Jiffy

Lube fleet #: 12363012

Vehicle Inspection

INSPECTION POINT



1.

Pass Fail

Foot brakes (pads/shoes thickness)

Min. per manufacture



Right Foot
Measurements _________
Left Foot
Measurements _________
Right Rear
Measurements _________
Left Rear
Measurements _________
2. Emergency brake (parking brake)


3. Steering Mechanism



Ball joints




Tie rods





Rack & pinion




Bushings




4. Windshield




Large crack




Small crack




5. Rear Window and other glass


6. Windshield wipers



7. Headlights




8. Tail lights




9. Turn indicator lights



10. Stop lights




11. Front seat adjustment

Vehicle Owner Name______________

Signature__________________________________
To Be Completed By Inspector (please print legibly)
Company__________________________________
License Plate #____________________________
Vehicle Make______________________________
Address___________________________
Inspector Name_____________________

INSPECTION POINT

Pass Fail
12. Doors (open, close, lock)

13. Horn



14. Speedometer


15. Bumpers



16. Muffler and exhaust system
17. Tire condition including tread depth

Right front
[32 nds/in] ___________

Left front
[32 nds/in] ___________

Right rear
[32 nds/in] ___________

Left rear
[32 nds/in] ___________
18. Interior and exterior rear view mirrors
19. Safety belts for driver & passengers
















VEHICLE INSPECTION PASS FAIL


(Please circle one)

Vehicle inspections must be passed annually.

Email__________________________________
Phone Number_______________________

Vehicle Mileage________________
VIN#_________________________
Vehicle Model__________________
________________________________________
Inspector Signature______________

Date___________________




Vehicle Year_________

Date_____________________

This inspection was completed by a technician or mechanic shop that is certified with the California Bureau of
Automotive Repair.


Upon completion of this inspection, email a picture or scanned copy of the signed form to apply@side.cr