Vehicle Safety Inspection Sheet
Instruction: Use this form to do a safety check on a vehicle and record whether systems meet compliance with New Zealand Vehicle Safety Regulations. Information on Regulations can be found at http://www.nzta.govt.nz/resources/virm-in-service-certification/virm-in-service-certification.html#intro. Use a flat floor shop area and a vehicle to perform the inspection. ( keep standard safety practices in mind. ) The Brake Test to be performed on the Rolling Road Dyno in 108-1065 under the guidance of your Lecturer. Analyze your findings at the end to make recommendations for the vehicle.
Student Name Leo Contac No 021908162
Vehicle: Make MAZDA Model FAMILIA Year 1998
VIN: SSBELTSOK01007 Fule type: Petrol
External Inspection:
Compliant? Item: Comments:
Yes Direction Ind. Lamps Front Good
Yes Forward Position Lamps Good
Yes Front Fog Lamps Good
Yes Direction Ind. Lamps Rear Good
Yes Rearward Position Lamps Good
Yes Stop Lamps Good
Yes Hig-mounted Stop Lamps Good
Yes Registration Plate Lamps Good
Yes Rear Reflectors Good
Yes Other Lamps Good
Yes Windscreen Good
Yes Other Glazing Good
Yes Doors and Hinged Panels Good
Yes Mudguards Good
Yes External Projections Good
Yes Structure/Corrosion Good
Yes Dimensions Good
Internal Inspection:
Compliance? Item: Comments:
No Wipers/Operation Non operation
Yes Rear View Mirrors Good
Yes Sun Visors Good
No Seatbelts Getting old
Yes Seatbelt Anchorages Good
Yes Seatbelt & Seat Anchorages Good
Yes Head Restraints Good
No Interior Impact N/A
Yes Air Bag Self Check Good
No ABS Self Check No ABS Check Light
Yes Audible Warning Device Good
No Spare Wheel Security N/A
No Space Saver Warning Label N/A
Chassis Underbody:
Compliance? Item: Comments:
Yes Wheels, Hubs & Axels Good
Yes Steering Mechanism Good
No Suspension Mechanism Bent Suspension Link
Yes Fuel Tank & Fuel Lines Good
Yes Cable Linkage Good
Yes Brake Controls Good
Yes Lines & Hoses Good
Yes Exhaust System Good
Yes Tire Condition Good
Yes Tire Tread Depth Good
LF 4mm RF 2.9mm LR 3mm RR 4.1mm
Yes Towing Connections Good
Yes Towing Safety Chain( s ) Good
Yes Structure/Corrosion Good
Road Brake Test:
Compliance? Item: Comments:
Yes Service Brake Readings Pass
Front 7% Rear 8% or LF 2.83 RF 3.7 LR 1.00 RR 0.92
Yes Service Brake Performance Good
Yes Service Brake Balance Good
Yes Parking Brake Readings Good
16% or LH 1.23 RH 1.03
Yes Parking Brake Performance Good
Yes Speedometer Good
Under Bonnet:
Compliance? Item: Comments:
No A/F System in Working Order N/A
No A/F System Cert. Current N/A
No A/F System Safe N/A
No Modified Vehicle N/A
No Chassis VIN Number N/A
No Structure/Corrosion N/A
No Engine & Drive Train N/A
No Fuel System N/A
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