ETP CDL PRE-TRIP INSPECTION AND SKILLS EVALUATION SCORE SHEET Pre-trip must be passed before skill/road tests are taken. To pass the skills test, you ...
Title: DL 65 ETP, ETP CDL Pre-Trip Inspection Evaluation Score Sheet Author: ca dmv Subject: index-ready This form is used to record the results of an ETP CDL pre
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ETP CDL PRE-TRIP INSPECTION AND SKILLS EVALUATION SCORE SHEET
STATE OF CALIFORNIA
DEPARTMENT OF MOTOR VEHICLES
Pre-trip must be passed before skill/road tests are taken. To pass the skills test, you must have no more than 12 errors overall.
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A Public Service Agency
DaTe
TesT locaTion
VeHicle license no./TRaileR iD PlaTe no.
DRiVeR’s siGnaTURe
eXaMineR siGnaTURe
RESULT
eXaMineR iD nUMBeR
X
DRiVeR license nUMBeR
X
safety Belts emergency equipment (F-e-T) safe start Temperature Gauge TRUCK air/electric connector COUPLINg SySTEM Mounting Bolts Pintle Hook Hitch Release lever safety Devices fORM A fRONT Of VEHICLE lights/Reflectors (l-R-4-Hl-HB-c) ENgINE COMPARTMENT oil level coolant level Power steering Fluid/Belt Water Pump/Belt alternator/Belt air compressor/Belt leaks/Hoses STEERINg steering Box/Hoses steering linkage fRONT AXLE Front Wheel Tires (i-c-D) Rims/Wheels lug nuts Hub oil seals Front Suspension springs/shocks U-bolts spring Mounts Front Brake Brake Hoses/lines Brake chamber slack adjustor/Push-Rod Drum/linings/Rotor/Pads
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ALL VEHICLES oil Pressure Gauge 0 Horn(s) ammeter/Voltmeter Gauge 0 Heater/Defroster air Gauge 0 Windshield/Mirrors lighting indicators (l-R-4-H) 0 Wipers/Washers ALL COMBINATION VEHICLES TRAILER TRACTOR air/electric connectors/lines 0 air/electric connectors/lines Tongue storage area 0 COUPLINg SySTEM COUPLINg SySTEM Mounting Bolts Tongue/Drawbar 0 Platform Mounting Bolts 0 locking Jaws/lever safety Devices 0 Release arm/safety latch sliding Pintle 0 5th Wheel skid Plate sliding 5th Wheel locking Pins fORM B fORM C (COMBINATION) fUEL AREA/UNDER/SIDE TRAILER/SEMI-TRAILER Driver/Fuel Area Trailer Front Door/Mirror 0 Header Board/Bulkhead Fuel Tank/cap/leaks 0 light/Reflectors (c) catwalk/steps 0 SIDE Of TRAILER lights/Reflectors (l-R-4-c) 0 landing Gear Under Vehicle Frame/Tandem Release Drive shaft 0 Doors/Ties/lifts exhaust system 0 lights/Reflectors (l-R-4-c) Frame 0 TRAILER AXLES REAR AXLES Wheels Rear Wheels Tires (i-c-D) 0 Rims/Wheels Tires (i-c-D) Rims/Wheels 0 lug nuts lug nuts 0 axle/Hub oil seal axle seal 0 spacers/Budd spacing spacers/Budd spacing 0 SUSpenSion Rear Suspension springs/airbags/shocks springs/airbags/shocks 0 U-bolts U-bolts 0 spring/air Mounts/Torque arm spring/air Mounts/Torque arm 0 BRAkeS Rear Brakes Brake Hoses/lines Brake Hoses/lines 0 Brake chamber Brake chamber 0 slack adjustor/Push Rod slack adjustor/Push Rod 0 Drum/linings/Rotor/Pads Drum/linings/Rotor/Pads 0 ReAR oF TRAileR REAR Of VEHICLE Doors/Ties/lift Doors/Ties/lift 0 splash Guards splash Guards 0 lights/Reflectors (l-R-4-Tl-Bl-c) lights/Reflectors (l-R-4-Tl-Bl-c) 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
Parking Brake service Brake/aBs air Brake check (c-o-l-a-s) Hydraulic Brake check SEMI-TRAILER air/electric connectors COUPLINg SySTEM Kingpin apron Gap
ALL PASSENgER VEHICLES PASSENgER ITEMS Passenger entry/lift emergency exits seating BAggAgE COMPARTMENT Doors secure SCHOOL BUS (ONLy) STUDENT LIgHTS student lights (Front, Back) STUDENT SAfETy ITEMS stop arm/safety arm student Mirrors emergency Kit/Body Fluid Kit
0 0 0 0 0 0 0 0
0 0 0 0
TyPE Of VEHICLE Vehicle axles 1 2 3 number correct Trailer axles 1 2 Passing air Brakes Yes no Unsatisfactory GVWR Truck GVWR Trailer Mechanical cla Postponement clB PV BASIC CONTROL SKILLS TEST SIgHT-SIDE PARALLEL PARK CONVENTIONAL PARALLEL PARK Pull-ups 0 0 1 2 3 4 5 Pull-ups 0 0 1 2 3 4 5 encroachment 2 4 6 8 10 encroachment 2 4 6 8 10 looks 0 0 looks 0 0 inside Parallel 0 10 inside Parallel 0 10 OffSET BACK RIgHT OffSET BACK LEfT Pull-ups 0 0 1 2 3 4 5 Pull-ups 0 0 1 2 3 4 5 encroachment 2 4 6 8 10 encroachment 2 4 6 8 10 looks 0 0 looks 0 0 Final Position 0 10 Final Position 0 10 STRAIgHT LINE BACKINg ALLEy DOCK Pull-ups 0 1 2 3 4 5 Pull-ups 0 0 1 2 3 4 5 encroachment 2 4 6 8 10 encroachment 2 4 6 8 10 looks 0 looks 0 0 Final Position 0 10 inside alley 0 10 (3ft. Box) BASIC CONTROL SKILLS SUMMARy Unable to understand direction given in english 1 2 3 cited under Federal Regulation §391.11(b)(2).
0 sight side PP offset Back Right 0 st. line Backing 0 0
Total errors = Pass Fail conventional PP Pass Fail offset Back left Pass Fail alley Dock COMMENTS:
Pass Pass Pass
Fail Fail Fail
PRE-TRIP SUMMARy Unable to communicate in the english language only
1 2 3 cited under Federal Regulation §391.11(b)(2).
0 0 0 0 0 0 0 Dl 65 eTP PaRT i (ReV. 11/2011) WWW
PASSINg SCORES COMBINATION VEHICLES & STRAIgHT TRUCKS VEHICLE Pre-Trip form PRE-TRIP form A (Total is number of correct answers) form B
Class A
Class B and C
Air Brakes
No Air Brakes
Air Brakes
No Air Brakes
35
33
27
24
67
61
43
39
form C form full BASIC SKILLS EXERCISES (Total is number of errors)
12 errors or less (all vehicles)
COACH/TRANSIT & SCHOOL BUS VEHICLE Pre-Trip form PRE-TRIP (Total is number of correct answers) form A form B form full BASIC SKILLS EXERCISES (Total is number of errors)
