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Run: Driver Roadside Inspection Response Form

Track a roadside inspection from stop to closure, including CVSA outcome, OOSC status, DVIR clearance, and corrective actions. Use it to document what happen...

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Inspection Overview

Inspection Date (required)

Date the roadside inspection occurred.

Inspection Time

Approximate time of the inspection, if known.

Inspection Location

General location of the inspection. Do not include unnecessary personal data.

Driver Name (required)

Name of the driver involved in the inspection.

Vehicle Unit Number (required)

Fleet unit or tractor number associated with the inspection.

Trailer Number

Trailer number, if applicable.

Inspecting Agency

Agency or authority that conducted the inspection.

CVSA Inspection Outcome

CVSA Inspection Result (required)

Select the overall outcome of the CVSA roadside inspection.

CVSA Level

Inspection level, if known.

Number of Violations

Total number of violations identified during the inspection.

Inspection Report Number

Reference number from the inspection report or citation record.

Inspection Summary

Brief summary of the inspection findings and any immediate operational impact.

Violation and OOSC Details

Violation Categories

Select all categories that apply.

Violation Details

Describe each violation and the cited condition(s).

Was an Out-of-Service Condition Issued?

Indicate whether the vehicle, driver, or both were placed out of service.

OOSC Type

Select the type of out-of-service condition, if applicable.

OOSC Resolution Notes

Describe the corrective actions taken to resolve the out-of-service condition.

DVIR Clearance and Corrective Actions

Was a DVIR Required? (required)

Indicate whether a Driver Vehicle Inspection Report was required for this event.

DVIR Clearance Status

Current DVIR clearance status.

Defect Correction Date

Date the defect or issue was corrected, if applicable.

Corrective Actions Taken

Describe the repairs, inspections, or administrative actions completed to close the issue.

Supporting Documents

Upload repair orders, inspection reports, or other supporting evidence.

Review and Submission

Submitted By (required)

Name of the person submitting this form.

Submission Role (required)

Role of the person submitting the form.

I confirm this information is accurate to the best of my knowledge. (required)

Required acknowledgement before submission.

Yes No N/A

Additional Notes

Optional notes for compliance review or follow-up.

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