PAGS - Emergency Vehicle: Pre-Trip Inspection

Practical Application Guide Sheet

Emergency Vehicle: Pre-Trip Inspection
Candidate Name*

First NameLast Name
Candidate Performance Competency: The candidate will explain the purpose of and perform a pre-trip inspection on the vehicle. The Pre-Trip Inspection will be completed in accord with maryland Commercial Motor Vehicle Guidelines.
Vehicle Overview

5 points
Park the vehicle on a stable and reasonably level surface. Place a wheel chock to the front and rear of the rear tire.*
Value: 1 point
Body components and lights intact, not missing, or damaged.*
Value: 1 point
Look down each side of the body to identify any leaning that may indicate weak or broken suspension components.*
Value: 1 point
Vehicle Exterior: Mirrors secure, clean, and free of defects | Compartment and cab doors latch | Exterior mounted equipment secure*
Value: 1 point
Look beneath the vehicle for obvious leaks or components hanging loose.*
Value: 1 point
Vehicle Overview Total
Motor Compartment

23 points
Raise hood checking the springs and safety cables OR Tilt cab ensuring piston safety locks engage. Candidate must ensure loose items are secure inside the cab before tilting and overhead is clear. (CFP)*
Value: 2 points
Check the following fluids for adequate levels and quality as indicated:
Motor Oil: Level should be above the “add” mark; fill as needed | Foamy there may be water in the oil | Diesel fuel odor may indicate internal motor failure*
Value: 2 points
Coolant: Check level in sight glass or translucent area on reservoir | Only fill with proper mixture as provided by CMF*
Value: 2 points
Power Steering Fluid: Level should be above the “low” or “add” mark*
Value: 2 points
Brake Fluid (pre-2007 and post-2015 ambulances): Check level in both chambers on master cylinder; preferred to view through translucent chambers over removing caps | Observe any signs of leaks*
Value: 2 points
Alternator: Securely mounted | No loose connections*
Value: 1 point
Fan: All blades present with no damage | Shroud intact and free of debris*
Value: 1 point
Radiator: Securely mounted with cap securely in place | Free of leaks, major debris, and significant damage*
Value: 1 point
Water Pump: Securely mounted | Free of leaks | Candidate will note if the pump is belt or gear driven*
Value: 2 points
Air Compressor: Securely mounted | Free of leaks | Candidate will note if the pump is belt or gear driven*
Value: 2 points
Power Steering Pump: Securely mounted | Free of leaks | Candidate will note if the pump is belt or gear driven*
Value: 2 points
Hoses: Free of leaks, cuts, cracks, and bulges*
Value: 1 point
Belts: Free of cuts, cracks, and fraying | Properly tensioned - less than ¾" deflection*
Value: 1 point
Wiring: Securely fastened as appropriate | Free of damage or deterioration | No signs of overheating or melted insulation | Insulation intact | Terminals secure, free of corrosion*
Value: 1 point
Batteries: Free of leaks and corrosion | Terminals and connections secure | Batteries secured within box*
Value: 1 point
Motor Compartment Total
Steering System

12 points
Steering system components will be evaluated by the following criteria:

No loose or broken components. No welded repairs. No inappropriate movement or slack of any component.
Steering shaft to steering box*
Value: 1 point
Steering box securely mounted*
Value: 1 point
Steering box not leaking*
Value: 1 point
Output shaft properly aligned*
Value: 1 point
Pitman Arm*
Value: 1 point
Castle nut & locking pin*
Value: 1 point
Drag link*
Value: 1 point
Steering arm*
Value: 1 point
Castle nut & locking pin*
Value: 1 point
Driver’s side lower control arm*
Value: 1 point
Tie rod*
Value: 1 point
Officer’s side lower control arm*
Value: 1 point
Steering System Total
Suspension System

4 points
Spring Mounts: Must be secure to the frame | Free from cracks or damage*
Value: 1 point
Springs: Stack must aligned | Free of cracks or obvious deformity | No missing parts or spring leaves*
Value: 1 point
U-bolts: Must not be missing | Free of cracks or deformities | Locking nuts must be present*
Value: 1 point
Air Suspension: Inflates equally | Shock mounts free of cracks or deformity | No obvious leaks*
Value: 1 point
Suspension System Total
Brake System

14 points
Candidate will identify the type of brake system; air or hydraulic.*
Value: 2 points
Chambers: No obvious damage or defects*
Value: 1 point
Pushrods: Must not be overextended | Clevis pins must be in place*
Value: 1 point
Anti-Lock Wires: Free of obvious damage | Must be secured*
Value: 1 point
Fluid or Air Lines: Free of cracks, cuts, leaks, or deformity | Securely fastened to chambers*
Value: 1 point
Front
Disc or Drum*
Value: 1 point
No cracks or missing pieces*
Value: 1 point
Heat checks on < ½ surface*
Value: 1 point
Thickness > 1/8" pads or 1/4" shoes*
Value: 1 point
Rear
Disc or Drum*
Value: 1 point
No cracks or missing pieces*
Value: 1 point
Heat checks on < ½ surface*
Value: 1 point
Thickness > 1/8" pads or 1/4" shoes*
Value: 1 point
Brake System Total
Wheels & Tires

