ANNEX IVSupplementary provisions
ANNEX IV Text of image (front side) SPECIMEN MORE DETAILED TECHNICAL ROADSIDE INSPECTION REPORT INCORPORATING A CHECK-LIST 1. Place of technical roadside inspection … 2. Date … 3. Time … 4. Vehicle nationality mark and registration number … 5. Vehicle identification/VIN number … 6. Category of vehicle (a) N 2 (a) (3,5 to 12 t) (b) N 3 (a) (more than 12 t) (c) O 3 (a) (3,5 to 12 t) (d) O 4 (a) (more than 10 t) (e) M 2 (a) (> 9 seats (b) to 5 t) (f) M 3 (a) (> 9 seats (b) more than 5 t) (g) T5 (h) Other vehicle category: (please specify) 7. Odometer reading at the time of inspection 8. Undertaking carrying out transport (a) Name and address … (b) Number of the Community licence (c) (Regulations (EC) No 1072/2009 and (EC) No 1073/2009) … 9. Driver name … Text of image 10. Checklist Checked (d) Failed (e) (0) Identification (f) (1) Braking equipment (f) (2) Steering (f) (3) Visibility (f) (4) Lighting equipment and electrical system (f) (5) Axles, wheels, tyres, suspension (f) (6) Chassis and chassis attachments (f) (7) Other equipment incl. tachograph and speed limitation device (f) (8) Nuisance incl. emissions and spillage of fuel and/or oil (f) (9) Supplementary tests for category M 2 and M 3 vehicles (f) (10) Cargo securing (f) 11. Result of inspection: Passed Failed Prohibition or restriction on using the vehicle, which has dangerous deficiencies 12. Miscellaneous/remarks: … 13. Authority/officer or inspector having carried out the inspection Signature of: Competent authority/officer or inspector Driver Notes: (a) Vehicle category in accordance with Article 2 to Directive 2014/47/EU. (b) Number of seats including the driver’s seat (item S.1 of registration certificate). (c) If available. (d) ‘checked’ means that at least one or more of the inspection items of this group, as listed in Annex II or III to Directive 2014/47/EU, have been checked and minor or no deficiencies have been found. (e) Failed items with major or dangerous deficiencies indicated on the rear side. (f) Methods for testing and assessment of defects in accordance with Annex II or III to Directive 2014/47/EU. Text of image (reverse side) 0. IDENTIFICATION OF THE VEHICLE 0.1. Registration number plates 0.2. Vehicle identification/chassis/serial number 1. BRAKING EQUIPMENT 1.1. Mechanical condition and operation 1.1.1. Service brake pedal pivot 1.1.2. Pedal condition and travel of brake operating device 1.1.3. Vacuum pump or compressor and reservoirs 1.1.4. Low pressure warning gauge or indicator 1.1.5. Hand-operated brake control valve 1.1.6. Parking brake activator, lever control, parking brake ratchet, electronic parking brake 1.1.7. Braking valves (foot valves, un-loaders, governors) 1.1.8. Couplings for trailer brakes (electrical and pneumatic) 1.1.9. Energy storage reservoir pressure tank 1.1.10. Brake servo units, master cylinder (hydraulic. systems) 1.1.11. Rigid brake pipes 1.1.12. Flexible brake hoses 1.1.13. Brake linings and pads 1.1.14. Brake drums, brake discs 1.1.15. Brake cables, rods, levers, linkages 1.1.16. Brake actuators (incl. spring brakes or hydraulic cylinders) 1.1.17. Load sensing valve 1.1.18. Slack adjusters and indicators 1.1.19. Endurance braking system (where fitted or required) 1.1.20. Automatic operation of trailer brakes 1.1.21. Complete braking system 1.1.22. Test connections 1.1.23. Overrun brake 1.2. Service braking performance and efficiency 1.2.1. Performance 1.2.2. Efficiency 1.3. Secondary (emergency) braking performance and efficiency 1.3.1. Performance 1.3.2. Efficiency 1.4. Parking braking performance and efficiency 1.4.1. Performance 1.4.2. Efficiency 1.5. Endurance braking system performance 1.6. Anti-lock braking system 1.7. Electronic brake system (EBS) 1.8. Brake fluid 2. STEERING 2.1. Mechanical condition 2.1.1. Steering gear condition 2.1.2. Steering gear casing attachment 2.1.3. Steering linkage condition 2.1.4. Steering linkage operation 2.1.5. Power steering 2.2. Steering wheel, column and handle bar 2.2.1. Steering wheel condition 2.2.2. Steering column and steering dampers 2.3. Steering play 2.4. Wheel alignment 2.5. Trailer steered axle turntable 2.6. Electronic Power Steering (EPS) 