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Sales and service outlet no./Representative agency no./Dealership no. | Customer | |||
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Vehicle ident. no. | Repair job no. | |||
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Tester: Name | Date | |||
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Vehicle registration number | First registration | Type | Vehicle application profile | Odometer reading: km/miles |
Customer complaint: | |||||
LEAKY | ☐ | Closes poorly | ☐ | Noises | ☐ |
Gap dimension incorrect | ☐ | Transition incorrect | ☐ | ||
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Test and adjustment values for gap dimensions | Test and adjustment values for transitions | ||||
Actual (R) | Actual (L) | Actual (R) | Actual (L) | ||
Dimension "G" | ___________ | ___________ | Dimension "G" | ___________ | ___________ |
Dimension "I" | ___________ | ___________ | Dimension "I" | ___________ | ___________ |
Dimension "J" | ___________ | ___________ | Dimension "J" | ___________ | ___________ |
Dimension "K" (without CODE T16 and/or T19) | ___________ | ___________ | Dimension "K" (without CODE T16 and/or T19) | ___________ | ___________ |
Dimension "L" (with CODE T16 and/or T19) | ___________ | ___________ | Dimension "L" (with CODE T16 and/or T19) | ___________ | ___________ |
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Actual (R) | Actual (L) | Actual (R) | Actual (L) | ||
Dimension "G" | ___________ | ___________ | Dimension "G" | ___________ | ___________ |
Dimension "I" | ___________ | ___________ | Dimension "I" | ___________ | ___________ |
Dimension "J" | ___________ | ___________ | Dimension "J" | ___________ | ___________ |
Dimension "K" (without CODE T16 and/or T19) | ___________ | ___________ | Dimension "K" (without CODE T16 and/or T19) | ___________ | ___________ |
Dimension "L" (with CODE T16 and/or T19) | ___________ | ___________ | Dimension "L" (with CODE T16 and/or T19) | ___________ | ___________ |
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Yes | ☐ | No | ☐ | ||
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