MOTOR VEHICLE RECORD OF INSPECTION

1 VSSROI2009 P = PASS F = FAIL NA = Not Applicable ROI Page 1 of 3 MOTOR VEHICLE RECORD OF INSPECTION The original RECORD of INSPECTION must be given to the customer regardless of whether the VEHICLE passes or not. VEHICLE Information VIN Make Model Year Odometer Customer Information Last Name First Name Middle Initial Address Postal Code Section 1 Pre- INSPECTION Component PFNA Component Request for INSPECTION (RFI) VEHICLE wanders or pulls. VEHICLE accurately described on the RFI.

2 Brake system performance. VIN plate condition. Driveability. VIN consistent with RFI. Speedometer operation. CV joint road test result. Odometer (if equipped) operation. Universal joint road test result. NOTES: Section 2 Onboard Diagnostic Systems Component PFNA Component PCM codes present. SRS lamp fails to illuminate. PCM (MIL, SES, etc) lamp fails to illuminate. SRS lamp remains illuminated. ABS codes present. Airbag(s) present. ABS lamp fails to illuminate. Airbag cover integrity. ABS lamp remains illuminated. Electronic Stability Control (ESC).

3 Brake system warning lamp fails to illuminate. Powertrain Warning Lamps. Brake system warning lamp remains illuminated. Other safety systems. SRS codes present. NOTES: Section 3 Interior Component PFNA Component Doors. Instrument panel lamps. Rear view mirror. HVAC. Sun visors. Windshield wiper and washer operation. Horn. Accelerator. Seats. Service brake pedal. Seatbelts. Clutch pedal assembly. Signal lamp switch and indicator. Park brake. Hazard lamps. Neutral safety switch operation. Headlamp switch and High beam indicator.

4 Entertainment display lockout. Auxiliary lamp indicator(s) NOTES: Section 4 Glass Component PFNA Component Windshield marked AS-1, AS-10 or AS-14 Side window operation. Windshield condition. Side window aftermarket tint. Windshield tinting / decals Side window visibility (general) Windshield visibility (general) Rear window AS-1, AS-2, AS-3, AS-10, or AS-11 Side Glass marked AS-1, AS-2, AS-10 or AS-11 Other glass NOTES: VSSROI2009 P = PASS F = FAIL NA = Not Applicable ROI Page 2 of 3 MOTOR VEHICLE RECORD OF INSPECTION Section 5 Lamps Component PFNA Component Lamps (general).

5 Front side reflectors. Daytime running lamps. Rear side marker lamps. High mount brake lamp. Rear side reflectors. Headlamps. Licence plate lamp. Auxiliary lamps. Emergency lighting. Front side marker lamps NOTES: Section 6 Exterior, General Component PFNA Component Fuel cap. Bumpers. General body condition. Aftermarket equipment installation. NOTES: Section 7 Under Hood Component PFNA Component Hood latch mechanism. Clutch master cylinder. Hood prop / struts. Fuel system. Remote starter operation.

6 Exhaust manifold(s) Battery. Oil leaks. Accessory Belt Drive System Engine and transmission mounts. Brake master cylinder. NOTES: Section 8 Steering and Suspension Component PFNA Component Wheel bearings. Steering gear. Ball joints (front and rear) Rack & Pinion Tie rod ends (inner and outer) Power steering system. Pitman arm. Control arms. Idler arm. Struts and shocks. Steering stabilizer / damper. Springs. Steering shaft assembly. NOTES: Section 9 Tires and Wheels Component PFNA Component Tread depth.

7 LF___mm, RF___mm, RR___mm, LR___mm Tire serial numbers & dates of manufacture Tire condition (general) Wheels. Tire size. Wheel nuts and studs. NOTES: Section 10 Brakes Component PF NA Component PF Brakes (general). Brake lining LR: mm Brake lining LF: mm rotor or drum LR: mm Brake rotor thickness LF: mm Park brake lining LR: mm Brake lining RF: mm Park brake drum diameter LR: mm Brake rotor thickness RF: mm Brake lines and hoses.

8 Brake lining RR: mm Brake system wiring. Brake rotor or drum RR: mm Brake rotor condition (general) Park brake lining RR: mm Brake drum condition (general) Park brake drum diameter RR: mm Park brake. NOTES: VSSROI2009 P = PASS F = FAIL NA = Not Applicable ROI Page 3 of 3 MOTOR VEHICLE RECORD OF INSPECTION Section 11 Under VEHICLE Component PFNA Component Bumpers.

9 Drive Axles / Propeller Shafts. Engine. floor pan. Transmission /Transaxle / Transfer Case. Fuel system. Differential(s) Exhaust system. NOTES: Section 12 Structural Integrity Component PFNA Component Documentation Frame VEHICLE Identification Number Roof Body - General Pillars Structural Dimensions **Must Be Recorded** floor NOTES: Certification The VEHICLE for which this RECORD of INSPECTION is issued has PASSED (Certificate #_____) FAILED the INSPECTION and I certify it has been inspected in accordance with the VEHICLE INSPECTION Regulation, Alberta Regulation 211/2006 and the applicable INSPECTION Manual.

10 Date of INSPECTION (mechanical)Technician Number (mechanical)Facility Number (mechanical)Signature Date of INSPECTION (structural) Technician Number (structural) Facility Number (structural) Signature Customer Acknowledgment Date (Month/Day/ Year) I understand if a VEHICLE INSPECTION identifies defects and repairs are required, once repaired, the VEHICLE and this RECORD of INSPECTION (ROI) may be presented to any VEHICLE INSPECTION Facility within 10 days of the initial INSPECTION and only the failed items noted on this ROI are required to be re-inspected. If the VEHICLE is not returned for re- INSPECTION within 10 days of the initial date of INSPECTION , a new INSPECTION must be conducted.