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CPS
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Customer Satisfaction Survey
Contact
Truck and Trailer Inspection
Model Number
Vin Number
Customer
Date
Pallet Body Vin
Mileage
Pallet Style
Number of pallets
Liftgate Brand
Liftgate Serial Number
LIftgate Series or Model
Battery for Liftgate
Liftgate Lockout Switch
Toolbox Amount
Toolbox Size
Special Toolbox?
Toolbox provided by customer?
Unit Number
Chassis MFR.
DOT number
Chassis Serial Number
MFG Liftgate warning stickers
Length
Conspicuity tape on sides and rear
GVWR
Liftgate alarm
Axle
Bracket for cones
Bracket for wheel chocks
LED side and rear lighting
DOT Bumper
Pallet retention system: Strap Style, STP-PRS/Finger/Pneumatic
Liftgate works?
Lighting works?
Pins removed from air brakes?
Visual Inspection
Amount of equipment matches sales order
Body Builder Placard inside drivers door
Inspect registration holder. Ensure it is complete and there is no damage
YES
NO
Inspect safety inspection decal(s), state-provincial inspection sticker, permits, registration, insurance information and license plate
YES
NO
inspect condition of all operational and warning decals
YES
NO
Inspect gladhands, including gladhand orientation, and seals
YES
NO
Inspect air lines for condition, routing, and length
YES
NO
Inspect lights and wiring.
YES
NO
Inspect splash guard/mud flaps, brackets, and conspicuity marking(s)
YES
NO
Inspect HazMat Placard - Front, Sides, and Rear. Ensure 3" clearance from any decals
YES
NO
Inspect rear door(s) and ladder (if applicable) operation as required.
YES
NO
Perform RUG (rear underride guard) inspection
YES
NO
Inspect 7-way light receptacle.
YES
NO
Inspect and label camera receptacle
YES
NO
Inspect and label sonar receptacle.
YES
NO
Inspect communication device(s) for proper and secure mounting.
YES
NO
Install loose lug indicators
YES
NO
Hubs Running in Oil: Inspect and adjust lubricant level using 75W90 wt synthetic oil
YES
NO
Inspect, record, and adjust air pressure (including spare, if applicable)
YES
NO
Inspect wheels for cracks or loose lugs, and outer hub leaks
YES
NO
Inspect tire condition. Note: Axle alignment done when irregular tire wear detected.
YES
NO
Inspect and record tread depth (including spare, if applicable), refer to document FS-AP-0001.
YES
NO
Perform initial alignment
YES
NO
Verify wheels lug nut torque with a torque wrench, refer to document FTS-WT-0001
YES
NO
Inspect Auto-inflate and set to 100psi.
YES
NO
Inspect cross members and under structure for rust, broken welds and damage
YES
NO
inspect rear springs, shocks, and suspension
YES
NO
Inspect springs and spring brackets for damage, loose/cracked bolts, or missing pads.
YES
NO
Inspect air bags, mounting bolts, and air lines for damage, chafing, or leaking
YES
NO
Inspect operation of sliding tandem (if applicable).
YES
NO
Inspect all mounting brackets for cracks, missing pads, and damage.
YES
NO
Inspect air tank mounting for loose straps, brackets, and damage
YES
NO
Inspect and record brake lining thickeness (in space provided)
Inspect and record drum/rotor condition (In space provided).
Adjust manual slack adjusters (if applicable) with air applied.
YES
NO
Inspect adjustment of automatic slack adjusters with air applied
YES
NO
Inspect parking brake operation with air applied.
YES
NO
Inspect brake chambers, valves, dust caps and air lines. Inspect for leaks with air applied.
YES
NO
Inspect pintle hook for cracks or broken welds
YES
NO
Inspect pintle hook for loose or missing fasteners.
YES
NO
Inspect and clean pintle hook light receptacle and cord (if applicable).
YES
NO
inspect pintle hooks for excessive wear, using OEM gauges.
YES
NO
Inspect pintle hook gladhand connections.
YES
NO
Inspect landing gear crank handle and retaining clip.
YES
NO
Inspect landing gear legs, braces, including brace orientation, and support device. Refer to document FTS-LGT-0001
YES
NO
Inspect king pin and upper coupler plate with gauge # TF-0110
YES
NO
Crank landing gear, inspect for binding.
YES
NO
Lubricate the landing gear operating mechanism.
YES
NO
Install the VIN. Ensure all decals and conspicuity tape are applied where needed.
YES
NO
Test the backup camera (if applicable) to ensure it is operating properly.
YES
NO
Install a completed Federal Annual Inspection Decal, FM-977.
