Vehicle Inspection Checklist
| Store # |
7127 - Bremerton 3720 Kitsap Way # C Bremerton, WA 98312 (360) 373-2020 |
| Driver First Name |
Matthew
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| Driver Last Name |
Dotterweich
|
| Photo of drivers license | |
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| Photo of insurance card | |
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| Declarations page | |
| Photo of registration | |
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| Items | |
| Seat Belts | Pass |
| Brakes | Pass |
| Horn | Pass |
| Windshield and wipers | Pass |
| Tires (Safe Thread Depth) | Yes |
| Photo | |
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| Both headlights | Pass |
| Reverse lights | Pass |
| Brake lights | Pass |
| Both tail lights | Pass |
| Turn signals | Pass |
| Vehicle image: | Pass |
| Photo | |
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| Are there any failures on this inspection? | No |
| Is the driver being pulled from the road? | |
| COMMENTS: | |
Driver's Signature
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| Inspecting Person's Name |
Samuel Elrod
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Inspecting Person's Signature
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