application for a private hire vehicle licence - Wiltshire Council

P T O4. VEHICLE SPECIFICATION - CERTIFICATIONPlease read and check through the attached vehicle specification, taking the necessary measurements, and signeither statement A or B below.A: I have checked the vehicle identified overleaf and confirm that it does conform to the attached vehiclespecification.ORSigned: ................................................................................. Date: .....................................................B: I have checked the vehicle identified overleaf and found that it does not conform with the attached vehiclespecification for the following reasons:-..................................................................................................................................................................................................................................................................................................................................................Signed: ................................................................................. Date: .....................................................Garage stamp:5. INSPECTION REPORT - CERTIFICATIONPlease now check that the vehicle identified overleaf complies with the vehicle inspection report and completeeither statement A or B below:-A: I have inspected the vehicle identified overleaf in accordance with the vehicle inspection report attached andconfirm that the vehicle is in a good roadworthy condition and that all items are serviceable.Signed: ................................................................................. Date: .....................................................ORB: I have inspected the vehicle identified overleaf in accordance with the inspection report attached. The vehicleis not in a good roadworthy condition for the following reasons:..................................................................................................................................................................................................................................................................................................................................................Signed: ................................................................................. Date: .....................................................Garage Stamp:WILTSHIRE COUNCIL5PHV application form

INSIDE CHECK FOR SATISFACTORY UNSATISFACTORY COMMENTSWindscreen Wipers,Washers, Horns, SwitchesGauges, Warning DevicesPanel LightsDriving SeatMirrorsAir VacuumBrake ControlClutch & Throttle ControlsSteering WheelsSteering ColumnUpholsteryCab Floors & StepsSeat BeltsOPERATIONOPERATION & LOCATIONSECURITY / DAMAGESECURITY / DAMAGESECURITY / DAMAGEBUILD UP / LEAKSOPERATION / DAMAGEOPERATION / DAMAGEPLAY / DAMAGESECURITYVIEW / CONDITIONSECURITY/DAMAGESECURITY OF MOUNTINGSCONDITION OF BELTSOPERATIONGROUP LEVEL CHECK FOR SATISFACTORY UNSATISFACTORY COMMENTSHeadlightsSide, Read, Stop LampsDirection IndicatorsAccident DamageCab MountingWingsDoors, LocksExhaust SmokeFuel Tank, Cap, Fuel PipesOPERATION / DIPOPERATION / DAMAGEOPERATION / DAMAGEEFFECTIVE REPAIRSECURITYSECURITY/DAMAGESECURITY/DAMAGEEXCESSSECURITY / DAMAGE / LEAKSHubs & Wheels CRACKS / NUTS /RINGBUTTINGTyresTyre ConditionSIZE / COR. PAIRINGWEAR / DAMAGE / PRESSUREBody SECURITY / DAMAGE /CONDITIONBumpersBody WorkTowing Gear (If Fitted)SECURITY / DAMAGERUSTSECURITYUNDER VEHICLE CHECK FOR SATISFACTORY UNSATISFACTORY COMMENTSWILTSHIRE COUNCIL6PHV application form

ChassisSpring Shackles, BracketsSuspensionShock AbsorbersEngine MountingsCRACKS / LOOSE BOLTS ORRIVETSSECURITY / DAMAGESECURITY / FAILURESECURITY / LEAKSSECURITY / FAILUREPipes & HosesSECURITY / DAMAGE / LEAKS/ CHAFINGBattery, Wiring SECURITY / DAMAGE /CHAFINGExhaust SystemSpare Wheel & CarrierOil LeaksSECURITY / BLOWINGSECURITY / DAMAGEEXCESS LEAKAGESteering Box & Linkage SECURITY / DAMAGE /OPERATIONChassis, IntegralConstruction MembersTransmissionBrake LiningsBrake DrumsBrake LinkageBrake Wheel UnitsStub Axles, Wheel BearingsAncillary EquipmentRUSTSECURITY / DAMAGE / LOOSEBOLTSWEAR / ADJUSTMENTSECURITY / CRACKSADJUSTMENT / LOCKINGDEVICESSECURITY / LEAKSDAMAGE / SIGNS OF WEARSECURITY / DAMAGEROAD TEST & SPEEDOOPERATIONTransmissionSteeringBraking SystemCHECK FOR SATISFACTORY UNSATISFACTORY COMMENTSNOISEALIGNMENTSERVICE BRAKE CONDITIONPARKING BRAKE CONDITIONSERVICE BRAKE EFFICIENCYPARKING BRAKE EFFICIENCYSERVICE BRAKE BALANCEEngineACCELERATIONVALVES / TAPPETSNOISE / VIBRATIONFUEL / CARB / IGNITIONMISCELLANEOUS ITEMSCOMMENTSWILTSHIRE COUNCIL7PHV application form

Hackney Carriage Roof SignPlates: INTERIOREXTERIORFire ExtinguisherFirst Aid BoxYES/NOYES/NOYES/NOYES/NOYES/NOSeating Capacity 4 / 5 / 6 / 7Recorded MileageTaximeter FittedYES/NOMeter No.Four DoorsFour WheelsYES/NOYES/NOWILTSHIRE COUNCIL8PHV application form