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Welds 5. LIGHTING DEVICES a. Headlamps 12. WINDSHIELDS/Glazing 13. WIPERS/WASHER DEFROSTERS b. Tail Lamps 14. PERIODIC VEHICLE INSPECTION REPORT 1. Date MM/DD/YYYY 2. Insp.Location Address 3. Time AM / PM 4. DECAL 5. Veh Make 6. Mod. Yr 8. Odometer Reading C or H 9. VIN 12. Owner Name 13. Owner Str. Address 14. City State ZIP 15. Carrier Name 16. Carrier Str. Address 18. Owner USDOT PASS FAIL 19. Carrier USDOT N/A 10. Lic 20. Inspector Name 7. COUPLING DEVICES a. 5th Wheel Mounting/King Pin...
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