Attachment J.3 - Sample Test Report.docx

ATTACHMENT J.3

SAMPLE TEST REPORT

FRONT COVER

The information required on the cover is as follows:

A. Final Report Number such as 221_ABC_0X_001, where:

B. Final Report Title and Subtitle (example):

SAFETY COMPLIANCE TESTING FOR FMVSS 221

School Bus Body Joint Strength World Motors Corporation 200X World XYZ 65-Passenger School Bus NHTSA No. CX0901

C. Contractor's Name and Address (example):

ABC LABORATORIES, INC.

405 Main Street Detroit, Michigan 48070

NOTE: DOT SYMBOL WILL BE PLACED BETWEEN ITEMS (C) AND (D)

D. Date of Final Report completion

E. The words "FINAL REPORT"

F. The sponsoring agency's name and address as follows –

U. S. DEPARTMENT OF TRANSPORTATION

National Highway Traffic Safety Administration Enforcement Office of Vehicle Safety Compliance Mail Code: NEF-240 1200 New Jersey Avenue SE Washington, DC 20590

FIRST PAGE AFTER FRONT COVER

A disclaimer statement and an acceptance signature block for the COR shall be provided as follows:

This publication is distributed by the U.S. Department of Transportation, National Highway Traffic Safety Administration, in the interest of information exchange. The opinions, findings and conclusions expressed in this publication are those of the author(s) and not necessarily those of the Department of Transportation or the National Highway Traffic Safety Administration. The United States Government assumes no liability for its contents or use thereof. If trade or manufacturers' names or products are mentioned, it is only because they are considered essential to the object of the publication and should not be construed as an endorsement. The United States Government does not endorse products or manufacturers.

Prepared By:

Reviewed By:

Approved By: __________________________

Approval Date:

FINAL REPORT ACCEPTANCE BY OVSC:

Accepted By:

Acceptance Date:

SECOND PAGE AFTER FRONT COVER

A completed Technical Report Documentation Page (Form DOT F1700.7) shall be completed for those items that are applicable with the other spaces left blank. Sample data for the applicable block numbers of the title page follow:

Block 1 — REPORT NUMBER

221_ABC_0X_001

Block 2 — GOVERNMENT ACCESSION NUMBER

Leave blank

Block 3 — RECIPIENT'S CATALOG NUMBER

Leave blank

Block 4 — TITLE AND SUBTITLE

Block 5 — REPORT DATE

March 1, 200X

Block 6 — PERFORMING ORGANIZATION CODE

ABC

Block 7 — AUTHOR(S)

Block 8 — PERFORMING ORGANIZATION REPORT NUMBER

ABC_DOT_XXX_001

Block 9 — PERFORMING ORGANIZATION NAME AND ADDRESS

Block 10 — WORK UNIT NUMBER

Leave blank

Block 11 — CONTRACT OR GRANT NUMBER

DTNH22_0X_C_12345

Block 12 — SPONSORING AGENCY NAME AND ADDRESS

Block 13 — TYPE OF REPORT AND PERIOD COVERED

Block 14 — SPONSORING AGENCY CODE

NEF-240

Block 15 — SUPPLEMENTARY NOTES

Leave blank (if applicable)

Block 16 — ABSTRACT

Compliance tests were conducted on the subject 200X World XYZ 65-passenger school bus in accordance with the specifications of the Office of Vehicle Safety Compliance Test Procedure No. TP_221_0X for the determination of FMVSS 221 compliance. Test failures identified were as follows:

None (or, if any, describe)

Block 17 — KEY WORDS

Block 18 — DISTRIBUTION STATEMENT

Copies of this report are available from:

National Highway Traffic Safety Administration Technical Information Services Division, NIO-120 1200 New Jersey Avenue SE Washington, DC 20590 Telephone No. 202-366-2588 e-mail: tis@nhtsa.dot.gov

FAX: 202-493-2833

Block 19 — SECURITY CLASSIFICATION OF REPORT

Unclassified

Block 20 — SECURITY CLASSIFICATION OF PAGE

Unclassified

Block 21 — NUMBER OF PAGES

Add appropriate number

Block 22 — PRICE

Leave blank

THIRD PAGE AFTER FRONT COVER

TABLE OF CONTENTS

Sample Test Report Table of Contents:

Section 1 — Purpose of Compliance Test

Section 2 — Compliance Data Summary

Section 3 — Test Data (including acceleration and velocity plots)

Section 4 — Test Equipment List and Calibration Information

Section 5 — Photographs

Section 6 — Vehicle Condition Report

Section 7 — Notice of Test Failure (if applicable)