The Mrp 65 form serves as a crucial tool in ensuring the safety and maintenance of vehicles within the USDA's fleet. It meticulously outlines the procedures for the annual vehicle inspection, detailing various components that must be examined by a qualified mechanic at either a commercial or government facility. This form helps to verify that vehicles are safe to operate and are in compliance with operational standards. Key sections include a thorough examination of the engine, brakes, steering, lighting, exhaust system, and tires, alongside inspections of safety items and emergency kits. Additionally, the form allows for the documentation of necessary repairs or adjustments, categorizing them based on whether they have been made, need to be made, or if special approval from the Regional Office is required for repairs exceeding certain costs. It essentially creates a comprehensive record of the vehicle's condition, ensuring safety items, in particular, are repaired promptly if the vehicle is nearing replacement. By requiring both mechanic and driver or safety officer signatures, the Mrp 65 form ensures accountability and adherence to maintenance schedules, thereby reinforcing safety protocols and regulatory compliance across the fleet.
| Question | Answer |
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| Form Name | Mrp Form 65 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | usda mrp form, usda mrp 65, usda annual vehicle, 65 vehicle inspection |
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DATE OF INSPECTION |
ODOMETER READING |
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ANNUAL VEHICLE INSPECTION |
(Include on MPR Form 64 for quarter |
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in which inspected) |
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VEHICLE NO. |
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LICENCE PLATE NO. |
MAKE |
MODEL |
MODEL YEAR |
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CODE: 1 = OK; 2 = Repairs or adjustments needed; 3 = Repairs or adjustments made (not to exceed $500 without approval from Regional Office)
IF VEHICLE IS SCHEDULED TO BE REPLACED, REPAIR SAFETY ITEMS ONLY (Not to exceed $500 without approval from Regional Office)
SECTION I – TO BE COMPLETED AT A COMMERCAIL OR GOVERNMENT FACILITY BY A QUALIFIED MECHANIC
1. ENGINE |
CODE |
2. BRAKES |
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CODE |
5. STEERING |
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CODE |
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a. Manifold Heat Control Valve |
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b. Drums/rotors |
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d. Tire Rod Ends |
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b. PCV Valve |
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c. Cylinder/Caliper leaks |
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e. Wheel |
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c. Motor Mounts |
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d. Wheel Bearings |
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1. Sway or Drift |
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d. Emissions control/catalytic converter |
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e. Fluid level |
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2. Excessive Play |
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e. Hoses |
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f. Pedal operation |
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3. Binding |
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f. |
Belts |
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g. Parking/Emergency Brakes |
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6. LIGHTS |
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g. Battery |
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3. SUSPENSION |
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a. Headlights |
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1. Connections |
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a. |
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1. Alignment |
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2. Carrier and hold down |
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b. Upper and lower control arms |
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b. Parking Lights |
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h. Fuses |
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c. Springs |
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c. Tail Lights |
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i. |
Speedometer/odometer |
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d. Ball joints |
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d. Breaking Lights |
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j. |
Radiator |
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e. Center bolts |
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e. Turn Signals |
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1. Pressure Cap |
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f. |
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f. License Plate Light |
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2. Antifreeze level |
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g. Shock absorbers |
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g. Interior/Trunk |
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k. Transmission |
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h. Differential fluid |
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h. Instrument Panel |
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1. Bends |
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4. EXHAUST SYSTEM |
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7. TIRES |
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2. Linkage |
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a. Muffler |
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a. Rotation |
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3. Fluid level |
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b. Pipes |
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b. Pressure |
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l. |
Heating/Air Conditioning System |
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c. Hangers and clamps |
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c. Tread |
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m. Horn |
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5. STEERING |
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8. STATE OR COUNTY INSPECTION |
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n. Clutch |
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a. Arms |
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REQUIREMENTS MET |
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2. BRAKES |
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b. Mounting Bolts |
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̊Met |
̊Not Met |
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a. Lining/Pads |
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c. Drag Link |
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SECTION II – TO BE COMPLETED BY THE DRIVER, VEHICLE ACCOUNTABLE OFFICER, OR SAFETY OFFICER |
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9. EXTERIOR |
CODE |
11. WINDOWS |
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CODE |
12. SAFETY ITEMS/EMERGENCY KIT |
CODE |
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a. Body Condition |
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a. Condition |
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h. Spare Tire |
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b. License Plates |
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b. Opening/closing operation |
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i. List of Poison Control Centers |
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Emergency #s |
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c. Brackets and Bolts – Hood Latch |
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c. Defrosters |
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j. Toxic Material Antidote Information |
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d. Molding |
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d. Wipers/washers |
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e. Bumper |
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12. SAFETY ITMES/EMERGENCY KIT |
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f. |
Decals |
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a. First Aid Kit |
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g. General appearance |
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b. Flashlight |
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h. Doors |
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c. Pliers/Screwdriver |
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10. INTERIOR |
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d. Warning Signals/Flares |
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a. Mirrors |
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e. Hammer |
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13. MAINTENANCE SCHEUDULE COMPLICANTCE |
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b. Seatbelts |
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f. Jack |
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̊Met |
̊Not Met |
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c. Decals |
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g. Accident Reporting Kit (includes |
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d. Instrument panel gauges |
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Instructions and forms) |
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14. NAME, ORGANIZATION, AND ADDRESS OF PERSON DOING |
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15. NAME, ORGANIZATION, AND ADDRESS OF DRIVER, VAO, OR SAFETY |
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INSPECTION (Commercial or Government Facility) |
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OFFICER DOING INSPECTION |
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CERTIFICATION: I / WE CERTIFY THAT THIS VEHICLE WAS INSPECTED AND THE REPAIRS INDICATED WERE MADE.
16. |
SIGNATURE OF QUALIFIED MECHANIC |
17. SIGNATURE OF DRIVER/VAO/SAFETY OFFICER |
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18. |
REPAIRS WERE NOT MADE BECAUSE: |
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Repairs between $500 - $1,000 require approval at regional level. Repairs over $1,000 require approval by Property Section, MBS
MRP FORM 65
AUG 2000