New West Auto Mall 110 131 12th Street, New Westminster, B.C. V3M 4G9 Tel: 604-759-2244 Fax: 604-759-2615 www.newwestautomall.com NEW WEST AUTO MALL Retail ● Wholesale ● Lease ● Finance Specializing in ALL make Leasing Safety Inspection

Year, Make & Model: Date: Mileage: VIN #:

ELECTRICAL Backup Lights: Select... Good/OK Req. Attn. Unsafe Headlight High: Select... Good/OK Req. Attn. Unsafe Brake Lights: Select... Good/OK Req. Attn. Unsafe Headlight Low: Select... Good/OK Req. Attn. Unsafe Dashlights: Select... Good/OK Req. Attn. Unsafe Horn: Select... Good/OK Req. Attn. Unsafe Headlight Alm: Select... Good/OK Req. Attn. Unsafe Mirrors: Select... Good/OK Req. Attn. Unsafe Parking Lights: Select... Good/OK Req. Attn. Unsafe Turn Signal Select... Good/OK Req. Attn. Unsafe Reflectors: Select... Good/OK Req. Attn. Unsafe Wipers: Select... Good/OK Req. Attn. Unsafe FRONT AXLE Alignment: Select... Good/OK Req. Attn. Unsafe Frame Unit Body: Select... Good/OK Req. Attn. Unsafe Road Clearence Front: Select... Good/OK Req. Attn. Unsafe L/F R/F Tire Condition: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe L/R R/R Wear: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe L R Wheels: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Springs: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Bearings: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Inner Outer L R L R CV Boots: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Front Rear L R L R Shocks: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Ball Joints: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe ENGINE & COOLING SYSTEM Belts (excluding timing belt): Select... Good/OK Req. Attn. Unsafe Fan: Select... Good/OK Req. Attn. Unsafe Coolant Protection/Condition: Select... Good/OK Req. Attn. Unsafe Hood & Safety Catch: Select... Good/OK Req. Attn. Unsafe Engine Mounts: Select... Good/OK Req. Attn. Unsafe Hoses: Select... Good/OK Req. Attn. Unsafe Radiator: Select... Good/OK Req. Attn. Unsafe Waterpump: Select... Good/OK Req. Attn. Unsafe Vaccum System: Select... Good/OK Req. Attn. Unsafe OIL & FUEL SYSTEM LEAKS Accelarator Pedal/Cable: Select... Good/OK Req. Attn. Unsafe Mainseal: Select... Good/OK Req. Attn. Unsafe Breather Hose: Select... Good/OK Req. Attn. Unsafe Oil Level: Select... Good/OK Req. Attn. Unsafe Cam Seal: Select... Good/OK Req. Attn. Unsafe Oil Pan: Select... Good/OK Req. Attn. Unsafe Cyl Head Gasket: Select... Good/OK Req. Attn. Unsafe Pressure Switch: Select... Good/OK Req. Attn. Unsafe Fuel Tank/Hoses: Select... Good/OK Req. Attn. Unsafe Pulley Seal: Select... Good/OK Req. Attn. Unsafe Inter/Seal: Select... Good/OK Req. Attn. Unsafe V/Cover: Select... Good/OK Req. Attn. Unsafe

TRANSMISSION Noise: Select... Good/OK Req. Attn. Unsafe Clutch: Select... Good/OK Req. Attn. Unsafe Fluid Leaks: Select... Good/OK Req. Attn. Unsafe BRAKES Front Rear L R L R Select... Good/OK Req. Attn. Unsafe % Select... Good/OK Req. Attn. Unsafe % Select... Good/OK Req. Attn. Unsafe % Select... Good/OK Req. Attn. Unsafe % Brake Lines: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Pads: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Rotors: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe ABS Light: Select... Good/OK Req. Attn. Unsafe Master Cylinder: Select... Good/OK Req. Attn. Unsafe Brake Failure Indicator: Select... Good/OK Req. Attn. Unsafe Parking Brake: Select... Good/OK Req. Attn. Unsafe Brake Pedal Reserve: Select... Good/OK Req. Attn. Unsafe Power Brake Operation: Select... Good/OK Req. Attn. Unsafe EXHAUST Cat/Converter: Select... Good/OK Req. Attn. Unsafe Manifold Gasket: Select... Good/OK Req. Attn. Unsafe Resonator: Select... Good/OK Req. Attn. Unsafe Hangers: Select... Good/OK Req. Attn. Unsafe Muffler: Select... Good/OK Req. Attn. Unsafe Tailpipe: Select... Good/OK Req. Attn. Unsafe STEERING Power Steering System: Select... Good/OK Req. Attn. Unsafe Steering Boots: Select... Good/OK Req. Attn. Unsafe Steering Column/Cupler: Select... Good/OK Req. Attn. Unsafe Steering Lash/Travel: Select... Good/OK Req. Attn. Unsafe Steering Linkage/Arms Select... Good/OK Req. Attn. Unsafe Steering Rack: Select... Good/OK Req. Attn. Unsafe L R Tie Rods Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe REAR AXLE L R CV Boots: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Road Clearance: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Shocks: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Tire Construction: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Tires: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe Wheels: Select... Good/OK Req. Attn. Unsafe Select... Good/OK Req. Attn. Unsafe

BODY A/C Drains: Select... Good/OK Req. Attn. Unsafe Seatbelts: Select... Good/OK Req. Attn. Unsafe Windows: Select... Good/OK Req. Attn. Unsafe Exterior Body: Select... Good/OK Req. Attn. Unsafe Seats: Select... Good/OK Req. Attn. Unsafe Windshield: Select... Good/OK Req. Attn. Unsafe Front/Rear Bumper: Select... Good/OK Req. Attn. Unsafe Sunroof Drains: Select... Good/OK Req. Attn. Unsafe Protruding Metal: Select... Good/OK Req. Attn. Unsafe Trunk/Tailgate: Select... Good/OK Req. Attn. Unsafe

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