Side 1
STATE OF CALIFORNIA
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
DAILY EQUIPMENT REPORT – LIGHT VEHICLES
ME-102 (Rev. 4/11)
(vehicles 3/4 ton or smaller and home storage permittee’s)
ASSIGNED LOCATION
MONTH
YEAR
THIS FORM MUST BE KEPT ON FILE FOR 5 YEARS
LICENSE
CAL FIRE N0.
RADIO NO.
X
Previous Month
Ending Mileage:
DATE
DAILY
ENDING
MILEAGE
TRIP
MILES
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
TIME
OUT
TIME
IN
END OF
DAY
LOCATION
GALS. of
FUEL
Bulk
Card
B
U
L
K
F
U
E
L
FUEL
TYPE
DRIVER’S
CERTIFICATION
SIGNATURE
S
T
A
T
E
F
U
E
L
C
A
R
D
CERTIFICATION OF SAFETY INSPECTION: By signing his/her name in the “Driver’s Safety
Inspection Certification Signature” blocks on this form, the driver certifies that he/she has
performed all of the safety inspection checks listed below, and that any problems affecting
driving safety were repaired prior to driving the vehicle each day. Remaining problems must be
documented on form ME-14 and routed as necessary to accomplish repairs.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Visually Inspect Tires for Wear and Proper Inflation
Check Engine Oil, Coolant and Fuel Levels
Windshield, Wiper Blades, Side and Rear Glass
Seats, Seat Belts, Loose Items, Horn, Rear View Mirrors.
Exterior Lighting – Headlight High and Low Beam, Turn Signals, Parking and
Clearance Lights, Brake Lights, Code 3 Lighting, Siren
Brakes: Drive Vehicle 10 ft., Apply Brakes, Check Operation
Check Emergency/Parking Brake Operation
Fire Extinguisher, First Aid Kit, Accident Forms, Vehicle Registration
Emergency Reflectors
HOME STORAGE PERMIT CERTIFICATION
Permittee hereby certifies that ALL usage and storage recorded meets the laws, rules and
regulations governing the use and storage of state and local government-owned vehicles (HB 6700).
Any personal use of a vehicle is considered by the state and the Internal Revenue Service as
compensation and will be taxed.
DATE ______________
PERMITTEE ________________________________________________________
PERMITTEE’S SUPERVISOR __________________________________________
PERMITTEE’S SIGNATURE _____________________________________________
24
25
26
27
28
29
30
31
Total days used
DAILY EQUIPMENT REPORT – LIGHT VEHICLES
PRE-USE VEHICLE SAFETY INSPECTION
NOTE: Daily Safety Inspection Procedure and Home
Storage Certification is shown on reverse side.
Total miles
Total bulk fuel
END OF DAY LOCATION: 1=En route
FUEL TYPE: 1=Gas 2=Diesel 3=LPG (Liquid Propane Gas)
2=State Facility 3=Residence address on file
4=CNG (Compressed Natural Gas) 5=E-85 (Ethanol)
4=On incident
At the end of each month total columns and ensure they are entered into the Fleet automated
system. Submit hard copy to the Unit Fleet Manager or the proper unit program