Section 5310 Blank Inspection Form - Phoenix



CITY OF PHOENIX

PUBLIC TRANSIT DEPARTMENT – OPERATIONS DIVISION

VEHICLE MAINTENANCE INSPECTION

|Location: |Inspection Date: |Bus #: |

|Coordinated: |Follow-Up Inspection Date: |

|Lic. # : |Vin: |Make/Model: |

|Hub: |Scheduled: |Inspector: |

|PAS = Item Passed DEF = Item Defective COR = Item Corrected OS = Out Of Service |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Driver’s Area | | | | | |Front Dash Area | |

| | | | | | |Windshield | |

| | | | | | |Front/Side Visors | |

| | | | | | |Registration & Holder | |

| | | | | | |Annual Inspection |Expiration Date: |

| | | | | | |Emissions Test |Expiration Date: |

|Safety Equip. | | | | | |Fire Suppression |Expiration Date: |

|Safety Equip. | | | | | |Fire Extinguisher |Expiration Date: |

|Safety Equip. | | | | | |Triangles | |

| | | | | | |Accelerator/Brake Pedal | |

| | | | | | |Operator Seat & Belt | |

| | | | | | |Mirrors & Mirror Controls | |

| | | | | | |Wipers/Washer | |

| | | | | | |Horn/Steering Wheel | |

| | | | | | |Dash Panels & Lights | |

| | | | | | |Brake Air Leak Test | |

| | | | | | |Low Air Light /Alarm | |

| | | | | | |Warning Light/Alarms | |

| | | | | | |Check Gas: | |

| | | | | | |Fire Detector: | |

| | | | | | |Check VMS: | |

| | | | | | |Farebox Operation: | |

| | | | | | |Speedometer | |

| | | | | | |Transmission Controls | |

| | | | | | |Parking Brake | |

| | | | | | |AC/Defrost /Heat | |

| | | | | | |Reading Lights/Interior Dome | |

| | | | | | |Lights | |

| | | | | | |Front Door Operation & Overhead| |

| | | | | | |Lights | |

| | | | | | |Rear Door Operation & Overhead | |

| | | | | | |Lights | |

| | | | | | |DVIR Booklet | |

|Camera System | | | | | |Red Light Off | |

| | | | | | |Green Light On | |

| | | | | | |Parameters Ok | |

| | | | | | |Driver’s Barrier/ | |

| | | | | | |Side & Ceiling Panels | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Interior Equip. | | | | | |DVR S/N: | |

|Serial Num. & | | | | | | | |

|Operation | | | | | | | |

| | | | | | |PA S/N: | |

| | | | | | |Radio S/N: | |

| | | | | | |SMDT S/N: | |

| | | | | | |Farebox S/N: | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

| Interior | | | | | |Standee Sign/Line | |

| | | | | | |Radio Box & Drawers | |

| | | | | | |Ceiling Panels & Lofts | |

| | | | | | |Informational Signage/ | |

| | | | | | |Car Cards / Decals | |

| | | | | | |Stanchions/ Passenger Assists | |

| | | | | | |Floor Covering/ | |

| | | | | | |Step Well & Step Well Lights | |

| | | | | | |Passenger Seats | |

| | | | | | |Upper Level Modesty Panels | |

| | | | | | |Rear Door Modesty Panels | |

| | | | | | |Turntable Bellows | |

| | | | | | |Windows/Operation | |

| | | | | | |Emergency Exits | |

| | | | | | |Vandalism/Graffiti | |

| | | | | | |Cleanliness/Appearance | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Systems Check | | | | | |APC Test | |

| | | | | | |Rear Door Sensitive Edges | |

| | | | | | |Stop Request System | |

|Accessibility | | | | | | | |

|Features | | | | | | | |

|Kneeling System | | | | | |Operation | |

|Front Door | | | | | | | |

|Kneeling System Rear | | | | | |Operation | |

|Door | | | | | | | |

|Wheelchair Lift/Ramp | | | | | |Operation & Condition | |

|Wheelchair | | | | | |Operation & Condition | |

|Securements | | | | | | | |

|Palm Switches | | | | | |Operation & Condition | |

|Wheel Chair Stop | | | | | |Operation & Condition | |

|Request Chimes & | | | | | | | |

|Lights | | | | | | | |

|Enunciation | | | | | | | |

|System | | | | | | | |

| | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Air Conditioning | | | | | |Operation | |

