Evaluation and inspection Form for National Small Series type Approval (NSSTA) for Category O1 & O2 trailers (O1= <750KG laden) (O2 =<3500Kg laden) Part I and part II of evaluation form is to be completed by the applicant (with the exception of areas verified by an NSAI ATC) An NSAI Approved Test Centre (ATC) will verify and complete relevant sections of Part I where it states “verified by ATC” and inspection requirements as in Part IV. Part IV shall be signed and stamped by an ATC The applicant shall submit with evaluation and inspection form: -Braking calculations (compatibility results between control device and brake), drawings and diagrams, braking test reports -A copy of installation instructions for the coupling device and a signed declaration that the installation instructions were followed -Dimensional drawings, specifications, Bill of materials and photographs describing the trailer build -Copy of the Certificate of Conformity (COC) or Whole Vehicle Type Approval Certificate for the original trailer (if applicable). -All EC/UN-ECE type approvals granted for the base vehicle (see Part II). (if available) Audit carried out: Date of audit: Audit report issued: Audit findings: Quality System Audit for NSSTA Yes: No: Yes: No: Closed off: In Progress: Audit not carried out Yes: No: Completion date: Has audit been scheduled: If Yes, date of audit: If No, then application cannot be finalised until Quality System Audit has been scheduled Page 1 of 18 Rev.01 Part I Applicant’s Name Applicant’s Address VIN or Unique identifier No. of Employees Telephone number Fax number Email Web address Applicant is a subsidiary of Page 2 of 18 Rev.01 0. GENERAL 0.1. Make trade name of manufacturer: 0.2. Type: Variant(s): Version(s): 0.3 Commercial name(s) if available: 0.4. 0.5. Incomplete/complete/completed: Type of bodywork: 0.6. 0.7. Means of identification of type, if marked on the vehicle: Location of that marking: 0.8. Category of trailer: 0.9. 0.10. If applicable, classifications according to the dangerous goods which the vehicle is intended to transport: Name and address of manufacturer: 0.11. Addresses of assembly plants: 1. GENERAL CONSTRUCTION CHARACTERISTICS OF THE VEHICLE 1.1. 1.2. Photographs and/or drawings of a representative vehicle: Number of axles and wheels: 1.3. Number and position of steered axles: 1.4. Chassis, overall drawing: 1.5. If fitted, position and arrangement of engine: (DA, DB, DC, DE)1 (O1, O2,) 1 DA=semi trailer, DB=Drawbar trailer, DC=Centre axle trailer, DE= Rigid drawbar trailer Page 3 of 18 Rev.01 2. MASSES AND DIMENSIONS in kg and mm. Refer to drawings where applicable. 2.1. Wheelbases For two axle vehicles: For multi-axle vehicles: mm mm (More than two axles) Overall axle spacing (1st axle to last axle): mm 1st axle to 2nd axle: mm 2nd axle to 3rd axle: mm 3rd axle to 4th axle: Track of each steered axle (if applicable): Track of all other axles: mm mm Axle 1: mm Axle 2: mm Axle 3: mm Axle 4: mm Range of vehicle dimensions (overall) Length: Length of the loading area: Width: Height (in running order): mm mm mm mm For suspensions adjustable for height, indicate normal running position: Mass of the vehicle with bodywork in running order: Distribution of this mass among the axles: (axles numbered front to rear) 2.2. 2.3. 2.4. 2.6. 2.7. (Axles numbered front to rear) Axle 1: kg. Axle 2: mm Kg kg. Axle 3: kg. Axle 4: kg. Page 4 of 18 Rev.01 2.8. 2.9. Technically permissible maximum laden mass stated by the manufacturer: Distribution of this mass among the axles: (Axles numbered front to rear) kg Axle 1: kg. Axle 2: kg. Axle 3: Axle 1: kg. Axle 4: kg. Axle 2: kg. kg. Axle 3: kg. Axle 4: kg. 2.10. Technically permissible maximum mass on each axle: 2.11. Technically permissible maximum mass on each axle group (tandem axles etc) (if applicable): kg. Maximum mass of unbraked trailer (if applicable): kg. kg Maximum mass of braked trailer: kg 2.14. Technically permissible maximum static vertical load/mass on the vehicles coupling point: kg 5. SUSPENSION 5.1. Level adjustment: (Yes/No) 5.2. Air-suspension: (Yes/No) 5.3. Tyre / wheel combinations: (for tyres indicate size designation, minimum load-capacity index, minimum speed category symbol, suspension) 2.13. Axle (numbered front to rear) Tyre size and Type Load Index Speed Rating Twin or Single Suspension Type (air, steel, hydraulic etc) Axle 1: Axle 2: Axle 3: Axle 4: 5.5. Upper and lower limits of rolling radii: Axle 1: mm Axle 2: mm Axle 3: mm Axle 4: mm Page 5 of 18 Rev.01 6. 6.0. Steering (if applicable) Brief description of steering system: 6.1. 