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Cartage Australia Pty Ltd
ABN 60 108 355 344
PO Box 879 Cranbourne Vic 3977
Tel: (03) 5996 1019 Fax: (03) 5996 6570

Brake and Rotor Campaign Form

Date and Time *

Supervisor *

Supervisor Email *

Other *If CMV Technician then CMV Technician ID is required, please contact derrimutservicebookings@cmvtb.com.au

Second Supervisor

Second Supervisor Email

Other *If CMV Technician then CMV Technician ID is required, please contact derrimutservicebookings@cmvtb.com.au

Please enter a Trailer fleet number.
You can lookup the fleet number using the registration number if required.
The corresponding registration number must be looked up or entered manually.

Truck has been removed at the request of the Client.
Please review the conditional logic to reinstate if required.

Truck Fleet No.

If Truck not listed please use 999 and enter missing truck identification information.

Truck Registration No.

Lookup

If Truck is 999 and the registration is not known please enter NOTKWN as the value. Max 6 characters.

Truck Vehicle Identification Number *Please provide identification information for Head Office to add this as a new Truck.

No. Drive Axles? *Excluding front steering axle.

No. Tyres per Drive Axle? *

Trailer Fleet No.

If Trailer not listed please use T999 and enter missing trailer identification information.

Trailer Registration No.

Lookup

If Trailer is T999 and the registration is not known please enter NOTKWN as the value. Max 6 characters.

Trailer Vehicle Identification Number *Please provide identification information for Head Office to add this as a new Trailer.

No. Trailer Axles? *

No. Tyres per Trailer Axle? *

Truck

Steer Rotor (PS) *

Steer Brake (PS) *

Steer Brake (DS) *

Steer Rotor (DS) *

1st Drive Rotor (PS) *

1st Drive Brake (PS) *

1st Drive Brake (DS) *

1st Drive Rotor (DS) *

2nd Drive Rotor (PS) *

2nd Drive Brake (PS) *

2nd Drive Brake (DS) *

2nd Drive Rotor (DS) *

Trailer

Please enter or select "N/A" for axles that were inspected but not measured.

1st Axle Rotor (PS) *

1st Axle Brake (PS) *

1st Axle Brake (DS) *

1st Axle Rotor (DS) *

2nd Axle Rotor (PS) *

2nd Axle Brake (PS) *

2nd Axle Brake (DS) *

2nd Axle Rotor (DS) *

3rd Axle Rotor (PS) *

3rd Axle Brake (PS) *

3rd Axle Brake (DS) *

3rd Axle Rotor (DS) *

4th Axle Rotor (PS) *

4th Axle Brake (PS) *

4th Axle Brake (DS) *

4th Axle Rotor (DS) *

5th Axle Rotor (PS) *

5th Axle Brake (PS) *

5th Axle Brake (DS) *

5th Axle Rotor (DS) *

6th Axle Rotor (PS) *

6th Axle Brake (PS) *

6th Axle Brake (DS) *

6th Axle Rotor (DS) *

Signature *

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Second Supervisor Signature

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