Form Design WI

The inspection form has the following groups

• Document

• Inspection Description

• Location

• Carrier

• Driver

• Vehicle

  • EIP

  • Decal and Cargo

• Load

  • Hazardous Material

• Brake Inspection

• Axle Detail

  • Axles

• PreSale Defect

• Violation

  • Mandated Defect

  • MCSAP Defect

  • Non MCSAP Defect

• Level VI

  • Package

• Inspection Result

• Reinspection

• Summary

• Special Study

• Agency

• Attachment

Each Inspection form contains one Document group. The fields within the group are shown in the figure below.

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• How many times do you transmit a specific MCSAP Form.

• Inspection Report Type—Delete DO NOT NEED

Each Inspection form contains one Inspection Description group. The fields within the group are shown in the figure below. This group should be filled out first as it sets of the form deleting and adding groups as well as disabling fields not needed.

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• Inspection Time Zone— remove all values except one.

• Level—MCSAP only, choose the appropriate level.

  • 1—Full inspection

  • 2—Walk-Around Driver/Vehicle

  • 3—Driver Only

  • 4—Special Inspection

  • 5—Terminal Inspection

  • 6—Radioactive Material Inspection

• Special Checks— choose the appropriate selection that applies for the CMV non-MCAP report.

  • Size and Weight Enforcement

  • Alcohol Substance Check

  • Traffic Enforcement

  • Local Enforcement

  • Post-Crash

  • PBBT Inspection

  • Drug Interdiction

  • PASA Inspection –> Entrant Inspection

  • eScreen Inspection

• eScreen Type – TYPE

  • get table from Steve

• Drivers—put in the number of Drivers; this is used for the CMV non-MCSAP and MCSAP reports only and can be 1 or 2 drivers only. After entering this field, the appropriate number of driver groups will be added.

• Total Units—put in the number of units up to 7

• Axles—Put in the total number of Axles for all units up to 20

• Special Studies-put in the total number of special studies, the appropriate number of groups will open

• Drug Search—If a drug search was completed enter yes and the drug arrest number will display. they put in Driver group

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• Facility Type

  • Fixed

  • Roadside

  • VWIM

• VWIM Drop Down single list

• Mile Post #

• Lat and Long

Each Inspection form contains one Carrier group. The fields within the group are shown in the figure below. US DOT # field is searchable.

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• Remove WI Account Number

• Add fields.

Each Inspection form contains one or two driver groups. The fields within the group are shown in the figure below. Last Name field is searchable.

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Add 5 fields.

Each Inspection form contains one Vehicle / Equipment group. On the CMV report the number of Vehicle Groups can increase up to 7. The fields within the group are shown in the figure below. Registration Number field is searchable.

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EIP Group

This group opens for every vehicle group where Vehicle Type is Intermodal Chassis when MCSAP Inspection type is chosen.

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Decal and Cargo Group

This group opens for every vehicle group when MCSAP Inspection type is chosen.

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Just missing Existing Cargo Seal #

Each CMV/MCSAP Inspection form contains one load group. This group is not used for the Ambulance/bus inspection reports. The fields within the group are shown in the figure below.

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• Cargo table same

• should move Haz Type to subgroup subgroup?

• placards Required yes no unknown table with radio buttons

• Missing Cargo Tank radio Yes no

• Cargo Tank specificities same table

Up to 3 HazMat groups may open depending upon how many Total HazMat Types are entered.

• rept Q change to radio button

• haz waste change to radio button

• Class different table current table same as crash form.

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Each Inspection form contains up to 10 Violation groups. The fields within the group are shown in the figure below. The “Additional Violation Description “field is optional and used to add additional statute or ordinance description information. This information will display on all reports.

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• Missing Full Description

• Vehicle Combination table missing one option

  • property single unit with GVWR of more than 10 K lbs

• EXTRA fields

  • scale type

    • Portable

    • Private

    • State

    • Government Other

  • Overload disposition

    • offload

    • permit obtained

    • reload

    • shifted

One of the violation groups will appear based upon what report type is being created.

Violation Group(MCSAP)

Each Inspection form contains up to 999 Violation groups. The fields within the group are shown in the figure below. The “Additional Violation Description “field is optional and used to add additional statute or ordinance description information. This information will display on all reports.

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• Missing Proper Shipping Name

Each Inspection form contains one Inspection Result groups. This information will display on all reports. Depending upon the type of report certain fields will populate.

