DL 65 ETP, ETP CDL Pre-Trip Inspection Evaluation Score Sheet

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...

3 downloads 766 Views 213KB Size
Date

test Location

VehicLe License no./traiLer iD pLate no.

roUte no.

ETP CDL PRE-TRIP INSPECTION EVALUATION SCORE SHEET examiner's signatUre

examiner DL no.

RESULT Number of errors ____________

x

passing

DriVer’s signatUre:

DriVer License no.

mechanical postponement

x cL a

TYPE VEHICLE cL B pV

Vehicle axles trailer axles air brakes

2 1 Yes

3 2 no (*)

(*) if vehicle has no air brakes, put a line through these components.

ALL VEHICLES

PRE-DRIVE CHECKLIST

oil level coolant level power steering fluid/(belt) Water pump (belt) alternator (belt) *air compressor (belt) Leaks/hoses

2. Brake lights 3. horn 4. emergency Flashers

TRUCK/TRACTOR Front of Vehicle Lights steering box/hoses steering linkage Front Suspension spring/air spring mount shock absorber

0 0 0 0 0 0

Front Wheel rims hub oil seal tires (i-c-D) Lug nuts

0 0 0 0

Front Brake *slack adjustor *Brake chamber Brake hoses/lines Brake drum/linings

0 0 0 0

Driver/Fuel Area Door, mirror Fuel tank/leaks Battery box

0 0 0

Under Vehicle Drive shaft exhaust system Frame

0 0 0

DL 65 etp part i (reV. 4/2003) WWW

Rear Wheels rims tires (i-c-D) axle seals Lug nuts spacers Rear Suspension springs/air/torque spring mounts shock absorbers Rear Brakes *slack adjustor *Brake chamber Brake hoses/lines Brake drum/linings Rear of Vehicle Lights/reflectors Doors/ties/lift splash guards

Engine Start

Engine Compartment

1. turn signals F / B

0 0 0 0 0 0 0

clutch/gearshift temperature oil pressure ammeter/voltmeter *air brake check (c-o-L-a) steering play parking brake/hydraulic

TRAILER F 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0

Coupling System catwalk/tongue storage area air/electric lines mounting bolts safety latch/locking jaws/ safety devices platform (fifth wheel/pintle hook) release arm Kingpin/apron/gap/tongue/drawbar sliding 5th wheel locking pins/sliding pintle

0 0 0 0 0 0 0 0

0 0 0

Side of Trailer Landing gear Frame, tandem release Lights/reflectors Doors/ties/lifts

0 0 0 0

Wheels rims tires (i-c-D) axle seals Lug nuts spacers

F 0 0 0 0 0

R 0 0 0 0 0

Suspension springs/air/torque spring mounts

0 0

0 0

Brakes *slack adjustor *Brake chamber Brake hoses/lines Brake drum/linings

0 0 0 0

0 0 0 0

Rear of Trailer Lights/reflectors Doors/ties/lift splash guards

mirrors, windshield Wiper/washers Lighting indicators (L-r-4-h) horn(s) heater/defroster safety belt/emerg (F-e-t)

0 0 0 0 0 0 0

0 0 0 0 0 0

BUS

Trailer Front air/electric connect header board Lights/reflectors

R 0 0 0 0 0

Unsatisfactory

0 0 0

Front of Vehicle Lights

0

Passenger Items passenger entry/lift emergency exits seating

0 0 0

Drive/Entry Area Door(s), mirror

0

Baggage Compartments Battery box 0 Doors secure 0 Rear Wheels rims tires (i-c-D) axle seals Lug nuts spacers

F 0 0 0 0 0

R 0 0 0 0 0

Front Brakes/Suspension air leaks/level 0 *slack adjustor 0 *Brake chamber 0 Brake hoses/lines 0 Brake drum/linings 0

Rear Brakes/Suspension air leaks/level 0 *slack adjustor 0 *Brake chamber 0 Brake hoses/lines 0 Brake drum/linings 0

Front Wheel rims hub oil seal tires (i-c-D) Lug nuts

0 0 0 0

Rear of Vehicle Lights/reflectors splash guards

Fuel Tank Area Fuel tank/leaks

0

0 0

THE PRE-TRIP MUST BE PASSED BEFORE SKILL AND ROAD TESTS ARE TAKEN.

Circle below the passing score for the type of vehicle the applicant is testing in on the applicant’s copy of the score sheet. Please enter the number on the front of the score sheet in the circle provided.

ETP CDL PRE-TRIP EVALUATION PASSING SCORES TRACTOR/TRUCK-TRAILER PASSING SCORES (Class A) With Air Brakes 3-axle tractor/truck

2 or more-axle trailer

22 errors or less

3-axle tractor/truck

1-axle trailer

19 errors or less

2-axle tractor/truck

2-axle trailer

19 errors or less

2-axle tractor/truck

1-axle trailer

15 errors or less

3-axle tractor/truck

2 or more-axle trailer

19 errors or less

3-axle tractor/truck

1-axle trailer

17 errors or less

2-axle tractor/truck

2-axle trailer

17 errors or less

2-axle tractor/truck

1-axle trailer

12 errors or less

No Air Brakes

STRAIGHT TRUCK/BUS PASSING SCORES straight truck (class B)

Bus (pV)

3 axles

13 errors or less

9 errors or less

2 axles

11 errors or less

8 errors or less

3 axles

12 errors or less

9 errors or less

2 axles

10 errors or less

8 errors or less

With Air Brakes

No Air Brakes

AIR BRAKE AUTOMATIC DISQUALIFICATION Failure to perform all four elements of the air brake check will result in an Automatic Disqualification for the CDL DPE.

DL 65 etp part i BacK (reV. 4/2003) WWW