FHWA Inspection Return to Forms Page Step 1 of 2 50% FHWA - PERIODIC INSPECTIONMonth*Enter 3 characters max.Year*Trailer*W/O #Registered OwnerControlling OwnerLicense NumberStateEnter state abbreviation (2-letters)Vehicle Identification Number (VIN)Location Inspection PerformedHub Reading Item CheckedLIGHTS OK?*Type 'OK' in the text box.LIGHTS NotesREFLECTORS OK?*Type 'OK' in the text box.REFLECTORS NotesWIRING OK?*Type 'OK' in the text box.WIRING NotesBRAKES OK?*Type 'OK' in the text box.BRAKES NotesAIRLINES OK?*Type 'OK' in the text box.AIRLINES NotesKINGPIN OK?*Type 'OK' in the text box.KINGPIN NotesTIRES OK?*Type 'OK' in the text box.TIRES NotesWHEELS & RIMS OK?*Type 'OK' in the text box.WHEELS & RIMS NotesFRAME & ASSEMBLY OK?*Type 'OK' in the text box.FRAME & ASSEMBLY NotesSUSPENSION OK?*Type 'OK' in the text box.SUSPENSION NotesAXLE OK?*Type 'OK' in the text box.AXLE NotesVerify Inspection* By checking this box, I certify that this unit was inspected and meets all FHWA-P149 C.F.R. Part396 requirements. Date* MM slash DD slash YYYY Inspector's Name*Inspector's Signature
