AEPS Electric – Vehicle Safety Inspection

Header Information

Date

Time

Employee Filling out Form

Inspection Location

Vehicle Information

Vehicle Type

Vehicle Number

License Plate

Odometer (mi)

Inspection Type

Start of Shift End of Shift Weekly Inspection Other

Safety Checklist

✅ OK ⚠️ Needs Attention — N/A

Item	OK	Attn	N/A

Issues Found Summary

✅ No issues marked — all items OK or N/A

Follow-Up Actions

Action Required?

Yes No

Reported To

Date Reported

Resolution Notes

Resolved By

Resolution Date

Employee Certification

By signing below, I certify that I inspected this vehicle and reported any visible safety concerns.

Employee Signature

Sign above

Date