Fuel

Date

Driver Name

Vehicle / Bus #

You may submit this form multiple times per day. Fill out only what applies at that moment.

Did you log into the Samsara App and complete the Pre-Trip Inspection?

Yes No

Did you log into Samsara and complete the Post-Trip Inspection?

Yes No

If your trip exceeded 150 air miles(Local), did you properly complete ELD compliance within the Samsara App?

Yes No

If you are operating local (under 150 air miles), state your start time and end time:

Local Start Time

Local End Time

Vehicle Fuel Compliance