NASATKA FINAL INSPECTION FOR MOBILES

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

BARRIER INFORMATION

• ENTER BARRIER SERIAL NUMBER

  Yes

  No

  N/A

• ENTER BARRIER VIN #

  Yes

  No

  N/A

ENTER VALUE YES=PASS, NO=FAIL (TAKE PICTURES OF ANY FAILED ITEMS)

FRONT TONGUE AREA

• 1. Tongue and Assembly

  Yes

  No

  N/A

• 2. Pintle Hitch-Nuts, Bolts, Washers

  Yes

  No

  N/A

• 3. 24-12 Volt Converter box

  Yes

  No

  N/A

• 4. Breakaway Switch and Assembly

  Yes

  No

  N/A

• 5. Front Marker Lights and Assembly (2)

  Yes

  No

  N/A

• 7. Remote SDI Connector

  Yes

  No

  N/A

• 8. AC Power Box Control Connector & Labels

  Yes

  No

  N/A

• 9. Jacks & Welds, Handle, Assembly-Crank

  Yes

  No

  N/A

• 10. Battery Charger (Housing Area)

  Yes

  No

  N/A

• 11. Tether controller operation

  Yes

  No

  N/A

• 12 NOT USED

  Yes

  No

  N/A

FRONT HOUSING

• 13. Hydro Power Unit & Mounting

  Yes

  No

  N/A

• 14. Hydro Cylinder, Mounting & Hoses<br>

  Yes

  No

  N/A

• 15. Spring & Assembly

  Yes

  No

  N/A

• 16. Control Box and Panel

  Yes

  No

  N/A

• 17. Lid & Mounting

  Yes

  No

  N/A

• 18. Decals on top of lid

  Yes

  No

  N/A

• 19. Schematic attached to door handle<br>

  Yes

  No

  N/A

• 20. Limit Switches (2) and Mounting<br>

  Yes

  No

  N/A

• 21. Battery Box and Mounting (ground to Barrier)

  Yes

  No

  N/A

• 22. Traffic Lights, Function and Seal

  Yes

  No

  N/A

• 23. Door and Lid Secured

  Yes

  No

  N/A

REAR HOUSING

• 24. Spring & Assembly (nut)

  Yes

  No

  N/A

• 25. NOT USED<br>

  Yes

  No

  N/A

• 26. Lid and Mounting and Lid Decal<br>

  Yes

  No

  N/A

• 27. Gate Lock<br>

  Yes

  No

  N/A

VISUAL OUTSIDE RIGHT

• 28. Air Pressure 120 psi<br>

  Yes

  No

  N/A

• 29. Tire/Rim/Lug Nuts

  Yes

  No

  N/A

• 30. Marker Lights<br>

  Yes

  No

  N/A

• 31. Axles and Assembly<br>

  Yes

  No

  N/A

• 32. Break Drum and Assembly

  Yes

  No

  N/A

• 33. Fenders-Decal, Align, Apprrearance

  Yes

  No

  N/A

• 34. Electrical and Brake Connection

  Yes

  No

  N/A

• 35. Gate Door

  Yes

  No

  N/A

TOOL BOX CONTENTS

• 36. Safety Chains

  Yes

  No

  N/A

• 37. Master Control Box with SDI Connector

  Yes

  No

  N/A

• 38. Pliers

  Yes

  No

  N/A

• 39. Adjustable Wrench

  Yes

  No

  N/A

• 40. Push Button Control w/cord<br>

  Yes

  No

  N/A

• 41. Lug Wrench

  Yes

  No

  N/A

• 42. Break Controller

  Yes

  No

  N/A

• 43. Axel Pins (4)

  Yes

  No

  N/A

• 44. Manual Lift Bars

  Yes

  No

  N/A

• 45. CD/Manual

  Yes

  No

  N/A

WELDING

• 46. Visual Inspection of Structural Welds

  Yes

  No

  N/A

• 47. 3rd Party (random) Inspection of Structural Welds

  Yes

  No

  N/A

VISUAL OUTSIDE LEFT

• 48. Air Pressure 120 psi<br>

  Yes

  No

  N/A

• 49. Tire/Rim/Lug Nuts

  Yes

  No

  N/A

• 50. Marker Light<br>

  Yes

  No

  N/A

• 51. Axle and Assembly

  Yes

  No

  N/A

• 52. Break Drum and Assembly

  Yes

  No

  N/A

• 53. Fenders-Decal, Align, Appearance<br>

  Yes

  No

  N/A

• 54. Elect and Brake Connection / Wire tied up

  Yes

  No

  N/A

• 55. Decals on Gate

  Yes

  No

  N/A

REAR BUMPER AREA

• 56. Marker Lights

  Yes

  No

  N/A

• 57. Turn Signals/Break Lights<br>

  Yes

  No

  N/A

• 58. Jacks & Welds/Connecting Bar-Crank

  Yes

  No

  N/A

• 59. Bumper & Assembly

  Yes

  No

  N/A

• 60. Tag Bracket

  Yes

  No

  N/A

• 61. Barrel Plugs in Place (3)<br>

  Yes

  No

  N/A

• 62. Lifting Lugs (2)

  Yes

  No

  N/A

• 63. VIN Sticker applied

  Yes

  No

  N/A

FINAL TEST - RUN THE BARRIER UP/DOWN

• 64. Enter the # of Cycles Completed

  Yes

  No

  N/A

AUTHORIZED BY AND INSPECTED BY

• Inspected By:

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• Authorized By:

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• Nasatka Rep:

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