Read MV3199 Private Vehicle Inspection Report text version

Private Vehicle Priv ehicle vate Vehicle Re port Inspection Repor t Report

INSPECTION RESULT INSPECTION TYPE 1. PASS 1. COMPLETE 2. FAIL 2 . RE-INSPECTION

WORK ORDER NUMBER

PLACE DECAL HERE

DECAL EXPIRY DATE INSPECTOR'S SIGNATURE

Day Month Year

Department Use or Confirmation Number

INSPECTION COMPLETE TIME

Inspector's Number Inspection Types Date Inspector's Name (printed) Facility Number Facility Name Inspection Types Expiry Date

UNIT/FLEET# (Optional) ODOMETER

COMPLETE REPAIRS BY

Card Expiry

OWNER

LAST NAME GIVEN NAMES

ADDRESS

Insp Date DD/MMM/YY

CITY REGISTRATION NUMBER YEAR BODY STYLE MAKE VIN

PROV. PLATE NUMBER MODEL

POSTAL CODE

MI KM

FUEL CODE

G

D

P

REASON FOR INSPECTION:

FIRST TIME REGISTERED IN BC NOTICE & ORDER MOTORCYCLE REBUILT FROM SALVAGE

OTHER _____________________________________

COLLISION REPAIR FACILITY NAME (FOR REBUILT FROM SALVAGE)

Phone No

HAS CUSTOMER BEEN NOTIFIED OF AIRBAG STATUS?

YES

NO

THE FACILITY AND INSPECTOR MUST BOTH BE AUTHORIZED FOR CLASSES OF VEHICLES INSPECTED

MARK EACH ITEM AS:

DOCUMENTATION

Vehicle Identification

"F" Failed

F R P

"R" Repaired (After a Fail)

Floors Bumpers

"P" Passed

F R P BRAKES

Drum Brakes Disc Brakes Proportioning Valve Mechanical Components Brake Lines, Hoses Master Cylinder

F

R

P

DRIVER'S CONTROLS

Horn Mirrors Windshield Wipers Windshield and Windows Windshield Defroster Visors Interior Heaters Parking Brake Power Brake Operation Brake Pedal Reserve & Leakage Test Steering Lash and Travel Power Steering Handle Bars Accelerator Pedal Transmission/Speedo/Odom

Trunk Trailer Hitch Body Exterior/Protruding Metal Motorcycle Kickstand Frame Frame Structural Body Unibody Unibody Structural Integrity Airbag - Driver (rebuilt & new to BC - fail) Airbag - Passenger (rebuilt & new to BC - fail)

ENGINE COMPARTMENT

Hood & Safety Catch Vacuum System Power Train Fuel System

UNDERCARRIAGE

Tires Tire Construction (Mixed) Wheels/Nuts/Studs Road Clearance Steering Linkage Steering Column and Coupler

PRESSURE FUEL

Liquid Propane Gas Compressed Natural Gas

LIGHTING/ELECTRICAL

Battery Switches Visible Wiring Indicator Lights Lamps Headlight Aim

BODY INTEGRITY

Driver's Seat Seat Belts Motorcycle Seat Doors Physically Disabled Passenger Vehicles Reflex Reflectors

Kingpins Ball Joints Springs and Attachments Shock Absorbers Wheel Bearings Fuel System Exhaust System & Catalytic Converter

Where a pass is indicated in the inspection result box, the inspector's signature above is certification that this vehicle conforms to all the safety requirements of the Motor Vehicle Act and Regulations.

Vehicle has been road tested Altered/ modified U-Built Replicar Speciality Vehicle Amalgamated Replikit

NOTICE: KEEP THIS VEHICLE INSPECTION REPORT WITH VEHICLE REGISTRATION

The information on this form is collected under the authority of the Motor Vehicle Act, Section 216. The information will be used to process your vehicle inspection. If you have any questions please call 250-952-0577 or see our website at www.th.gov.bc.ca/cvse

MV3199 (092005)

Commercial Vehicle Safety and Enforcement Branch

On the date and place noted, a vehicle registered in your name was inspected pursuant to the provisions of the Motor Vehicle Act and Regulations. In order to ensure the safe performance of the vehicle, the components marked in the "F" column must be corrected immediately.

If your vehicle met the appropriate inspection standards, a Certificate of Approval (Decal) was issued and affixed to the windshield. Retain this Inspection Report in the vehicle as you may be required to present it to an Insurance Agent as proof of a passed inspection when renewing the vehicle licence. In the event the vehicle is checked at the roadside during the next twelve months, a Peace/Police Officer may request the operator of the vehicle to present this Inspection Report.

If a Notice and Order has been issued against the vehicle, a copy of a passed Inspection Report must be submitted to the Commercial Vehicle Safety and Enforcement Branch within 30 days of the date of the Notice and Order if the vehicle is operated on the highway. A copy of the passed Inspection Report will be forwarded to the Inspection Facility which performed the inspection and will be recorded against the vehicle record. It is the obligation of the registered owner to advise a subsequent registered owner of any outstanding vehicle inspection requirements.

Private Vehicle Inspection Report MV3199 (092005)

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MV3199 Private Vehicle Inspection Report

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