| | | | | | |Compressor/Belt | |

| | | | | | |Refrigerant - Level | |

| | | | | | |Hoses & Valves | |

| | | | | | |Cores/Filters | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Undercarriage | | | | | |King Pins/ | |

| | | | | | |Wheel Bearings | |

| | | | | | |Steering Components | |

| | | | | | |Springs, Bellows | |

| | | | | | |Radius Rods | |

| | | | | | |Sway Bar, Bushings | |

| | | | | | |Shock Absorber/Bushings | |

| | | | | | |Engine/Trans Mounts | |

| | | | | | |Air Leaks | |

| | | | | | |Driveshaft/Protection | |

| | | | | | |Bulkheads | |

| | | | | | |Differential | |

| | | | | | |Body/Chassis Mounts | |

| | | | | | |Fuel System | |

| | | | | | |Under Body Hoses & Lines | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Brakes | | | | | |Brake Chambers | |

| | | | | | |Brake Interlock | |

| | | | | | |Relay Valves | |

| | | | | | |Air Lines/Hoses | |

| | | | | | |Slack Adjusters/ | |

| | | | | | |Check Travel | |

| | | | | | |Air Tanks/Dryers | |

| | | | | | |Wheels/Seals/ Fasteners | |

| | | | | | |Brake Shoes/Lining | |

| | | | | | |Springs/Rollers | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Engine | | | | | |Oil/Grease Leaks | |

|Compartment | | | | | | | |

| | | | | | |Cooling System | |

| | | | | | |Clamps & Brackets | |

| | | | | | |Belts/Guards | |

| | | | | | |Hoses/Lines | |

| | | | | | |Auxiliary Components | |

| | | | | | |Exhaust/Turbo | |

| | | | | | |Wiring/Batteries | |

| | | | | | |Fan Drive | |

| | | | | | |Transmission | |

| | | | | | |Engine S/N: | |

| | | | | | |Transmission S/N: | |

| | | | | | |A/C Compressor S/N: | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

|Exterior Lights & Body| | | | | |Brake Lights | |

|Condition | | | | | | | |

| | | | | | |License Plate Light | |

| | | | | | |Back-Up Lights & Alarm | |

| | | | | | |Tail Lights | |

| | | | | | |Marker Lights | |

| | | | | | |Hazard & Decel Lights | |

| | | | | | |Head Lights High & Low | |

| | | | | | |Turn Signals | |

| | | | | | |Reflectors | |

| | | | | | |General Body Condition | |

| | | | | | |Bike Rack | |

| | | | | | |Accident Damage | |

| | | | | | |Bumpers | |

| | | | | | |Owner/Operator Decals / | |

| | | | | | |Exterior Decals | |

| | | | | | |Paint | |

| | | | | | |Destination/Route Signs | |

| | | | | | |Cleanliness/Appearance | |

| | | | | | |Tires & Wheels | |

|Area |PAS |DEF |COR |OS |Repair Comp. |Item Inspected |Comments |

| | | | | |Date | | |

| | | | | | | | |

|Component | | | | | |Engine | |

|Cleaning | | | | | | | |

| | | | | | |Transmission | |

| | | | | | |Radiator | |

| | | | | | |Condensers | |

| | | | | | | | |

|Bus Placed Out Of | | | | | |1) | |

|Service For: | | | | | | | |

| | | | | | |2) | |

List Open Items Not Completed In the Thirty-Day Time Frame Below:

|Open Repair |Reason |Part Number |

| | | |

| | | |

| | | |

Below Are The Deficiencies Found On The Post-PMI Audits:

PMI Deficiencies

|Bus Number |Deficiencies |

| | |

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