Driver Evaluation Form

• Conducted on

  Date

• Prepared by

• Location
  Address

• Name

• Date of Hire

  Date

• Street Address (incl. city & postal code)

• Drivers License #, Class, Endorsements, Province, Expiry

• Truck/Tractor Unit #

• Trailer Unit #

• Test Date

  Date

• Mileage Start

• Mileage End

• Total Mileage

Part 1 - Pre-Trip Inspection & Emergency Equipment

• General vehicle condition noted

  Yes

  No

  N/A

• Parking brake set/applied

  Yes

  No

  N/A

• Lighting inspected

  Yes

  No

  N/A

• Horn and windshield wipers inspected

  Yes

  No

  N/A

• Emergency equipment inspected

  Yes

  No

  N/A

• Fluid levels checked

  Yes

  No

  N/A

• 360 degree walk-around performed

  Yes

  No

  N/A

• Tires evaluated

  Yes

  No

  N/A

• Steering inspected

  Yes

  No

  N/A

• Mirrors inspected/adjusted

  Yes

  No

  N/A

• Insurance/licensing info inspected

  Yes

  No

  N/A

• Does a visual inspection of fifth wheel and pin after hooking onto trailer (not just a tug test)

  Yes

  No

  N/A

Part 2 - Placing Vehicle in Operation

• Uses seatbelt

  Yes

  No

  N/A

• Starts vehicle properly

  Yes

  No

  N/A

• Does not allow vehicle to roll while stopped

  Yes

  No

  N/A

• Steers smoothly

  Yes

  No

  N/A

• Verifies passenger is wearing seatbelt

  Yes

  No

  N/A

• Drives with both hands on steering wheel

  Yes

  No

  N/A

• Speed is appropriate for conditions

  Yes

  No

  N/A

• Shifts smoothly (not grinding gears/slipping out of gear)

  Yes

  No

  N/A

Part 3 - Backing & Parking

• Gets out to look before backing

  Yes

  No

  N/A

• Uses mirror properly

  Yes

  No

  N/A

• Avoids backing when possible

  Yes

  No

  N/A

Part 4 - Intersections

• Covers the brake with foot at intersections

  Yes

  No

  N/A

• Stops vehicle in proper location

  Yes

  No

  N/A

• Checks traffic in all directions

  Yes

  No

  N/A

• Does not allow vehicle to roll when stopped

  Yes

  No

  N/A

Part 5 - Turning

• Vehicle is in proper lane for turn

  Yes

  No

  N/A

• Approaches turn at proper speed

  Yes

  No

  N/A

• Turns only when traffic is cleared

  Yes

  No

  N/A

• Signals used in advance of turn

  Yes

  No

  N/A

• Checks traffic conditions

  Yes

  No

  N/A

• Keeps vehicle in proper lane while turning

  Yes

  No

  N/A

Part 6 - Passing

• Determines if pass is legal and safe

  Yes

  No

  N/A

• Checks ahead before passing

  Yes

  No

  N/A

• Returns to lane safely

  Yes

  No

  N/A

• Passes in safe location

  Yes

  No

  N/A

• Uses turn signal appropriately

  Yes

  No

  N/A

Section 7 - Load Securement

• Checks freight properly

  Yes

  No

  N/A

• Handles and loads freight properly

  Yes

  No

  N/A

• Load is tied down to meet NSC standards

  Yes

  No

  N/A

Remarks

• Remarks on driving evaluation (positive & negative)

General Performance

• Satisfactory

  Yes

  No

  N/A

• Re-test on this date: (minimum 12 months from initial test-date)

• Qualified for: Truck / Trailer #

Sign-Off

• Examiner's Signature

  Sign

• Driver's Signature

  Sign