3. VISIBILITY 3.1. Field of vision 3.2. Condition of glass 3.3. Rear-view mirrors 3.4. Windscreen wipers 3.5. Windscreen washers 3.6. Demisting system 4. LAMPS, REFLECTORS, ELECTRICAL EQUIPMENT 4.1. Headlamps 4.1.1. Condition and operation 4.1.2. Alignment 4.1.3. Switching 4.1.4. Compliance with requirements 4.1.5. Levelling devices 4.1.6. Headlamp cleaning device 4.2. Front and rear position lamps, side marker lamps, end outline marker lamps and daytime running lamps 4.2.1. Condition and operation 4.2.2. Switching 4.2.3. Compliance with requirements 4.3. Stop lamps 4.3.1. Condition and operation 4.3.2. Switching 4.3.3. Compliance with requirements 4.4. Direction indicator and hazard warning lamps 4.4.1. Condition and operation 4.4.2. Switching 4.4.3. Compliance with requirements 4.4.4. Flashing frequency 4.5. Front and rear fog lamps 4.5.1. Condition and operation 4.5.2. Alignment 4.5.3. Switching 4.5.4. Compliance with requirements 4.6. Reversing lamps 4.6.1. Condition and operation 4.6.2. Compliance with requirements 4.6.3. Switching 4.7. Rear registration plate lamp 4.7.1. Condition and operation 4.7.2. Compliance with requirements 4.8. Retro-reflectors, conspicuity markings and rear marking plates 4.8.1. Condition 4.8.2. Compliance with requirements 4.9. Tell-tales mandatory for lighting equipment 4.9.1. Condition and operation 4.9.2. Compliance with requirements 4.10. Electrical connections between towing vehicle and trailer or semi-trailer 4.11. Electrical wiring 4.12. Non-obligatory lamps and reflectors 4.13. Battery Text of image 5. AXLES, WHEELS, TYRES AND SUSPENSION 5.1. Axles 5.1.1. Axles 5.1.2. Stub axles 5.1.3. Wheel bearings 5.2. Wheels and tyres 5.2.1. Road wheel hub 5.2.2. Wheels 5.2.3. Tyres 5.3. Suspension system 5.3.1. Springs and stabiliser 5.3.2. Shock absorbers 5.3.3. Torque tubes, radius arms, wishbones and susp. arms 5.3.4. Suspension joints 5.3.5. Air suspension 6. CHASSIS AND CHASSIS ATTACHMENTS 6.1. Chassis or frame and attachments 6.1.1. General condition 6.1.2. Exhaust pipes and silencers 6.1.3. Fuel tank and pipes (incl. heating fuel tank and pipes) 6.1.4. Bumpers, lateral protection and rear under-run devices 6.1.5. Spare wheel carrier 6.1.6. Mechanical coupling and towing device 6.1.7. Transmission 6.1.8. Engine mountings 6.1.9. Engine performance 6.2. Cab and bodywork 6.2.1. Condition 6.2.2. Mounting 6.2.3. Doors and door catches 6.2.4. Floor 6.2.5. Driver’s seat 6.2.6. Other seats 6.2.7. Driving controls 6.2.8. Cab steps 6.2.9. Other interior and exterior fittings and equipment 6.2.10. Mudguards (wings), spray suppression devices 7. OTHER EQUIPMENT 7.1. Safety-belts/buckles and restraint systems 7.1.1. Security of safety-belts/buckles mounting 7.1.2. Condition of safety-belts/buckles 7.1.3. Safety belt load-limiter 7.1.4. Safety belt pre-tensioners 7.1.5. Airbag 7.1.6. SRS Systems 7.2. Fire extinguisher 7.3. Locks and anti-theft device 7.4. Warning triangle 7.5. First aid kit. 7.6. Wheel chocks (wedges) 7.7. Audible warning device 7.8. Speedometer 7.9. Tachograph 7.10. Speed limitation device 7.11. Odometer 7.12. Electronic Stability Control (ESC) 8. NUISANCE 8.1. Noise suppression system 8.2. Exhaust emissions 8.2.1. Positive ignition engine emissions 8.2.1.1. Exhaust emission control equipment 8.2.1.2. Gaseous emissions 8.2.2. Compression ignition engine emissions 8.2.2.1. Exhaust emission control equipment 8.2.2.2. Opacity 8.4. Other items related to the environment 8.4.1. Fluid leaks 9. SUPPLEMENTARY TESTS FOR PASSENGER, CARRYING VEHICLES OF CATEGORIES M 2 ; M 3 9.1. Doors 9.1.1. Entrance and exit doors 9.1.2. Emergency exits 9.2. Demisting and defrosting systems 9.3. Ventilation and heating systems 9.4. Seats 9.4.1. Passenger seats 9.4.2. Driver’s seat 9.5. Interior lighting and destination device 9.6. Gangways, standing areas 9.7. Stairs and steps 9.8. Passenger communication system 9.9. Notices 9.10. Requirements regarding the transportation of children 9.10.1. Doors 9.10.2. Signalling and special equipment 9.11. Requirements regarding the transportation of persons with reduced mobility 9.11.1. Doors, ramps and lifts 9.11.2. Wheelchair restraint system 9.11.3. Signalling and special equipment