School District or Contractor’s Name

Bus Identification No.

Date

Time

PLEASE CHECK “S” FOR SATISFACTORY OR “U” FOR UNISATISFACTORY (Ö) EACH COMPONENT CAREFULLY AND INDIVIDUALLY

Open Hood and Check:

With Engine Running, Driver Activates All Exterior

Lights, Walks Around the Bus and Checks:

S

U

S

U

S

U

Oil

Power Steering Fluid

Right Front Wheel and Tire

Coolant

Washer Fluid

Right Side Marker and Turn Signal

Battery

All Belts

Right Side Reflectors

Transmission Fluid

Wiring

Right Side Rear View and Safety Mirrors

Master Cylinder Brake Fluid

Crossing Control Arm (if applicable)

Headlights (high/low beams)

Front Turn Signal Lights

Signature of person performing above inspection if not the driver/ Date

Front Clearance Lights

Front Identification/Cluster Lights

Driver Enters Bus and Checks:

Front Eight Light Flashing System

S

U

S

U

Front Reflectors

Steps

Warning Devices

Windshield

Cleanliness

Fuses

Underside of Chassis

Seats

First Aid Kit

Crossover Mirror(s)

Seat Belts (if applicable)

Fire Extinguisher

Left Side Rear View and Safety Mirrors

Windows

Lettering

Left Front Wheel and Tire

Driver’s Side Window

Stop Arm Panel

Left Side Marker and Turn Signal Lights

Record odometer reading and confirm that the reading is not greater

Left Side Reflectors

than the miles recorded on the back of the Certificate of Safety. (If

Side Emergency Door (open and close) (if applicable)

odometer reading is greater, the Certificate of Safety has expired.)

Left Rear Wheel(s) and Tire(s)

Exhaust System (tail pipe clear?)

Driver Starts Engine, Activates All Interior Lights and Checks:

Rear Tail/Brake Lights

S

U

S

U

Rear Turn Signal Lights

Steering Wheel

Braking Warning Alarm

Rear Clearance Lights

Windshield Wipers and Washers

Controls and Indicators

Rear Identification/Cluster Lights

Heater and Defroster

Ammeter (voltmeter)

Rear Eight Light Flashing System

All Interior Lights

Gear Shift Lever

Rear Reflectors

Horn

Neutral Safety Switch

Rear Emergency Door (open and close) (if applicable)

Service Door (open & close)

Water Temperature Gauge

Right Rear Wheel(s) and Tire(s)

All Mirrors (adjustments)

Fuel Gauge

Fuel Tank Filler Caps

Sun Visor

Vacuum or Air Pressure Gauge

Drive Bus Forward and Apply Brakes

Emergency Exits (windows &

Odometer

S

U

doors) and Alarms

Switches

Service and Emergency Brake Operation

Clutch (if applicable)

Driver’s Seat Belt

REMARKS

Signature of Driver

Signature of Mechanic Making Report/Adjustments

Date Repairs/Adjustments Completed

IS2332 (rev 9/97)