16 points
All tires must be free of damage that exposes the cords and bulges that are indicative of tire core separation.
Front
Condition*
Value: 1 point
Inflation*
Value: 1 point
Depth >4/32"*
Value: 1 point
Tires match*
Value: 1 point
Bead not exposed*
Value: 1 point
Wheels not cracked or welded*
Value: 1 point
Studs and lugs tight*
Value: 1 point
Hub oil present & clean*
Value: 1 point
Rear
Condition*
Value: 1 point
Inflation*
Value: 1 point
Depth >2/32"*
Value: 1 point
Dual tires not touching*
Value: 1 point
Bead not exposed*
Value: 1 point
Wheels not cracked or welded*
Value: 1 point
Studs and lugs tight*
Value: 1 point
Mud flaps present, not rubbing tires*
Value: 1 point
Wheels & Tires Total
Undercarriage

4 points
Frame rails and cross members: No bends, sags, or cracks in rails or cross members | No illegal welded repairs | No missing, broken, or loose bolts*
Value: 1 point
Cab, motor, and body mounts: No obvious damage or defects | No loose or broken connections*
Value: 1 point
Exhaust System: No leaks | All hangers are secure | No significant damage or defects*
Value: 1 point
Automatic Chains: No missing components | Securely mounted | Friction rubber on chain wheel intact*
Value: 1 point
Undercarriage Total
Drive Line

2 points
Drive shaft: No obvious damage or defects*
Value: 1 point
U-joint and carrier bearing: No missing components or obvious defects | Bearing secure*
Value: 1 point
Drive Line Total
Fuel Tank

3 points
Mount: Gaskets and straps in place and secure | No signs of leaks*
Value: 1 point
Fuel cap: Gasket in place*
Value: 1 point
Fuel level: Visually compare actual level to gauge reading*
Value: 1 point
Fuel Tank Total
In Cab

10 points
Housekeeping: Trash and debris removed | No loose items on the floor or dashboard | Windows reasonably clean*
Value: 1 point
Defroster: Vents clear of blockages | Blower and thermostat function*
Value: 1 point
Seats & Seatbelts: Seat secured to the floor with no missing fasteners or components | Seat adjusts and locks into position | Seatbelt free of cuts, holes, fraying | Seatbelt buckles and unbuckles freely | Seatbelt retracts and extends freely*
Value: 2 points
Windshield: Free of defects that distort vision | Free of cracks | Wipers function; blades intact and make good contact with glass*
Value: 1 point
Steering Wheel: No defects or damage | No more than 10% free play | Horn functions*
Value: 1 point
Running Lights: Headlights, taillights, turn signals, marker lights, hazard signals all functional | Light lenses not faded and proper color*
Value: 1 point
Warning Lights: All lights functioning | Lenses in place with no damage*
Value: 1 point
Reverse Signals: Audible alarm functioning at proper volume | Reverse lights functioning | Camera functioning*
Value: 1 point
Safety Equipment: Wheel chock(s) present | High visibility vests for each riding position | Six road flares or three triangles present | Fire extinguisher with a rating of greater than 5B:C*
Value: 1 point
In Cab Total
Motor Running

7 points
Gauges: Gauges reading within normal ranges with motor running | Gauges illuminated and legible*
Value: 1 point
Transmission Fluid: Checked with motor running | Transmission in neutral and warmed to 140-160ºF | Fluid should be reddish color; not brown | Brown fluid that smells burnt signals a potential problem*
Value: 2 points
Listen for abnormal sounds from the motor, belts, mechanical linkages, or other components.*
Value: 2 points
Note abnormal smells such as coolant, fuel, or electrical overheating.*
Value: 2 points
Motor Running Total
Total Points
Critical Fail Points
Failure to successfully perform any of the following components will result in an automatic failure of this evaluation regardless of total score.
1. Failing to engage the safety mechanism on a tilt cab prior to starting an inspection
2. Failure to conduct a thorough examination of any of the following systems as a whole: brakes, steering, tires, and suspension
Evaluator: Select the final outcome of the exam below.*

PASSFAIL - Overall Points ( < 70% )FAIL - Critical Fail Point
Evaluator Name*

First NameLast Name
Date*

MonthDayYear
Date
Evaluator Signature*

Clear
Evaluator Comments
Should be Empty:

Practical Application Guide Sheet

Vehicle Overview

Motor Compartment

Check the following fluids for adequate levels and quality as indicated:

Steering System

Suspension System

Brake System

Front

Rear

Wheels & Tires

Front

Rear

Undercarriage

Drive Line

Fuel Tank

In Cab

Motor Running

Critical Fail Points