YES
NO
Capture pictures of the Front, Rear, and Sides. Also capture pictures of lift gates at different stances, up, down, tilted.
YES
NO
Brake Lining (32nds) Axle 1
Brake Lining (32nds) Axle 1
Brake Lining (32nds) Axle 2
Brake Lining (32nds) Axle 2
Brake Lining (32nds) Axle 3
Brake Lining (32nds) Axle 3
Brake Lining (32nds) Axle 4
Brake Lining (32nds) Axle 4
Air Pressure (PSI) Axle 1 Driver Side
Tread Depth (32nds) Axle 1 Driver Side
Air Pressure (PSI) Axle 1 Driver Side
Tread Depth (32nds) Axle 1 Driver Side
Air Pressure (PSI) Axle 1 Passenger Side
Tread Depth (32nds) Axle 1 Passenger Side
Air Pressure (PSI) Axle 1 Passenger Side
Tread Depth (32nds) Axle 1 Passenger Side
Air Pressure (PSI) Axle 2 Driver Side
Tread Depth (32nds) Axle 2 Driver Side
Air Pressure (PSI) Axle 2 Driver Side
Tread Depth (32nds) Axle 2 Driver Side
Air Pressure (PSI) Axle 2 Passenger Side
Tread Depth (32nds) Axle 2 Passenger Side
Air Pressure (PSI) Axle 2 Passenger Side
Tread Depth (32nds) Axle 2 Passenger Side
Air Pressure (PSI) Axle 3 Driver Side
Tread Depth (32nds) Axle 3 Driver Side
Air Pressure (PSI) Axle 3 Driver Side
Tread Depth (32nds) Axle 3 Driver Side
Air Pressure (PSI) Axle 3 Passenger Side
Tread Depth (32nds) Axle 3 Passenger Side
Air Pressure (PSI) Axle 3 Passenger Side
Tread Depth (32nds) Axle 3 Passenger Side
Air Pressure (PSI) Axle 4 Driver Side
Tread Depth (32nds) Axle 4 Driver Side
Air Pressure (PSI) Axle 4 Driver Side
Tread Depth (32nds) Axle 4 Driver Side
Air Pressure (PSI) Axle 4 Passenger Side
Tread Depth (32nds) Axle 4 Passenger Side
Air Pressure (PSI) Axle 4 Passenger Side
Tread Depth (32nds) Axle 4 Passenger Side
Lug Nut #1 (Inspection Torque) Drivers-Side Axle
Lug Nut #1 (Inspection Torque) Passenger-Side Axle
Lug Nut #2 (Inspection Torque) Drivers-Side Axle
Lug Nut #2 (Inspection Torque) Passenger-Side Axle
Lug Nut #3 (Inspection Torque) Drivers-Side Axle
Lug Nut #3 (Inspection Torque) Passenger-Side Axle
Lug Nut #4 (Inspection Torque) Drivers-Side Axle
Lug Nut #4 (Inspection Torque) Passenger-Side Axle
Lug Nut #5 (Inspection Torque) Drivers-Side Axle
Lug Nut #5 (Inspection Torque) Passenger-Side Axle
Lug Nut #6 (Inspection Torque) Drivers-Side Axle
Lug Nut #6 (Inspection Torque) Passenger-Side Axle
Lug Nut #7 (Inspection Torque) Drivers-Side Axle
Lug Nut #7 (Inspection Torque) Passenger-Side Axle
Lug Nut #8 (Inspection Torque) Drivers-Side Axle
Lug Nut #8 (Inspection Torque) Passenger-Side Axle
Lug Nut #9 (Inspection Torque) Drivers-Side Axle
Lug Nut #9 (Inspection Torque) Passenger-Side Axle
Lug Nut #10 (Inspection Torque) Drivers-Side Axle
Lug Nut #10 (Inspection Torque) Passenger-Side Axle
Lug Nut #1 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #1 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #2 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #2 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #3 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #3 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #4 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #4 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #5 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #5 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #6 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #6 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #7 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #7 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #8 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #8 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #9 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #9 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #10 (Inspection Torque) Left-Curb-Side, First Axle
Lug Nut #10 (Inspection Torque) Left-Curb-Side, Second Axle
Lug Nut #1 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #1 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #2 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #2 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #3 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #3 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #4 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #4 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #5 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #5 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #6 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #6 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #7 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #7 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #8 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #8 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #9 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #9 (Inspection Torque) Right-Curb-Side, Second Axle
Lug Nut #10 (Inspection Torque) Right-Curb-Side, First Axle
Lug Nut #10 (Inspection Torque) Right-Curb-Side, Second Axle
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