels Compartments ☐ Full Undercarriage ☐

Tire Treads Tracks; Rims; Fender Wells ☐ Spare Tire Mounting Area ☐

Bumpers (Inside and Outside) ☐ Around and Behind Grills ☐

Radiator Vent Openings ☐ Brake Mechanisms ☐

Transmission ☐ Stabilizer Bar ☐

Shock Absorbers ☐ Axles ☐

Beds and Bed Liners ☐ Suspension Units ☐

Exhaust Systems ☐ Light Casings and Mirrors ☐

Support Rollers ☐ Windshields, Windows, Windshield Wipers ☐

Between Rubber or Gridded Areas ☐ Hatches ☐

Hood Vents ☐ Interior Floor Mats ☐

Hitches and Accessories ☐

Inspection Results: ☐ PASSED ☐ FAILED Reason for Failure:_________________________________

Inspector Signature: _____________________________________ Date:_________________________