6.2. Type of steering (specify for front and rear, if applicable): Method of assistance, if any (steering wedges, etc): 7. BRAKES 7.0 Brief description of braking system: 7.1. Is vehicle fitted with an anti-lock braking system: (Yes/No): If yes state category of ABS (1, 2 or 3): Category 1: What type of brake system is fitted: 7.1.1 7.2 Air/Vacuum Hydraulic Other (specify): Full Air 7.3 Yes: Hydraulic No: Category 2: Electric Category 3: Inertia Which axles have parking brakes fitted: Axle 1 Axle 2 Axle 3 Axle 4 Page 6 of 18 Rev.01 8. BODYWORK 8.1. Bodywork 8.2. 8.3. Incomplete/complete/completed: For incomplete trailer, type of bodywork: (DA, DB, DC, DE): For complete or completed trailer, final description : Caravan: Horsebox: Other: 8.4. (Specify) Filled in by applicant Verified by ATC For trailers fitted with a coupling device EC approval number of coupling device: Class of coupling device: 8.5 D-value: kN S-value: kg V-value: kN U-value: tonnes Vehicle is fitted with a statutory plate in accordance with EC Directive 76/114/EC (Yes / No) Statutory plate contains: Verified by ATC Name of manufacturer Type-approval number (if available at time of inspection) Vehicle Identification Number (VIN) or Unique Identifier Maximum permitted laden mass of the trailer. Maximum permitted road mass for each axle, listed in order from front to rear. Verified by ATC VIN or unique identifier is marked on chassis or other structure on right hand side in such a way that it cannot be obliterated or deteriorate Page 7 of 18 Rev.01 Part II Matrix showing the combinations of the entries listed in Part I within the versions and variants of the vehicle type Item No All Version 1 Version 2 Version 3 Version n Notes: (a) A separate matrix shall be compiled for each variant within the type. (b) Entries for which there are no restrictions on their combination within a variant shall be listed in the column headed ‘all’. (c) The above information may be presented in an alternative layout or merged with the information supplied in Part I. (d) Each variant and each version shall be identified by an alphanumerical code consisting of a combination of letters and numbers, which shall also be indicated in the certificate of conformity (Annex IX) of the vehicle concerned. (e) Variant(s) which fall(s) under Annex XI of 2007/46/EC (Special Purpose Vehicles) shall be identified by a specific alphanumerical code. Page 8 of 18 Rev.01 Part III Table of compliance with NSSTA Requirements Please indicate in the table below the EC or UN-ECE approvals and/or test reports in support of application for Individual Vehicle Approval. Where an EC approval or test report is not available for any item, an inspection or test will be required at an Approved Test Centre (ATC) of your choice. Please see a list of ATCs at: http://www.nsai.ie/Our-Services/Certification/Automotive-Certification/Type-Approval/Approved-TestCenters.aspx Item No. Category Subject Base Directive Number Yes: No: X UN-ECE Regulation Number 3 O1, O2 Fuel tanks Rear under run 70/221/EEC 4 5 9 O1, O2 O1, O2 O2 Rear reg. plate space Steering effort2 Braking 70/222/EEC 70/311/EEC 71/320/EEC 10 18 20 76/757/EEC 76/758/EEC R3 R7 23 24 28 29 36 43 45 46 See 20 See 20 See 20 See 20 O1, O2 O1, O2 O1, O2 O1, O2 Suppression (radio)3 Plates (statutory) Installation of lighting and light signalling devices Retro reflectors End-outline frontposition (side), rearposition (side), stop, side marker, daytime running lamps Direction indicators Rear reg. plate lamps Rear fog lamps Reversing lamps Heating systems4 Spray-suppression 4 Safety glass4 Tyres 72/245/EEC 76/114/EEC 76/756/EEC 21 22 O1, O2 O1, O2 O1, O2 See Appendix1 See 20 See 20 R34, R67, R110 R58 -R79 R13, R13H, R 90 R10 -R48 76/759/EEC 76/760/EEC 77/538/EEC 77/539/EEC 2001/56/EEC 91/226/EEC 92/22/EEC 92/23/EEC 48 O1, O2 97/27/EC R6 R4 R38 R23 R122 -R43 R30, R54, R117 -- 50 56 O1, O2 O1, O2 94/20/EC 98/91/EC R55, R102 R105 Masses and dimensions Couplings ADR Trailers4 Yes: No: X Test Report Yes: No: X 2 If one or more of the axles are steered axles Compliance can be demonstrated with e marked electronic components 4 If applicable 3 Page 9 of 18 Rev.01 Part IV Check list for NSSTA compliance of an O1 O2 trailer To be performed by an NSAI ATC 3. Rear Under run Result (Pass/Fail) When the construction of the rear of the vehicle forms the rear under run protection device, then the ground clearance of the rear part of the vehicle must not exceed 550mm over a width which is not shorter than that of the rear axle by more than 100mm on either side (excluding any tyre bulging close to the ground). 