Fillable 2020 Mip Isnpection Report Form P2 (Minnesota)

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2020 Mip Isnpection Report Form P2 (Minnesota)

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The 2020 Mip Isnpection Report Form P2 (Minnesota) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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PERIODIC VEHICLE INSPECTION INFORMATION FORM
Date: Time: Veh. Lic.# Decal #
Inspector
Name:
BRAKE ADJUSTMENT/BRAKE TYPE
Right
Chamber Type/Size
Pushrod Stroke (in.)
Axle # 1 2 3 4 5 6 7
Left
Pushrod Stroke (in.)
Chamber Type/Size
TIRE INFORMATION
Right
Tire Size
Outside
Min. Tread
PSI
Inside
Min. Tread
PSI
Axle # 1 2 3 4 5 6 7
Left
Inside
Min. Tread
PSI
Outside
Min. Tread
PSI
Tire Size
Brakes
Electric Surge
Controller
Make/Model:____________________
Tow Vehicle
Lic. Plate: ____________ State:______
GVWR:______________
Trailer
Lic. Plate:____________ State:______
GVWR:______________
Steering
Wheel diameter: ________________
Free Play (in.):___________________
Tractor Protection Valve
Activates at (PSI): _______________
Safety Devices
Chain Cable
Size:___________Grade:_______
Pivot Pin/Bracket:________________
Slider/Base:_____________________
Upper/Lower Halves: _____________
Tractor/Trailer used for Test
Lic. Plate: ____________ State:_____
5
th
Wheel Measurements (in.)
Motor Coaches
Emergency Exits/Push-out Windows:
Pass Fail NA
Notes:
I hereby certify the information contained herein is true and accurate: ________________________________________
Inspector signature
This is the only vehicle inspection form approved by the Minnesota State Patrol (01/01/2020)
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2020 Mip Isnpection Report Form P2 (Minnesota)

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Completed 21 July 2020

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