Monthly Inspection Report

Owner-Operators are required to submit this form by the 1st of the following month.



Owner-Operator Name
For Month of
Date
Tractor#
Trailer#
Odometer Reading
If you fail to complete this Report, Wellsite will be unable to Dispatch you on your next load. ALL DEFECTS & REPAIRS ON DVIRS FOR THE MONTH MUST BE INDICATED ON THIS REPORT. Repair Section – List all Repairs Made, Parts, or Equipment Installed. Please Attach Receipts
DateDescriptionLocation (City/State)
Lubrication Record-Please enter a check mark under each item serviced(Provide copy of receipts)
DateMiles LubeOil Filter Trans Diff R.EndWheel
Bearing
Tire Depth Record for All (In 32 nds) Attach Copy of Receipts Indicating Location of Replaced Tires.
 
      
  
TRACTOR  TRAILER  
  
      
 

Wellsite requires Owner-Operators to perform monthly preventative maintenance on all equipment operated. On a monthly basis you should check all items listed below and initial if okay and does not require repair at this time. Replace parts as needed – Attach copy of Receipts. .


Initial Service Checklist
 Check Fluid Levels, Antifreeze (Level &Degree) 
Power Steering Rear Ends Trans 
Steer Hubs  Engine Oil  Washer Fluid
 Replace all Oil, Fuel&Water Filters, Change Oil.

 Check Air Filter Indicator-Replace every 50,000 miles or as needed.
Check King Pins & U-Joints before greasing.
Check all front suspension & Steering Parts & Lube.

Lube Suspension & U-Joints

Check Driveline & Drive Axle for Damage.
Inspect and Adjust brakes; shoes, Cams, Boosters.
Leaking Wheel Seals; Differential Seals.
Check Clutch Adjustment
Air Tires & Check Abnormal Wear
Check Lug Nuts / Drain Tanks
Check Batteries & Cable Ends
Inspect Engine Belts
Inspect Hoses and Clamps
Check all lights, interior, Gauges, Brake, Marker & Load Lights.
Check Trailer Pig Tail Cord, Air Hoses & Glad Hands.
Check condition & Operation of wiper blades and washer.

Check Cab, Bunk, Engine & Transmission Mounts for Damage or wear.
Check Fuel Tank Mounting straps & bolts.
Check for Tags, Permits & Annual Vehicle Inspection.
Check mud flaps & Fender

Check Safety equipment / Triangles, fire extinguisher, fuses, first aid kits.
Lubricate all door locks & Hinges as needed.
Check differential lock and fifth wheel slide.
Visual Inspection for leaks and future repairs.
Be sure cab hood is locked down securely.
Check that Emergency Response Books are in Cab.
Check that Haz-Mat spill response number is readily available
Check that truck has necessary and required paperwork that hasn’t expired.
Check that you have checked everything!
Signature: