Check List for Interview: Check
Inspect the following items regarding the vehicle's state
| Writer/Inspect or |
Writer's name | |||||
| Inspector's Name | ||||||
| Vehicle information | Car accessory equipment condition | Car accessory is installed to the windshield glass. | No/Yes (Position:) | |||
| Other | No/Yes (Accessory's name:) |
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| Is there any modification for the following items? | Suspension? | Not changed/Changed (Describe concretely:) |
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| Headlight? | Not changed/Changed (Describe concretely:) |
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| Tire size? | Not changed/Changed (Describe concretely:) |
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| Front wiper? | Not changed/Changed (Describe concretely:) |
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| How is the condition around camera? | Is there any scratch or damage on the windshield glass? | No/Yes (Describe concretely:) |
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| Are antennas, etc. attached on the prohibited area? | No/Yes (Describe concretely:) |
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| Is wide mirror or accessory attached? | No/Yes (Describe concretely:) |
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| How is the surface condition of the windshield glass? | Presence of oil film, fogging, dirt and/or glass coating | No/Yes (Describe concretely:) |
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| How is the condition of the dashboard? | Is there anything that can be easily reflected against the windshield glass on the dashboard? | No/Yes (Describe concretely:) |
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| How is the deterioration of the wiper? | Does any streak or uneven wiping area remain in front of the camera? | No/Yes (Describe concretely:) |
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| How is the condition of the tire? | Is there any wear? | No/Yes | ||||
| Is there any excessive wear difference? | (Describe concretely:) | |||||
| Is the air pressure proper? | Proper/Improper (Describe concretely:) | |||||
| How is the condition of the camera lens filter? | Is there finger print adhesion or cracks on the lens filter? | No/Yes (Describe concretely:) |
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| Description of malfunction | What kind of malfunction has been detected? | Failure/temporary stop/faulty operation of adaptive cruise control/faulty operation of pre-collision brake/other faulty operations | ||||
| What kind of DTC and/or cancel code is displayed? | ||||||
| How is the meter display? | EyeSight warning light | Off/On/Blink | ||||
| Pre-collision brake OFF indicator light | Off/On | |||||
| Lane departure warning OFF indicator light | Off/On | |||||
| Multi-information display |
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| Occurrence conditions | Occurrence date | Occurrence location | ||||
| Vehicle speed at occurrence | Approximately mile | Occurrence timing | During driving/during stopping/continues after engine has started | |||
| Road type | Express way/limited highway/main highway/general road | Weather | Fine/cloudy/rainy/snowy/other | |||
| Road condition (1) | Dry/slippery (rainy
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Ambient air temperature | Approximately °C (°F) | |||
| Road condition (2) | Asphalt/gravel/earth and sand/other | Position of solar radiation | Described in the detailed chart when the weather is fine. | |||
| Road shape | Uphill/downhill/ban k/roll/uneven surface | Time elapsed after engine start | Immediately after engine start/within 5 minutes after engine start/more than 5 minutes after engine start | |||
| Wiper operation status | OFF/INT/LO/HI/AUTO | Light on status | Off/LO On/HI On | |||
| Curb weight | Number of passengers: (), Did the vehicle carry heavy load? (No/Yes (Approx. kg)) |
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| Detailed chart (Refer to the example of description.) |
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In case of malfunction caused by temporary stop or faulty operation, describe the details by referring to the example below so that the following conditions can be recognized. (Images taken with a digital camera, etc. are acceptable.)
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EXAMPLE OF WRITING