Q2-Q3 Safety Quiz - Expirations Survey

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* 1. What is your Name?

First Name:

Last Name:

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* 2. What is your truck #?

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* 3. What is the expiration date on your driver's license?

Date / Time

Date

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* 4. When does your medical card expire?

Date / Time

Date

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* 5. When does your truck registration expire?

12/31/21

5/31/21

5/31/22

12/31/20

Other (please specify)

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* 6. When does your truck inspection expire?

Date / Time

Date

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* 7. What color are the 2021 IFTA stickers on your truck?

Yellow

Red

Blue

I don't have any on my truck

Other (please specify)

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* 8. What Color is the New York HUT sticker on your truck?

Yellow

Red

Blue

I don't have one on my truck

Other (please specify)

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* 9. When does the Pennsylvania Alcohol Permit expire for your truck?

12/31/22

12/31/21

12/31/20

Never

I do not have a Pennsylvania Alcohol Permit

Other (please specify)

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* 10. When does the New Hampshire Alcohol Permit expire for your truck?

12/31/21

2/28/21

2/28/22

Never

I do not have a New Hampshire Alcohol Permit

Other (please specify)

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* 11. When does the North Carolina Alcohol Permit expire for your truck?

12/31/21

12/31/22

Never

With an Ownership Change

I do not have a North Carolina Alcohol Permit

Other (please specify)

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* 12. When does the New Jersey Alcohol Permit expire for your truck?

12/31/21

6/31/21

6/31/22

Never

I do not have a New Jersey Alcohol Pemit

Other (please specify)

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* 13. What is the Effective date of the Insrurance cab card in your truck?

12/31/21

3/1/21

3/1/20

I do not have a insurance cab card in my truck

Other (please specify)

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* 14. Do you have a fully charged and secured fire extinguisher in your truck?

Yes

I don't know

Other (please specify)

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* 15. Do you have spare fuses in your truck?

Yes

I don't know

Other (please specify)

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* 16. Do you have 3 triangles in your truck?

Yes

I don't know

Other (please specifiy)

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* 17. Does your truck have a spill kit in it?

Yes

I don't know

Other (please specify)

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* 18. Do you have Ice cleats?

Yes

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* 19. If you have a trailer on, what is your current trailer number? If you do not have a trailer on, please skip

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* 20. If you have a trailer on, what is the registration expiration date?

Date / Time

Date

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* 21. If you have a trailer, does it have a Federal or State of Maine inspection?

Federal

Maine

Other (please specify)

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* 22. If you have a trailer, when does the inspection expire?

Date / Time

Date

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* 23. Do you know how to transfer your log to an Officer or Inspector in your Omnitracs or Orbcomm unit (ERODS)?

Yes

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* 24. When you log into your ELD it is best to log in "off duty" until your log update is complete

True

False

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* 25. It is best practice to accept all "unassigned" drive time without reviewing it?

True

False

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* 26. Do you have spare "paper logs" in your truck in the event that your Omnitracs or Orbcomm unit fail?

Yes

Other (please specify)