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Get Ccm Report Chassis Form

CCM CHASSIS INDUCTION REPORT Inter-Pool Transfer From to Pool Pool Marking Circle One DCCP MCCP MWCP GCCP Coop SACP COCP De-Coop City / State Chassis Number VIN Chassis Contributor Date Manufactured Facility of Inspection FMCSA Date / License Number License Exp. Date Date Re-Mac State of Registration Chassis Size / Type Circle One 40 /45 40 /45 /48 Tri-Axle Underslung Genset Chassis INSPECTION NOTE If any exceptions are noted they must be repaired before induction into THE POOL. All expenses resulting from this inspection and subsequent repair are for the account of the owner. Upon completion of the inspection and acceptance into THE POOL the chassis shall have 4 THE POOL stenciled on each of the main rails and 2 THE POOL stenciled on the front and rear bolsters in a contrasting color. This is for the account of the owner. Limit for Automatic Repair - 150. 00 USD and the cost of 1 tire plus labor to install* If the needed repairs for induction exceed this limit the owner shall receive an estimate of repair within 24 hours of inspection and shall have 5 working days to render a decision as to whether to proceed with repairs or remove the chassis from facility where it was inspected* Completed form should be sent via email as a PDF attachment to the respective Pool Manager and M R Manager. Item Accept Decline Repaired Tires Front Bolster Front Locking Devices Gladhands Connections LIF LOF LIR Air Lines Main Rails Main Rail Crossmembers Landing Gear Crank Handle Radius Rods Air System / Relay Valve Brakes / Adjustment Wheel Seals Grease Wheel Seals Oil Brake Chambers Slack Adjusters Rear Bolsters Rear Locking Devices ICC Bumper Mud Flaps Mud Flap Brackets Lights / Electrical LOR RIF ROF RIR ROR DATE NOTE Rims / Studs / Clamps shall also be inspected CIR CHECKLIST FMCSA Date 90 or 90 Chassis stenciled all 4 sides of chassis Form is signed Remember repair limits Prepare estimate if over limit the inspection Send estimate to owner within 24 hours VENDOR COMPANY NAME ACCEPTED DECLINED DATE ACCEPTED AFTER OWNER APPROVAL INSPECTOR PRINT SIGN CCM CIR v1. All expenses resulting from this inspection and subsequent repair are for the account of the owner. Upon completion of the inspection and acceptance into THE POOL the chassis shall have 4 THE POOL stenciled on each of the main rails and 2 THE POOL stenciled on the front and rear bolsters in a contrasting color. Upon completion of the inspection and acceptance into THE POOL the chassis shall have 4 THE POOL stenciled on each of the main rails and 2 THE POOL stenciled on the front and rear bolsters in a contrasting color. This is for the account of the owner. Limit for Automatic Repair - 150. 00 USD and the cost of 1 tire plus labor to install* If the needed repairs for induction exceed this limit the owner shall receive an estimate of repair within 24 hours of inspection and shall have 5 working days to render a decision as to whether to proceed with repairs or remove the chassis from facility where it was inspected* Completed form should be sent via email as a PDF attachment to the respective Pool Manager and M R Manager.

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