Fillable VIN MOTOR VEHICLE RECORD OF INSPECTION (Alberta Student Aid)

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VIN MOTOR VEHICLE RECORD OF INSPECTION (Alberta Student Aid)

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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.
V
ehicle Information
VIN
Make Model Year Odometer
Customer Information
Last Name First Name Middle Initial
Address Postal Code
Section 1 Pre-Inspection
Component P F NA Component P F NA
1.1a. Request for Inspection (RFI) 1.3c. Vehicle wanders or pulls.
1.1b. Vehicle accurately described on the RFI. 1.3d. Brake system performance.
1.2a. VIN plate condition. 1.3e. Driveability.
1.2b. VIN consistent with RFI. 1.3f. Speedometer operation.
1.3a. CV joint road test result. 1.3g. Odometer (if equipped) operation.
1.3b. Universal joint road test result.
NOTES:
Section 2 Onboard Diagnostic Systems
Component P F NA Component P F NA
2.1a. PCM codes present. 2.4b. SRS lamp fails to illuminate.
2.1b. PCM (MIL, SES, etc) lamp fails to illuminate. 2.4c. SRS lamp remains illuminated.
2.2a. ABS codes present. 2.4d. Airbag(s) present.
2.2b. ABS lamp fails to illuminate. 2.4e. Airbag cover integrity.
2.2c. ABS lamp remains illuminated. 2.5. Electronic Stability Control (ESC).
2.3a. Brake system warning lamp fails to illuminate. 2.6. Powertrain Warning Lamps.
2.3b. Brake system warning lamp remains illuminated. 2.7. Other safety systems.
2.4a. SRS codes present.
NOTES:
Section 3 Interio
r
Component P F NA Component P F NA
3.1. Doors. 3.11. Instrument panel lamps.
3.2. Rear view mirror. 3.12. HVAC.
3.3. Sun visors. 3.13. Windshield wiper and washer operation.
3.4. Horn. 3.14. Accelerator.
3.5. Seats. 3.15. Service brake pedal.
3.6. Seatbelts. 3.16. Clutch pedal assembly.
3.7. Signal lamp switch and indicator. 3.17. Park brake.
3.8. Hazard lamps. 3.18. Neutral safety switch operation.
3.9. Headlamp switch and High beam indicator. 3.19. Entertainment display lockout.
3.10. Auxiliary lamp indicator(s)
NOTES:
Section 4 Glass
Component P F NA Component P F NA
4.1a. Windshield marked AS-1, AS-10 or AS-14 4.2b. Side window operation.
4.1b. Windshield condition. 4.2c. Side window aftermarket tint.
4.1e. Windshield tinting / decals 4.2d. Side window visibility (general)
4.1f. Windshield visibility (general) 4.3a. Rear window AS-1, AS-2, AS-3, AS-10, or AS-11
4.2a. Side Glass marked AS-1, AS-2, AS-10 or AS-11 4.4a. Other glass
NOTES:
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VSSROI2009 P = PASS F = FAIL NA = Not Applicable ROI Page 2 of 3
MOTOR VEHICLE RECORD OF INSPECTION
Section 5 Lamps
Component P F NA Component P F NA
5.1. Lamps (general). 5.7. Front side reflectors.
5.2. Daytime running lamps. 5.8. Rear side marker lamps.
5.3. High mount brake lamp. 5.9. Rear side reflectors.
5.4. Headlamps. 5.10. Licence plate lamp.
5.5. Auxiliary lamps. 5.11. Emergency lighting.
5.6. Front side marker lamps
NOTES:
Section 6 Exterior, General
Component P F NA Component P F NA
6.1. Fuel cap. 6.3. Bumpers.
6.2. General body condition. 6.4. Aftermarket equipment installation.
NOTES:
Section 7 Under Hood
Component P F NA Component P F NA
7.1. Hood latch mechanism. 7.7. Clutch master cylinder.
7.2. Hood prop / struts. 7.8. Fuel system.
7.3. Remote starter operation. 7.9. Exhaust manifold(s)
7.4. Battery. 7.10. Oil leaks.
7.5. Accessory Belt Drive System 7.11. Engine and transmission mounts.
7.6. Brake master cylinder.
NOTES:
Section 8 Steering and Suspension
Component P F NA Component P F NA
8.1. Wheel bearings. 8.8. Steering gear.
8.2. Ball joints (front and rear) 8.9. Rack & Pinion
8.3. Tie rod ends (inner and outer) 8.10. Power steering system.
8.4. Pitman arm. 8.11. Control arms.
8.5. Idler arm. 8.12. Struts and shocks.
8.6. Steering stabilizer / damper. 8.13. Springs.
8.7. Steering shaft assembly.
NOTES:
Section 9 Tires and Wheels
Component P F NA Component P F NA
9.1. Tread depth. LF___mm, RF___mm, RR___mm, LR___mm 9.4. Tire serial numbers & dates of manufacture
9.2. Tire condition (general) 9.5. Wheels.
9.3. Tire size. 9.6. Wheel nuts and studs.
NOTES:
Section 10 Brakes
Component P F NA Component P F NA
10.1. Brakes (general). 10.2. Brake lining – LR: mm
10.2. Brake lining – LF: mm 10.8. rotor or drum – LR: mm
10.6. Brake rotor thickness – LF: mm 10.2. Park brake lining – LR: mm
10.2. Brake lining – RF: mm 10.6. Park brake drum diameter – LR: mm
10.6. Brake rotor thickness – RF: mm 10.3. Brake lines and hoses.
10.2. Brake lining – RR: mm 10.4. Brake system wiring.
10.8. Brake rotor or drum – RR: mm 10.5. Brake rotor condition (general)
10.2. Park brake lining – RR: mm 10.7. Brake drum condition (general)
10.6. Park brake drum diameter – RR: mm 10.9. Park brake.
NOTES:
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VSSROI2009 P = PASS F = FAIL NA = Not Applicable ROI Page 3 of 3
MOTOR VEHICLE RECORD OF INSPECTION
Section 11 Under Vehicle
Component P F NA Component P F NA
11.1. Bumpers. 11.5. Drive Axles / Propeller Shafts.
11.2. Engine. 11.6. Floor pan.
11.3. Transmission /Transaxle / Transfer Case. 11.7. Fuel system.
11.4. Differential(s) 11.8. Exhaust system.
NOTES:
Section 12 Structural Integrity
Component P F NA Component P F N
A
12.1. Documentation 12.5. Frame
12.2. Vehicle Identification Number 12.6. Roof
12.3. Body - General 12.7. Pillars
12.4. Structural Dimensions –***Must Be Recorded*** 12.8. 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.
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.
Customer Signature
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VIN MOTOR VEHICLE RECORD OF INSPECTION (Alberta Student Aid)

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Completed 20 April 2021

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