4. Rear Registration plate space Result (Pass/Fail) The space for mounting the rear registration plate shall comprise an even or virtually even rectangular surface with the following dimensions: Width 520 or 120mm Height 120 or 240mm The space must allow the mounting of a plate in a position as close to vertical as is possible by the vehicle structure available. o < 30º from the vertical if plate is facing upwards. o < 15º from the vertical if plate is facing downwards. The plate shall be visible in the whole space. 46. Tyres (Note - see appendix 2 below) is fitted with e or E marked tyres (record approval number) are marked with the appropriate speed and load ratings for their particular axle locations and the intended use of the vehicle. (see appendix 2 below for indices) Each tyre fitted must have the same structure (eg bias-belted, crossply or radial), nominal size and aspect ratio as any other tyre on the same axle Result (Pass/Fail) Page 10 of 18 Rev.01 20. Installation of lighting and light signalling devices (note-see appendix1 below) Record approval number, characteristic and location of each light signalling device Approval number and characteristic Reversing Lamp No. of Measured devices Height* Measured width** Measured length*** n/a Direction Indicator Lamp Hazard warning signal Lamp Stop Lamp n/a Rear Registration Lamp Front position Lamp n/a Rear position Lamp n/a Rear fog Lamp n/a End outline marker lamp n/a Rear retro reflector (triangular) Front retro Reflector n/a n/a n/a n/a n/a Side retro Reflector Side marker Lamps Conspicuity markings * ** *** n/a = height indicates distance from ground to lower edge of illuminated area = width indicates distance from nearest external vertical edge of trailer to nearest edge of illuminated area = length indicates distance from rear external edge of trailer to nearest edge of illuminated area on side lamps/reflectors or the distance between adjacent lamps. It must be specified where measured is taken from Page 11 of 18 Rev.01 20. Installation of lighting and light signalling devices (note-see appendix 1 below) Requirement Result (Pass/Fail) Observation/ comments -Check that all mandatory lighting devices and max and min number of each as described in Appendix 1 are evident: Reversing lamp(white) Direction indicator(amber) Hazard warning signal(amber) Stop lamp(red) Rear Registration(white) Front position lamp(white) Rear position lamp(red) Rear fog lamp(red) End outline marker lamp (white front / red rear) Rear retro reflector (triangular) (red) Front retro reflector (white) Side retro reflector (amber) Side marker lamps (amber) -Check measured results recorded above are within the limits set out in Appendix 1 for each of the positions of the required lamps/reflectors: Reversing lamp(white) Direction indicator(amber) Hazard warning signal(amber) Stop lamp(red) Rear Registration(white) Front position lamp(white) Rear position lamp(red) Rear fog lamp(red) End outline marker lamp (white front / red rear) Rear retro reflector (triangular) (red) Front retro reflector (white) Side retro reflector (amber) Side marker lamps (amber) 20. Installation of lighting and light signalling devices (note-see appendix 1 below) Requirement Result (Pass/Fail) Observation/ comments -Check that the each of the lamps when activated have the required colour of light emitted and are activated by required control i.e. brake pedal activates brake light, reverse gear activates reverse light etc: Reversing lamp(white) Direction indicator(amber) Hazard warning signal(amber) Stop lamp(red) Rear Registration(white) Front position lamp(white) Rear position lamp(red) Rear fog lamp(red) End outline marker lamp (white front / red rear) Rear retro reflector (triangular) (red) Front retro reflector (white) Side retro reflector (amber) Side marker lamps (amber) Page 12 of 18 Rev.01 20. Installation of lighting and light signalling devices (note-see appendix 1 below) Requirement Result (Pass/Fail) Observation/ comments - Check the geometric visibility of each of the lighting devices against the requirements of appendix 1: Reversing lamp(white) Direction indicator(amber) Hazard warning signal(amber) Stop lamp(red) Rear Registration(white) Front position lamp(white) Rear position lamp(red) Rear fog lamp(red) End outline marker lamp (white front / red rear) Rear retro reflector (triangular) (red) Front retro reflector (white) Side retro reflector (amber) Side marker lamps (amber) 9. Brakes (inertia brakes) Result Observation/ comments (Pass/Fail) -A laden parking brake test shall be carried out on the trailer on an 18° gradient - Check to see if reverse is capable with towing vehicle Visual inspection of : - sliding member to ensure brake can be fully applied - sliding members of control device are protected by bellows or some equivalent device 48. Masses and dimensions Attached (Yes/No) Report TR048 to be completed by the ATC and attached 5. Signature and Authorisation of ATC I confirm that I have carried out the relevant inspections in accordance with the IVA test procedures for this category of trailer and category of approval. The vehicle (identification) complies with the requirements. Signature ----------------------Name Date ----------------------- [official stamp of ATC] Page 13 of 18 Rev.01 Appendix 1 Colour Presence Number Arrangement Position* Geometric Visibility Electrical Connections Tell-Tale α =15° upwards and 5° downwards ß=45° to right and left if one device. 