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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