You are on page 1of 2

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.
DATE TEST LOCATION EXAMINER SIGNATURE
X
EXAMINER ID NUMBER
RESULT TYPE OF VEHICLE
Number Correct
Passing
Unsatisfactory
Mechanical
Postponement
Vehicle Axles 1 2 3
VEHICLE LICENSE NO./TRAILER ID PLATE NO. DRIVERS SIGNATURE
X
DRIVER LICENSE NUMBER
Trailer Axles 1 2
Air Brakes Yes No
ALL VEHICLES GVWR Truck
Safety Belts 0 Oil Pressure Gauge 0 Horn(s) 0 Parking Brake 0 GVWR Trailer
Emergency Equipment (F-E-T) 0 Ammeter/Voltmeter Gauge 0 Heater/Defroster 0 Service Brake/ABS 0 CLA CLB PV
Safe Start 0 Air Gauge 0 Windshield/Mirrors 0 Air Brake Check (C-O-L-A-S) 0 BASIC CONTROL SKILLS TEST
Temperature Gauge 0 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 0 0 1 2 3 4 5
TRUCK TRAILER TRACTOR SEMI-TRAILER Encroachment 2 4 6 8 10 Encroachment 2 4 6 8 10
Air/Electric Connector 0 Air/Electric Connectors/Lines 0 Air/Electric Connectors/Lines 0 Air/Electric Connectors 0 Looks 0 0 Looks 0 0
COUPLING SYSTEM Tongue Storage Area 0 COUPLING SYSTEM COUPLING SYSTEM Inside Parallel 0 10 Inside Parallel 0 10
Mounting Bolts 0 COUPLING SYSTEM Mounting Bolts 0 Kingpin 0 OFFSET BACK RIGHT OFFSET BACK LEFT
Pintle Hook 0 Tongue/Drawbar 0 Platform 0 Apron 0 Pull-ups 0 0 1 2 3 4 5 Pull-ups 0 0 1 2 3 4 5
Hitch Release Lever 0 Mounting Bolts 0 Locking Jaws/Lever 0 Gap 0 Encroachment 2 4 6 8 10 Encroachment 2 4 6 8 10
Safety Devices 0 Safety Devices 0 Release Arm/Safety Latch 0 Looks 0 0 Looks 0 0
Sliding Pintle 0 5th Wheel Skid Plate 0 Final Position 0 10 Final Position 0 10
Sliding 5
th
Wheel Locking Pins 0 STRAIGHT LINE BACKING ALLEY DOCK
FORM A FORM B FORM C (COMBINATION) ALL PASSENGER VEHICLES Pull-ups 0 1 2 3 4 5 Pull-ups 0 0 1 2 3 4 5
FRONT OF VEHICLE FUEL AREA/UNDER/SIDE TRAILER/SEMI-TRAILER PASSENGER ITEMS Encroachment 2 4 6 8 10 Encroachment 2 4 6 8 10
Lights/Refectors (L-R-4-HL-HB-C) 0 Driver/Fuel Area Trailer Front Passenger Entry/Lift 0 Looks 0 Looks 0 0
ENGINE COMPARTMENT Door/Mirror 0 Header Board/Bulkhead 0 Emergency Exits 0 Final Position 0 10 Inside Alley
(3ft. Box)
0 10
Oil Level 0 Fuel Tank/Cap/Leaks 0 Light/Refectors (C) 0 Seating 0
Coolant Level 0 Catwalk/Steps 0 SIDE OF TRAILER BAGGAGE COMPARTMENT BASIC CONTROL SKILLS SUMMARY
Power Steering Fluid/Belt 0 Lights/Refectors (L-R-4-C) 0 Landing Gear 0 Doors Secure 0 Unable to understand direction given in English 1 2 3
Water Pump/Belt 0 Under Vehicle Frame/Tandem Release 0 Cited under Federal Regulation 391.11(b)(2).
Alternator/Belt 0 Drive Shaft 0 Doors/Ties/Lifts 0 SCHOOL BUS (ONLY)
Total Errors = Air Compressor/Belt 0 Exhaust System 0 Lights/Refectors (L-R-4-C) 0 STUDENT LIGHTS
Leaks/Hoses 0 Frame 0 TRAILER AXLES Student Lights (Front, Back) 0 Sight Side PP Pass Fail Conventional PP Pass Fail
STEERING REAR AXLES Wheels STUDENT SAFETY ITEMS Offset Back Right Pass Fail Offset Back Left Pass Fail
Steering Box/Hoses 0 Rear Wheels Tires (I-C-D) 0 Stop Arm/Safety Arm 0 St. Line Backing Pass Fail Alley Dock Pass Fail
Steering Linkage 0 Tires (I-C-D) 0 Rims/Wheels 0 Student Mirrors 0 COMMENTS:
FRONT AXLE Rims/Wheels 0 Lug Nuts 0 Emergency Kit/Body Fluid Kit 0
Front Wheel Lug Nuts 0 Axle/Hub Oil Seal 0
Tires (I-C-D) 0 Axle Seal 0 Spacers/Budd Spacing 0 PRE-TRIP SUMMARY
Rims/Wheels 0 Spacers/Budd Spacing 0 SUSPENSION
Unable to communicate in
the English language only
Lug Nuts 0 Rear Suspension Springs/Airbags/Shocks 0
Hub Oil Seals 0 Springs/Airbags/Shocks 0 U-bolts 0 1 2 3
Front Suspension U-bolts 0 Spring/Air Mounts/Torque Arm 0 Cited under Federal Regulation
391.11(b)(2). Springs/Shocks 0 Spring/Air Mounts/Torque Arm 0 BRAKES
U-bolts 0 Rear Brakes Brake Hoses/Lines 0
Spring Mounts 0 Brake Hoses/Lines 0 Brake Chamber 0
Front Brake Brake Chamber 0 Slack Adjustor/Push Rod 0
Brake Hoses/Lines 0 Slack Adjustor/Push Rod 0 Drum/Linings/Rotor/Pads 0
Brake Chamber 0 Drum/Linings/Rotor/Pads 0 REAR OF TRAILER
Slack Adjustor/Push-Rod 0 REAR OF VEHICLE Doors/Ties/Lift 0
Drum/Linings/Rotor/Pads 0 Doors/Ties/Lift 0 Splash Guards 0
Splash Guards 0 Lights/Refectors (L-R-4-TL-BL-C)
0
Lights/Refectors (L-R-4-TL-BL-C) 0
STATE OF CALIFORNIA
DEPARTMENT OF MOTORVEHICLES
A Public Service Agency
DL 65 ETP PART I (REV. 11/2011) WWW

DL 65 ETP PART I (REV. 11/2011) WWW
PASSING SCORES
COMBINATION VEHICLES & STRAIGHT TRUCKS
PRE-TRIP
(Total is number of correct answers)
Pre-Trip Form
VEHICLE
Class A Class B and C
Air Brakes No Air Brakes Air Brakes No Air Brakes
Form A
35 33 27 24 Form B
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
PRE-TRIP
(Total is number of correct answers)
Pre-Trip Form
VEHICLE
Coach/Transit School Bus
Air Brakes No Air Brakes Air Brakes No Air Brakes
Form A
30 27 33 31
Form B
Form Full 46 42 49 45
BASIC SKILLS EXERCISES
(Total is number of errors)
12 errors or less (all vehicles)
Go to Page 1 Print Clear Form

You might also like