Form Center

2. Business Name

   Inspection must be completed and passed for each wrecker/service truck for which the above business has made application before said wrecker may be added to the rotation. 

4. Qualified Inspector's Name
6. Date of Inspection
7. Time
8. Company Unit #
10. Wrecker Year
11. Make
12. Model
14. VIN
15. USDOT#
17. Tag#/State
18. Tag Expires
19. 1. Roll Back
    2. Conventional
21. Wrecker Type:

    1. Class A
    2. Class B
    3. Class C
23. CLASS A WRECKER - CONVENTIONAL/ROLL BACK

    Minimum GVRW (Per manufacturer) greater than or equal to 10,000 pounds (conventional)  greater than or equal to 11,000 pounds (rollback

    1. YES

    1. NO

    1. N/A
25. Individual boom capacity (per manufacturer) greater than or equal to 8,000 pounds (conventional) 

    1. YES

    1. NO

    1. N/A
27. Individual PTO or hydraulic power winch capacity (per manufacturer) 􀀎 8,000 pounds, with minimum of 100-feet 3/8" cable (conventional) or minimum SO-feet 3/8" cable (rollback). NOTE: come-alongs, chains, or other similar devices shall NOT be used as substitutes for winch and cables. 

    1. YES

    1. NO

    1. N/A
29. Wheel lift with capacity (per manufacturer) greater than or equal to 3,500, with safety chains 

    1. YES

    1. NO

    1. N/A
31. Dual rear wheels

    1. YES

    1. NO

    1. N/A
33. Pair of magnetically mounted tow lights

    1. YES

    1. NO

    1. N/A
35. Minimum 16-foot bed (rollback)

    1. YES

    1. NO

    1. N/A
37. Brake lock device (rollback)

    1. YES

    1. NO

    1. N/A
39. 2 tie down chains - minimum 10-feet each (rollback)

    1. YES

    1. NO

    1. N/A
41. Class "B" Wrecker

    Minimum GVRW (per manufacturer) greater than or equal to 22,000 

    1. YES

    1. NO

    1. N/A
43. Boom assembly with minimum capacity (per manufacturer) greater than or equal to 24,000 pounds 

    1. YES

    1. NO

    1. N/A
45. Two winches, each with capacity (per manufacturer) greater than or equal to 10,000 each; NOTE: come-alongs, chains, or other similar devices shall NOT be used as substitutes for winch and cables. 

    1. YES

    1. NO

    1. N/A
47. Wheel lift with capacity (per manufacturer) greater than or equal to 6,500, with safety chains 

    1. YES

    1. NO

    1. N/A
49. Pair of magnetically mounted tow lights 

    1. YES

    1. NO

    1. N/A
51. Class "C" Wrecker*

    Truck chassis minimum GVWR (per manufacturer) greater than or equal to 46,000 pounds 

    1. YES

    1. NO

    1. N/A
53. Tandem axles or cab to axle length greater than or equal to 102 inches 

    1. YES

    1. NO

    1. N/A
55. Single or double boom capacity (per manufacturer) greater than or equal to 50,000 pounds 

    1. YES

    1. NO

    1. N/A
57. Single winch with capacity (per manufacturer) greater than or equal to 50,000 pounds, or two individual winches with capacity (per manufacturer) of greater than or equal to 25,000 pounds each and total rating of greater than or equal to 50,000 lbs; NOTE: come-alongs, chains, or other similar devices shall NOT be used as substitutes for winch and cables. 

    1. YES

    1. NO

    1. N/A
59. Wheel lift with capacity (per manufacturer) greater than or equal to 12,000 pounds, with safety chains 

    1. YES

    1. NO

    1. N/A
61. Minimum of 200-feet steel cable (5/8 inch) + 50-feet of 5/8-inch drop cable

    1. YES

    1. NO

    1. N/A
63. Airbrakes constructed so as to lock wheels automatically upon failure 

    1. YES

    1. NO

    1. N/A
65. Light and airbrake hookups 

    1. YES

    1. NO

    1. N/A
67. 2 chock blocks of width equal to that of dual rear wheels, capable of being tied to wrecker 

    1. YES

    1. NO

    1. N/A
69. Traffic cones (6) or reflective safety triangles (6) 

    1. YES

    1. NO

    1. N/A
71. Additional Equipment/Requirements - ALL CLASSIFICATIONS

    Exterior and interior well maintained, and clean appearance and condition; complies with all federal, state, and local laws and regulations 

    1. YES

    1. NO

    1. N/A
73. Tow bars

    1. YES

    1. NO

    1. N/A
75. Safety chains (minimum of 2) 

    1. YES

    1. NO

    1. N/A
77. Class C fire extinguishers {minimum of 2, mounted in accessible locations) 

    1. YES

    1. NO

    1. N/A
79. Pry bar or wrecker bar {minimum of 30") 

    1. YES

    1. NO

    1. N/A
81. Minimum of 3 safety flares (15-minute burn time) and/or 3 reflective safety triangles

    1. YES

    1. NO

    1. N/A
83. Push broom 

    1. YES

    1. NO

    1. N/A
85. Flat shovel 

    1. YES

    1. NO

    1. N/A
87. Axe

    1. YES

    1. NO

    1. N/A
89. Bolt cutters (minimum ½" opening} 

    1. YES

    1. NO

    1. N/A
91. Amber warning lights/light bar (360° visibility and greater than or equal to 1500' visibility under normal atmospheric conditions) 

    1. YES

    1. NO

    1. N/A
93. Dual rear, adjustable flood lights (minimum 20,000 candlepower) 

    1. YES

    1. NO

    1. N/A
95. Minimum of 40-pounds of absorbent material {sand, oil dry, etc.) 

    1. YES

    1. NO

    1. N/A
97. Current license plate/tag and registration paperwork with vehicle 

    1. YES

    1. NO

    1. N/A
99. Business name, address, phone number permanently affixed to both sides of wrecker; plainly visible at 100-feet 

    1. YES
    2. NO
    3. N/A
101. No markings on vehicles, uniforms, clothing, buildings, etc. that suggests or implies any official relationship between company and any law enforcement agency) 

     1. YES

     1. NO

     1. N/A
103. Evidence of current liability insurance in vehicle 

     1. YES

     1. NO

     1. N/A
105. Notes/Comments
Leave This Blank:


107. 1. Receive an email copy of this form.
108. Email address

     This field is not part of the form submission.

109. Submit

* indicates a required field