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Get FMCSA Intermodal Chassis Inspection Form Revised 2 August 2017

X X X X X X X X X X X X X X X License Plate: Expiration: / / Manufacturer Manufacture Year: State Registered: X X X X Refurb Y N OWNER: X XX Year X X X X Size/Type (Circle One): 20-FLB 20-GEN 20-SLD 20-STD 40-EX5 40-EX8 40-GEN 40-SLD 40-STD 45-GEN 45-STD Other: All inspection criteria derived from FMCSA CFR49 Part 396 and Appendix G subpart B Component/System BRAKE SYSTEM OK ABS Yes No Defect Repa.

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