DI5Q1
−
01
Supplemental Restraint System Check Sheet
Date Problem Dist Occurred
Customer’s Name
Registration No.
Registration
Year
Frame No.
Odometer Reading
Weather
Temperature
Vehicle Operation
Road Conditions
Details Of Problem
Vehicle Inspection, Repair Histo-
ry Prior to Occurrence of Mal-
function(Including Supplemental
Restraint System)
Diagnosis System Inspection
SRS Warning Light
Inspection
DTC Inspection
1st Time
2nd Time
1st Time
2nd Time
Inspector’s
Name
Fine
Cloudy
Rainy
Snowy
Other
Approx.
Starting
Idling
Driving [
Constant speed
Acceleration
Deceleration
Other
]
Remains ON
Sometimes Light Up
Does Not Light Up
Remains ON
Sometimes Light Up
Does Not Light Up
Normal Code
Malfunction Code
Normal Code
Malfunction Code
[ Code.
]
[ Code.
]
km
Miles
/
/
/
/
/
/
Date Vehicle Brought In
−
DIAGNOSTICS
SUPPLEMENTAL RESTRAINT SYSTEM
DI
−
239
1996 LAND CRUISER (RM451U)
CUSTOMER PROBLEM ANALYSIS CHECK
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Brought to you by BirfMark
Version 1.00 - 12/21/2010