Re-order code 4221 VC10 – MAINTENANCE INSPECTION – MOTOR VEHICLES

Company....................................................................................................................................................... Make.................................................................... Reg no.....................................................................

Address......................................................................................................................................................... Model.................................................................. Fleet no .................................................................
........................................................................................................................................................................ Body type........................................................... Odo reading......................................... miles/km
Tax expires............................................. O-licence review............................................................... Year...................................................................... Chassis no..............................................................
Tachograph calibration date..................................................................................................................... Last 2 year test date........................................ Inspection date.....................................................

PART 1: INSPECTION
NOTE FOR INSPECTORS:  IM numbered items are to be checked in accordance with the VOSA HGV Inspection Manual. Check for correct operation, security and
freedom from excessive wear, maladjustment, damage, fracture, corrosion, oil, fluid and air leaks. Check all hydraulic reservoirs for fluid level and possible fluid
contamination. Enter details of faults needing rectification in the space provided overleaf.

MARKING CODE (MC): ✓ = Serviceable X = Item requiring attention NC = Not checked N/A = Not applicable

INSIDE CAB MC IM No GROUND LEVEL MC IM No

DfT plate – condition-details Road wheels and hubs 6
Speed limiter plate – condition-details 33 Sideguards and rear underrun guards 9
Seat belts and supplementary restraint systems – condition 3 Spare wheel carrier (and spare wheel) 10
Cab floor and steps 17 Vehicle to trailer coupling 11
Seats 18 Condition of wings/spray suppression (rear) 14
Other seats and crew amenities Security/condition of body 19/20
Mirrors (internal) 22 Demountable bodies – chassis mounted equipment
View to front 23 Security of body, containers and crane support legs 19
Condition of glass (screen/windows) 23 Tipping gear – hydraulic rams, pivots and safety devices
Screen wipers and washers 25 Tailboard hoists
Speedometer/tachograph – operation-seals 26 Cranes, gantries
Engine tachometer Other ancillary equipment
Audible warning – horn 27
Driving controls 28
Steering wheel – free play 30
Steering wheel – security-condition 30 UNDER/ALONGSIDE VEHICLE MC IM No
Steering column 30 Chassis – condition 41
Anti-theft locks Electrical wiring and equipment including batteries 42
Pressure/vacuum – warning 34 Electrical connections for trailer 42
Pressure/vacuum – build up 34 Oil leaks 44
Other gauges – warning devices Fuel tanks and systems 45
Hand lever, controlling mechanical brake systems 36 Exhaust system 46
Service brake pedal 37 Suspension pins and bushes – condition 48
Service brake operation/anti-lock warning 38 Suspension units and linkages – condition 48
Hand operated brake control valves 39 Spring units, linkages and sub-frames – security 48
Electrical wiring/equipment/switches 42 Shock absorbers 48
Front fog and aux lamp switches Wheel bearings and seals (rear)
Panel/interior lamps and switches Stub axles and wheel bearings 53
Cab heater/demister/air conditioning Steering mechanism 54
Steering alignment
CAB-EXTERIOR MC IM No Steering gear 54
Bumper (front) 9 Power steering and fluid level 54
Condition of wings/spray suppression (front) 14 Axle alignment
Cab panels, trim and heated mirrors Clutch operation
Cab security including tilt warning 15 Gearbox and bell housing
Cab doors including hinges, locks 16 Change speed mechanism
Cab floor and steps 17 Power take-off
Mirrors and indirect vision devices (external) 22 Final drive
Front lamps (side lamps) and outline markers 63 2-speed shift mechanism
Headlamps – operation-aim-adjustment-mechanisms 67 Differential lock – traction control
Front fog lamps, spot lamps, dim dip device Load transfer/axle lift device
Transmission – drive line – mountings 57
BRAKES
ENGINE COMPARTMENT MC IM No
Electronic braking system/electronic stability
Engine mountings 43 38
control system – operation/warning
Oil leaks 44 Hydraulic fluid level 59
Fuel tanks and systems 45 Mechanical brake components 59
Exhaust systems 46 Drums and linings/discs and pads 59
Exhaust brake Brake actuators and adjusters 59
Radiator mounting Brake systems and components 59
Cooling system Trailer couplings, hoses and function of self-sealing valves 12
Fan, generator, aux belts Load sensing/anti-lock system 59
Fuel pump linkage seals and EDC equipment Air brake anti-freeze device
Speed limiter – condition-seals-linkage 33 Anti-lock device – operation/warning 38
Injectors, pipes, filters Operation of supply dump valve
Air intake system – Turbocharger intercooler and filters Operation of multi-circuit protection
Air compressor – Exhauster – drive belts (if applicable) 59 Additional braking devices 58
 PART 1: INSPECTION (Continued)
UNDER/ALONGSIDE VEHICLE (Continued) MC IM No TYRES MC IM No
Rear markings and conspicuity markings 62 Size and type of tyres 7
Rear lamps, outline markers and number plate lamp 63 Condition of tyres 8
Rear fog lamps including warning device 63 (strike out/amend boxes)
Reflectors (side and rear) 62
Direction/hazard indicators including warning device 66 TREAD WEAR
Side marker lamps 63
Stop lamps 63
Reversing lamps
Position lamps, headlamps and warning device 63 State –
Other lamps tread depth
Paintwork and livery – condition left in mm
Licences
Legal writing
Registration plates 1
Other dangerous defects 74
SMOKE EMISSION 5

PART 2: RECTIFICATION
DETAILS OF FAULTS IM NO ACTION TAKEN TO RECTIFY FAULTS DONE BY
1  Needing immediate attention

2  Less urgent – for early attention

Signature of inspector I consider the above defects have been rectified satisfactorily Date completed
and the vehicle is now in a safe and roadworthy condition

Signature ........................................................................................................................................

Position ...........................................................................................................................................

PART 3: ROAD/BRAKE TEST REPORT (*Delete as appropriate)

BRAKE PERFORMANCE kph*
ROAD SPEED LIMITER operational YES/NO* – set speed Load condition of vehicle
IM Nos 71, 72, 73 mph*
Decelerometer test* Road conditions Laden* Unladen*
@ kph* Service Secondary Parking Comments
mph*
% % %
Roller brake test*
ROAD TEST – OVERALL COMMENTS

Tester’s signature.........................................................................................

NOTE: When servicing is carried out following inspection and rectification, details should be recorded on the separate form VC80 available for the purpose.

OPTIONAL
Digital tachograph
Data download Yes / No*

THIS FORM IS PRODUCED BY FREIGHT TRANSPORT ASSOCIATION AND IS NOT PART OF THE FTA VEHICLE INSPECTION SERVICE SYSTEM

Freight Transport Association Limited • Registered Office • Hermes House, St John’s Road, Tunbridge Wells, Kent TN4 9UZ • Registered in England Number 391957 • © FTA 02.12