Exhibit 5 - FTC-FAC-55 - Vehicle Usage Report.pdf

FTC-FAC - 55 (12/87) DAILY VEHICLE USAGE REPORT

Vehicle Tag # Driver's Name (print) Date Class/Organization

Driver Odometer Reading Time Before Operations Check Checked Action

Taken Ending:___________ Out:______________ Lisence plates, forms (including accident report)

Beginning:_________ In:________________ Lights, signals, windshield wipers, horn

Total Miles:________ Tools and safety equipment

CONDITION (report any irregular conditions, Clean vehicle such as dents, scratches).

Engine oil level

Radiator coolant level and hoses - A/C - heater

Tire condition & pressure including spare

Battery fluid level

Power steering fluid level, hoses, and lines VEHICLE OPERATION (report any defects

Automatic transmission fluid level noted during operation).

Gauges and indicator lights

Fuel level

Starter

DRIVER'S SIGNATURE

Off Station Approval

YES______ NO_______

Initials

IN CASE OF AN EMERGENCY

1. NOTIFY FLETC SECURITY -PHONE (505) 748-8136

2. COMPLETE ACCIDENT FORM LOCATED IN POCKET OF VEHICLE

IN CASE OF MECHANICAL PROBLEMS

1. During duty hours 7:00AM to 5:00 PM, notify FLETC auto shop at 748-8055 with the following information:

a. Location:_____________________________________________________________________________

b. Vehicle Tag No:_______________________________________________________________________

c. Location of vehicle keys: ________________________________________________________________

2. After duty hours, notify FLETC Secuirity at 748-8136 with information listed in paragraph 1

SECTION J - EXHIBIT 5

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