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  • Equipment Operator'S Qualification Record (Except Aircraft)

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    Douglas
    27 vizualizări2 pagini
    This document is an equipment operator's qualification record containing information about an individual's qualifications and testing to operate various types of equipment. It includes sections on official qualifications listing equipment the individual is certified to use, background and experience operating other equipment, a performance record, examination findings from written tests and physical evaluations, and a driving performance test with checks for skills like controls, backing, and turns. The record contains identifying information about the individual and tracks their certification and skills testing over time.

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    A348

    Titlu original

    A348

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    This document is an equipment operator's qualification record containing information about an individual's qualifications and testing to operate various types of equipment. It includes sections on official qualifications listing equipment the individual is certified to use, background and experience operating other equipment, a performance record, examination findings from written tests and physical evaluations, and a driving performance test with checks for skills like controls, backing, and turns. The record contains identifying information about the individual and tracks their certification and skills testing over time.

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    © All Rights Reserved
    Descărcați ca PDF, TXT sau citiți online pe Scribd
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    27 vizualizări2 pagini

    Equipment Operator'S Qualification Record (Except Aircraft)

    Încărcat de

    Douglas
    This document is an equipment operator's qualification record containing information about an individual's qualifications and testing to operate various types of equipment. It includes sections on official qualifications listing equipment the individual is certified to use, background and experience operating other equipment, a performance record, examination findings from written tests and physical evaluations, and a driving performance test with checks for skills like controls, backing, and turns. The record contains identifying information about the individual and tracks their certification and skills testing over time.

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    © All Rights Reserved
    Descărcați ca PDF, TXT sau citiți online pe Scribd
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    din 2

    EQUIPMENT OPERATOR'S QUALIFICATION RECORD (EXCEPT AIRCRAFT)

    For use of this form, see AR 600-55; the proponent agency is DCS, G3/5/7.
    NAME (Last, first, initial)

    SEX

    PERMIT (Initial)

    DATE OF BIRTH

    COLOR HAIR

    COLOR EYES

    NUMBER

    DATE ISSUED

    TYPE

    LIMITATIONS (Physical or operational)

    HEIGHT

    WEIGHT

    POSITION TITLE (If civilian)

    SECTION I - OFFICIAL QUALIFICATIONS


    TYPE OF EQUIPMENT

    SIZE

    SPECIAL QUALIFICATION

    SIZE

    TYPE OF DRIVING
    OR OPERATION 2

    DATE QUALIFIED

    QUALIFIED AT

    NAME OF EXAMINER

    NUMBER OF OTHER
    DRIVER'S LICENSES

    SATISFACTORY EXPERIENCE
    VERIFIED BY

    SECTION II - BACKGROUND AND EXPERIENCE


    TYPE OF EQUIPMENT

    1 Special equipment, special operations or conditions

    ADDITIONAL
    DRIVER'S LICENSES
    (State or agency)

    2 City, rural, long haul, etc.

    SECTION III - PERFORMANCE RECORD


    (List chronologically as "credits" - awards, training, retraining, testing, retesting, roadeos, permit renewal,
    relicensing, etc; and as "debits" - accidents, arrests, violations, warnings, revocations, suspensions, etc.)
    DATE

    CREDITS

    DA FORM 348, AUG 2011

    DEBITS

    TYPE OR NATURE

    PREVIOUS EDITIONS ARE OBSOLETE.

    ACTION TAKEN

    (Extract from personnel file to


    maintain at operating level.)

    Page 1 of 2
    APD LC v1.00

    SECTION IV - EXAMINATION FINDINGS


    BATTERY II - (To be administered to all applicants for Driver Permit SF 46) (To transfer raw score to standard score
    BATTERY I - (Administered
    see DA Pamphlet 611-119)
    as a part of reception proRAW SCORE
    STANDARD SCORE
    cessing, at reception stations) DA FORM 6122
    DA FORM 6123
    ENTER SCORE FROM
    ITEM 24 OF INDIVIDUAL'S DA FORM 20

    DA FORM 6124

    TOTAL STANDARD SCORE


    STANDARD SCORE FOR BATTERY II (Divide Total Standard Score by 3)
    SUCCESSFUL COMPLETION

    STANDARD SCORE

    YES

    NO
    ? - IF QUALIF'D
    X - IF SUBSTAND.

    PHYSICAL EVALUATION MEASURES


    LEFT EYE
    20/
    LEFT EYE

    1. VISUAL ACUITY
    2. FIELD OF VISION

    EXAMINATION ADMINISTERED BY (Last name - first name - middle initial)

    COMMENTS AND RECOMMENDATIONS ON


    SUBSTANDARD ITEMS

    SIGNATURE OF
    EXAMINER

    RIGHT EYE
    20/
    RIGHT EYE
    o
    o

    LEFT EAR RIGHT EAR


    /20
    /20

    3. HEARING
    4. REACTION TIME

    /100 SEC

    /100 SEC

    SIGNATURE OF MEDICAL AUTHORITY

    5. DEPTH PERCEPTION
    6. COLOR PERCEPTION

    II

    DRIVING PERFORMANCE TEST (Check "? " if successful, "x" if failed and corrective training is needed)

    A.

    ROAD TEST - PREREQUISITE

    1. INSTRUMENTS (Location, correct reading, action for abnormal


    reading)

    2. BEFORE OPERATION CHECK

    3. EMERGENCY EQUIPMENT
    (Location and use)
    4. CONTROLS - "DRY RUN"
    5. DEPTH PERCEPTION
    (Two feet from target)
    6. PRACTICE RUN ( mile)

    OIL LEVEL STICK

    TEMPERATURE
    GAGE

    OIL PRESSURE
    GAGE

    VOLTOMETER

    AMMETER

    TACHOMETER

    FUEL GAGE

    AIR PRESSURE GAGE

    VEHICLE
    CONDITION
    DAMAGE
    OF TIRES
    MIRROR
    HORN
    ADJUSTMT.
    FIRE EXTINGUISHER
    GEARS

    BRAKE

    FIRST TRY
    START

    PULL OUT

    SEAT
    BATADJUSTMENT
    TERY
    WATER
    WIPER
    LEVEL
    OTHER (Describe)

    CLUTCH
    SECOND TRY

    LOCAL LAWS
    OTHER

    CLEAN
    OIL
    HEADLIGHTS
    LEVEL
    HAND
    FOOT
    BRAKES
    BRAKES
    HIGHWAY WARNING KIT

    SHIFT

    THIRD TRY
    3 STOPS

    OPERATING
    PROCEDURES

    FRONT AXLE

    TURNS

    BACKING

    ACCIDENT
    REPORTING

    (Describe)

    7. ADDITIONAL REQUIREMENTS FOR


    LICENSE

    B.

    ROAD TEST - SCORED PHASE (DA PRT 2678)

    COMMENTS AND RECOMMENDATIONS OF ROAD TEST EXAMINER

    100
    NUMBER OF TALLY MARKS ON
    CHECK LIST PRT 2678 (Subtract)
    ROAD TEST SCORE

    SIGNATURE OF ROAD TEST EXAMINER

    MY DRIVING WEAKNESSES HAVE BEEN


    MADE KNOWN TO ME AND I HAVE BEEN
    SHOWN HOW TO OVERCOME OR ADJUST THEM.

    DA FORM 348, AUG 2011

    DATE

    SIGNATURE OF APPLICANT

    Page 2 of 2
    APD LC v1.00

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