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The three radio buttons are used to determine which report to display for printing a CMV Inspection report.

Inspection Result --For MCSAP Inspections the result field will gray out and automatically populate based on form criteria.

• DISAPPROVED-OOS SELF CERTIFICATION
  DISAPPROVED-OOS RE-INSPECTION REQUIRED
  APPROVED-NO VIOLATION DETECTED
  APPROVED-MINOR VIOLATIONS DETECTED

• Need Out of Service

Driver OOSPursuant to authority contained in Title 49, Code of Federal Regulations, Section 395.13 and Wisconsin Administrative Code Trans 325/327, I hereby notify and declare the driver: @DriverName named on this report OUT OF SERVICE. No motor carrier shall permit or require this driver to drive or operate any motor vehicle until: @ViolationOOSUntil. Penalties up to $10,000 are prescribed for violating this out-of-service order (49 CFR 386.82).

Vehicle OOSPursuant to authority contained in Title 49, Code of Federal Regulations, Section 396.9(c), I hereby declare vehicles with defects followed by an "Y" in the "Out of Service" column in the violations discovered section of this report OUT OF SERVICE. No person shall remove the out of service stickers applied to these vehicles, or operate such vehicles until the out of service defects have been repaired and the vehicles have been restored to safe operating condition.

OOSThe undersigned certifies that all violations noted on this report have been corrected and action has been taken to assure compliance with the Federal Motor Carrier Safety and Hazardous Materials Regulations insofar as they are applicable to motor carriers and drivers. False certifications of the required repairs are required to be prosecuted with penalties up to $10,000.

Verify Driver NoteThis report must be furnished to the motor carrier whose name appears at the top of this report. [49 CFR 396.9(d)(1)]

Verify Motor Carrier NoteAll mechanical defects must be repaired before the vehicle is re-dispatched. This certification must be signed by the motor carrier and returned to the Wiscosnin State Patrol at the fax number or email address noted above within 15 days. The motor carrier is also required to retain a copy for 12 months from the date of inspection. If a citation was issued, the bond amount should be mailed to the applicable county Clerk of Court. Requests for Data Review: http://dataqs.fmcsa.dot.gov

Other Driver / Carrier Notifications

N/A

Delinquent Letter Section 1

Below is information on a State Department of Motor Safety Driver/Vehicle Examination report that was issued to one of your drivers and has not been returned to this office as of the current date.

Delinquent Letter Section 2

If, within 21 days after the date of this letter, we have not received repair verification on these vehicles, then more stringent enforcement action must be taken in order to ensure that defective equipment is not allowed to continue to operate on the highways of this state.

We appreciate your cooperation in the effort to make State's highways a safer place to travel. If you have any questions, please do not hesitate to call.

The re-inspection group is only opened if an officer reinspection is required.

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Each Inspection form contains one Summary group. The fields within the group are shown in the figure below. Both “Narrative” field has 10,000 max for characters.

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Form Design National

The inspection form has the following groups

• Document/Header

• Summary/Location

• Carrier

• Driver

• Vehicle

• PBBT

  • PBBT Axle

• Size Weight

  • Axle

  • Size Weight Total

• Cargo

• Violation

  • Smart Logic

• Brake Information

• OOS Notice

• Level VI

• Comments

• Studies

• Officer

• Officer Notes

• Attachment

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• Time zone

  • CT Central

• Commerce Type moved to Carrier same a crash form.

• Level

  • NULL
    1 - Full Inspection
    2 - Walk-Around Driver / Vehicle
    3 - Driver Only
    4 - Special Inspection
    5 - Terminal Inspection
    6 - RAM Inspection
    7 - State Specific

• Special Checks

  • 01 - Size and Weight Enforcement
    02 - Alcohol Substance Check
    03 - Traffic Enforcement
    04 - Local Enforcement
    05 - Post Crash
    06 - PBBT Inspection

• E-Screen Yes/NO

• Special Study Yes/No

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• State

  • Defaulted to WI do not need

• County

  • Already have FIPS County Code

• Location Number – Facility Type

  • Patrolling Roving

• Literal Description /MAP

• Mile Post #

• Lat and Long

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• Surveillance

NULL
1-Surv. Conducted-driver/vehicle did not leave site
2-Surv. Conducted-driver/vehicle left,violations corrected.
3-Surv. Conducted-driver/vehicle left,violations uncorrected
D-Drugs Found

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