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

STATE OF CALIFORNIA

DEPARTMENT OF MOTOR VEHICLES?

A Public Service Agency

DaTe

VeHicle license no./TRaileR iD PlaTe no.

safety Belts

0

emergency equipment (F-e-T)

0

safe start

0

Temperature Gauge

0

TRUCK

air/electric connector

0

COUPLING SYSTEM

Mounting Bolts

0

Pintle Hook

0

Hitch Release lever

0

safety Devices

0

FORM A

FRONT OF VEHICLE

lights/Reflectors (l-R-4-Hl-HB-c)

0

ENGINE COMPARTMENT

oil level

0

coolant level

0

Power steering Fluid/Belt

0

Water Pump/Belt

0

alternator/Belt

0

air compressor/Belt

0

leaks/Hoses

0

STEERING

steering Box/Hoses

0

steering linkage

0

FRONT AXLE

Front Wheel

Tires (i-c-D)

0

Rims/Wheels

0

lug nuts

0

Hub oil seals

0

Front Suspension

springs/shocks

0

U-bolts

0

spring Mounts

0

Front Brake

Brake Hoses/lines

0

Brake chamber

0

slack adjustor/Push-Rod

0

Drum/linings/Rotor/Pads

0

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 must have no more than 12 errors overall.

TesT locaTion

DRiVeR's siGnaTURe

X

eXaMineR siGnaTURe

X

eXaMineR iD nUMBeR DRiVeR license nUMBeR

RESULT

number correct Passing

TYPE OF VEHICLE

Vehicle axles

123

Trailer axles

12

air Brakes

Yes

no

ALL VEHICLES

Unsatisfactory

GVWR Truck

oil Pressure Gauge

0 Horn(s)

0 Parking Brake

0 Mechanical

GVWR Trailer

ammeter/Voltmeter Gauge

0 Heater/Defroster

0 service Brake/aBs

0 Postponement

cla

clB

PV

air Gauge

0 Windshield/Mirrors

0 air Brake check (c-o-l-a-s)

0

BASIC CONTROL SKILLS TEST

lighting indicators (l-R-4-H)

0 Wipers/Washers

0 Hydraulic Brake check

0 SIGHT-SIDE PARALLEL PARK CONVENTIONAL PARALLEL PARK

ALL COMBINATION VEHICLES

Pull-ups

0 0 1 2 3 4 5 Pull-ups

0012345

TRAILER

TRACTOR

SEMI-TRAILER

encroachment 2 4 6 8 10

encroachment 2 4 6 8 10

air/electric connectors/lines 0 air/electric connectors/lines 0 air/electric connectors

0 looks

00

looks

00

Tongue storage area

0 COUPLING SYSTEM

COUPLING SYSTEM

inside Parallel 0 10

inside Parallel 0 10

COUPLING SYSTEM

Mounting Bolts

0 Kingpin

0

OFFSET BACK RIGHT

OFFSET BACK LEFT

Tongue/Drawbar

0 Platform

0 apron

0 Pull-ups

0 0 1 2 3 4 5 Pull-ups

0012345

Mounting Bolts

0 locking Jaws/lever

0 Gap

0 encroachment 2 4 6 8 10

encroachment 2 4 6 8 10

safety Devices

0 Release arm/safety latch

0

looks

00

looks

00

sliding Pintle

0 5th Wheel skid Plate

0

Final Position 0 10

Final Position 0 10

sliding 5th Wheel locking Pins 0

STRAIGHT LINE BACKING

ALLEY DOCK

FORM B

FORM C (COMBINATION)

ALL PASSENGER VEHICLES Pull-ups

0 1 2 3 4 5 Pull-ups

0012345

FUEL AREA/UNDER/SIDE

TRAILER/SEMI-TRAILER

PASSENGER ITEMS

encroachment 2 4 6 8 10

encroachment 2 4 6 8 10

Driver/Fuel Area

Trailer Front

Passenger entry/lift

0 looks

0

looks

00

Door/Mirror

0 Header Board/Bulkhead

0 emergency exits

0 Final Position 0 10

inside alley 0 10

Fuel Tank/cap/leaks

0 light/Reflectors (c)

0 seating

0

(3ft. Box)

catwalk/steps

0 SIDE OF TRAILER

BAGGAGE COMPARTMENT

BASIC CONTROL SKILLS SUMMARY

lights/Reflectors (l-R-4-c)

0 landing Gear

0 Doors secure

0 Unable to understand direction given in english

123

Under Vehicle

Frame/Tandem Release

0

cited under Federal Regulation ?391.11(b)(2).

Drive shaft

0 Doors/Ties/lifts

0

SCHOOL BUS (ONLY)

exhaust system

0 lights/Reflectors (l-R-4-c)

0 STUDENT LIGHTS

Total errors =

Frame

0 TRAILER AXLES

student lights (Front, Back)

0 sight side PP

Pass Fail conventional PP Pass Fail

REAR AXLES

Wheels

STUDENT SAFETY ITEMS

offset Back Right Pass Fail offset Back left Pass Fail

Rear Wheels

Tires (i-c-D)

0 stop arm/safety arm

0 st. line Backing Pass Fail alley Dock

Pass Fail

Tires (i-c-D)

0 Rims/Wheels

0 student Mirrors

0

COMMENTS:

Rims/Wheels

0 lug nuts

0 emergency Kit/Body Fluid Kit 0

lug nuts

0 axle/Hub oil seal

0

axle seal

0 spacers/Budd spacing

0

PRE-TRIP SUMMARY

spacers/Budd spacing Rear Suspension

springs/airbags/shocks

0 SUSPENSION springs/airbags/shocks

0 U-bolts

0 0

Unable to communicate in the english language only

123

U-bolts

0 spring/air Mounts/Torque arm 0 cited under Federal Regulation

spring/air Mounts/Torque arm 0 BRAKES

?391.11(b)(2).

Rear Brakes

Brake Hoses/lines

0

Brake Hoses/lines

0 Brake chamber

0

Brake chamber

0 slack adjustor/Push Rod

0

slack adjustor/Push Rod

0 Drum/linings/Rotor/Pads

0

Drum/linings/Rotor/Pads

0 REAR OF TRAILER

REAR OF VEHICLE

Doors/Ties/lift

0

Doors/Ties/lift

0 splash Guards

0

splash Guards lights/Reflectors (l-R-4-Tl-Bl-c)

0 lights/Reflectors (l-R-4-Tl-Bl-c)

0

0

Dl 65 eTP PaRT i (ReV. 11/2011) WWW

PASSING SCORES

COMBINATION VEHICLES & STRAIGHT TRUCKS

VEHICLE

Pre-Trip Form

Class A

Class B and C

PRE-TRIP (Total is number of correct answers)

Form A

Form B

Air Brakes No Air Brakes Air Brakes No Air Brakes

35

33

27

24

Form C

Form Full

67

61

43

39

BASIC SKILLS EXERCISES (Total is number of errors)

12 errors or less (all vehicles)

COACH/TRANSIT & SCHOOL BUS

VEHICLE

Pre-Trip Form

Coach/Transit

School Bus

PRE-TRIP (Total is number of correct answers) Form A

Form B

Air Brakes No Air Brakes Air Brakes No Air Brakes

30

27

33

31

Form Full

46

42

49

45

BASIC SKILLS EXERCISES (Total is number of errors)

12 errors or less (all vehicles)

Dl 65 eTP PaRT i (ReV. 11/2011) WWW

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