LINEAR MOTOR CHECKLIST

ENTIDAD: MUNICIPALIDAD DISTRITAL PUCACOLPA RESP. AREA OF VEHICLE:

BRAND: CONDUCTOR:
COLOR: MODEL: YEAR: Nº DE LICENCIA:
ENGINE NUMBER KEYS: PLATE: DATE:
T. PROP. SERIES: HEAD OF AREA RESPONSIBLE:
No. DOCUMENTATION YES NO OBSERVATIONS
1 Do you have a property title?

2 Do you have accident insurance?

3 Does the driver have a license?

4 Do you have a technical inspection for circulation?

No. TIRES AND RIMS YES NO OBSERVATIONS

5 Does it have cracks from a blunt object?
6 Does it have fine cracks on the sides?
7 Are the tires deflated?
8 Are the tires overinflated?

9 Are the rims and fenders in good condition?

10 Does the suspension work correctly?

No. TRANSMISSION SI NO Observations
11 Does the chain shine (lack lubrication)?

12 Is the chain improperly tensioned? What do you hear when it rolls?

No. LIGHTS AND MIRRORS OBSERVATIONS

Do the low beam and brake lights work correctly?

13 (deterioration of headlights, lenses, and turn signals)

14 Are the mirrors in perfect condition?

15 Is the handlebar in perfect condition?

No. LEAKS YES NO OBSERVATIONS

16 Leaks in suspension and brake fluid?

17 Leaks in the transmission system (drive shaft, differential)?

18 Oil leaks in the engine and coolant fluids?

19 Leaks in the fluid that passes through the gearbox?

20 Leaks in the fuel tank?

21 Gas leaks in the muffler (deterioration)?

No. CONTROLS (SHIFTS, BRAKES) YES NO OBSERVATIONS

22 Is the clutch hardened?

23 Does the throttle cable return completely to its starting point?

24 Is your horn or siren operational?

No. GENERAL ENVIRONMENT YES NO OBSERVATIONS
25 Is the motorcycle in good condition of cleanliness and maintenance?

Is the motorcycle chassis damaged? (rust, dents,

26 missing parts

No. PROTECTION ELEMENTS OF THE CONDUCTOR YES NO OBSERVATIONS

27 Is a helmet for motorcycles available in good condition?

28 Are synthetic leather gloves for motorcycles available?

29 Are protective glasses for motorcycles available?

30 Is a reflective vest available for motorcycle riding?

31 Is there protection available for rainy seasons?

GENERAL OBSERVATIONS CONCLUDED:

AMBULANCE LIST

VEHICLE: HORA: 3:30

KILOMETRAJE: N/P
COMBI P.M.

BRAND: FUEL
PLATE: N/A
TOYOTA :

MODELO:AM FECHA DE INSPECCION:

GASOLINE
BALANCE SHEET 28/11/2018 84/90 OCT.

COLOR: LUGAR DE ISNPECCION: GARAJE

WHITE MUNICIPAL
OWNER: MUNICIPALITY OF
YEAR: 1998
CUSIPATA

MECHANICAL STATE OF THE EQUIPMENT

DESCRIPTION DESCRIPTION
B/SI M/NO N/A B/SI M/NO N/A
N N
LIGHTS MOTOR
LEAKS OF
LOW BEAMS X X
LIQUID
LEAKS BY
HIGH BEAMS X HOSE X
S
LIGHTS OF LEVEL OF
X X
BRAKES OIL
LIGHTS OF X LEVEL X
SETBACK RADIATOR
FILTER OF
INTERMITTENT AIR OF
X X
TES
MOTOR
LIGHT OF FILTER OF
X X
CABIN OIL
FILTER OF
START
X
OF THE MOTOR FUEL X
THE
LEVEL OF
X ADDRESS
BATTERY
LEVEL OF
BORNES X OIL X
ADDRESS

TERMINAL
ALTERNATING
X S OF X
R
ADDRESS
 NOISES
SHEET OF
X TRAIN X
START
Forward
TRANSMISSION
BRAKES X
ON
BOX OF
BRAKES X X
CHANGES
LEVEL OF
LEAKS OF
LIQUID OF X OIL X
BRAKES
BRAKE OF Crosses
X X
HAND CARDAN

NOISES X LEAKS X
ABNORMALS CROWN

FLIGHT NOISES
DELIQUID X ABNORMAL X
BRAKE S

WHEELS
ACCESSORY
LEFT AND X S X
LAW

PRESSURE OF
TACHOMETER
TIRE X X
O
S
STATE OF SPEAKER AND
X X
TIRES ALARMS

REVIEW OF DOORS AND

X X
NUTS CHAPAS

TIRE
MIRRORS
DE X R
LATERALS
REPLACEMENT

GLASSES AND
SUPPORT OF
X LIFT X
REPLACEMENT
GLASSES
BODYWORKX SEATS X
AND CHASSIS

FIXATION
CABIN A X HEATING X
N
CHASSIS
AIR
TUBE OF
X CONDITION X
ESCAPE
I need
SURE
X RADIO NO
HOOD

BAR ANTENNA
X YES
ANTI-ROLL RADIAL
FUNCTION
I am in X FIRE EXTINGUISHER NO
PEDALS

Belt
PAINTING
R S OF YES
GENERAL
SECURITY

Dampens FIRST AID KIT AND

DOR X TRIANGLE NO
FRONT S

Dampens WATER
DOR X CLEAN YES
BACK Breezes
BEAMS X IMPLEMENT
CHASSIS OS
GATA Y
LOGO OF
X ACCESSORY NO
COMPANY
S
BOX OF
INSURANCE AND
X
BRASS KNOCKERS TOOL NO
TAS
SOAT X WEDGES NO
Buoy Y
CARD X NO
THREE-POINTED

CERTIFICATE
DE
X
OPERATIVID
AD
NOTACION: B/SI: BUENO/SI M/NO: MALO / NO N/A: NO APLICA
OBSERVE
IONS
GENERAL
S
CONCLUDED
S: The
system
electric
requires
maintenance
nto in
general
how
also
everyone the
systems
what
corresponds
n al
functioning
nto del
motor. In
general him
vehicle
requires
maintenance
nto
corrective.