30°if two installed α = 15° upwards and downwards ß=80° outwards and 45° inwards Only light when in reverse Optional See R-48 Visible or auditory or both See direction indicators above See R-48 Circuit closed tell-tale see R-48 Width-inner edges not less than 600mm apart. 400mm if overall width trailer less 1300mm H: 350-1500mm (2100mm if 1500mm not possible) Such that the device illuminates the plate α = 15° upwards and downwards ß=45° to right and left Must light up when brake applied Optional, see R48 Such that the device illuminates the plate See R-48 Optional ß=horizontal angle α= vertical angle Reversing Lamp White Direction Indicators Amber Mandatory O2, O3,O4, optional on O1 trailers Category AR Mandatory 1 mandatory 2nd optional No individual specification Width - no requirement Height -above 250 – below 1200 mm 2 2 rear W: < 400mm from edge H: 3501500mm (2100mm if 1500mm not possible) See direction indicators above Category 2a or 2b Hazard Warning Amber Mandatory 2 2 rear Stop Lamp Red Mandatory Category S1 or S2 2 no special arrangements Rear Registration Plate Lamp White Mandatory Such that the device illuminates the plate Such that the device illuminates the plate 2 no special arrangements W: < 150mm from edge H: 3502100mm α = 15° upwards and downwards ß=80° outwards and 45° inwards See R-48 Circuit closed tell-tale 2, see R-48 no special arrangements W: <400mm H: 350-1500mm (2100mm if 1500mm not possible) α = 15° upwards and downwards ß=80° outwards and 45° inwards See R-48 Circuit closed tell-tale see R-48 Category L Front Position Lamp White Rear Position Lamp Red Mandatory on trailers if > 1600mm wide Category A Mandatory Category RorR1orR2 Page 14 of 18 Rev.01 Colour Presence Number Arrangement Position* Geometric Visibility Electrical Connections Tell-Tale α = 5° upwards and downwards ß=25° right and left α = 15° above and below ß=30° inwards and outwards α = 15° above and below ß=30° inwards and outwards α = 10° above and below ß=30° inwards and outwards α = 10° above and below ß=45° front and to the rear See R-48 Circuit closed telltale See R-48 Optional, see R-48 n/a n/a n/a n/a n/a n/a α = 10° above and below ß=45° front and to the rear See R-48 See R-48 See R-48 n/a n/a ß=horizontal angle α= vertical angle Rear Fog Lamp Red Mandatory Category F or F1 or F2 Mandatory if width >2.1m Category A or AM (front) R,R1,R2,RM1orRM2 (Rear) Mandatory Category class IIIA or IIIB 1 or 2 no special arrangements 2 front, 2 rear no special arrangements End-Outline Marker Lamp White Front, Red Rear Rear RetroReflector Triangular Red Front RetroReflector NonTriangular White Mandatory Category class IA or IB Side RetroReflector NonTriangular Amber Mandatory Category class IA or IB Side-Marker Lamps Amber Mandatory if: > 6m long, Category SM1 See R-48 No special arrangements Conspicuity Markings white/yellow side, red/yellow rear Mandatory if:>2100mm width O3, O4 Full contour markings rear >6mlong partial contour to side See R-48 See R-48 Apex of ▲ directed upwards See R-48 H: 250-1000mm W: < 400mm and as close as possible to edge H: at max. height compatible with design W: < 400mm H:250-900 or 1200 or 1500 See R-48 2 2 See R-48 No special arrangements W < 150mm H: 250-900mm (1500mm if 900mm not possible) No special arrangements H: 250-900mm(1500mm if 900mm not possible) L: fitted middle third and distance between adjacent reflectors <3m.See R-48 H: 250-900mm(1500mm if 900mm not possible) L: fitted middle third and distance between adjacent reflectors <3m.See R-48 See R-48 * Note: width indicates distance from external edge of trailer to nearest edge of illuminated area; height indicates distance from ground to lower edge of illuminated area Page 15 of 18 Rev.01 Appendix 2 Load capacity index Remark Page 16 of 18 Rev.01 Appendix 2 Speed category symbol Speed category symbol F G J K L M N P Q R S T U H V Corresponding speed 80 90 100 110 120 130 140 150 160 170 180 190 200 210 240 Page 17 of 18 Rev.01 Appendix 3 Remarks (if any): Page 18 of 18 Rev.01