THORN VALLEY ENTERPRISES
8498 W. Fall Creek Drive
Pendleton, IN 46064
Phone (888) 485-0767
Fax (317) 485-5386
January 7, 2011
Mr. XXXX XXXXXX- President
XXXXXX, AL #####
Dear Mr XXXXXX:
Thank you for the time that you provided our safety auditor during his recent visit. Overall, it appears that you
have a good safety program in place. During the visit our safety engineer, Bob Hampton noted a few things that
should be addressed to improve your level of safety and compliance. I have outlined these areas below.
Rec # Priority (C = Critical; I = Important; S = Suggested)Recommendation
01 S We suggest when you issue a copy of the written safety manual to a new driver at orientation,
have them sign a sheet documenting receipt. The signature page would then go into the driver qualification or
02 S We suggest implementation of a formal safety awards program for accident free driving and
other safety related items, i.e., no log violations, no violations at roadside inspections, increased tractor MPG, no
traffic citations, etc. The program can be based on either miles or months/years without violations in the target
areas. You may want to tie in the presentations with your annual safety meetings to make a bigger impact with
the drivers and/or family members. Professional drivers really appreciate recognition for their safety
03 S We suggest a monetary incentive for drivers that go through a roadside inspection with "no
violations." Typically, $50-$100 for each "clean" inspection is a good driver incentive. Lesser amounts may be
appropriate for your particular operation. Sell the program as a means to help the company and drivers improve
the CSA BASIC scores while decreasing driver OOS waiting time. Remember to emphasize, drivers are
penalized for excessive violations which could potentially lead to the loss of their CDL.
04 S We suggest a policy of remedial training for drivers receiving log violations, roadside
inspection violations, traffic citations and/or preventable accidents. This extra training could be either classroom
or observation rides with the driver depending on the particular violation. The extra training might highlight
some poor habits or practices and could correct a problem before it become a major issue. Document the
training and place in the DQ or personnel file.
05 I It is important for drivers using the 100 mile exemption and keeping a time sheet to be released
from duty within 12 hours subject to Part 395.1(1)(ii) of the FMCSA regulations. If a driver is on duty for 12 hrs
or more, they must prepare a log for that particular day. Some interstate carriers require all drivers to use logs
regardless of driving status (local or linehaul) to limit confusion. In your case, since your interstate carriage is
still rather limited, you may find it easier to just have the local driver complete a log for only the 12 hour day(s)
and use the time sheet for other days. Obviously, all interstate linehaul drivers must maintain a log accounting
for each day.
06 S We suggest implementing a written progressive disciplinary program for driver log violations,
roadside inspection/moving violations and preventable accidents. Start with a verbal counseling and/or extra
training but explain continued violations could result in more serious discipline up to a suspension and possible
discharge. A progression is then established for future warning letters, usually 3 written warnings in 12 months
would be grounds for discharge. A signature would be required by the driver and the supervisor discussing the
violation. The signed copy goes into the DQ or personnel file. Obviously, the intent is not to discharge drivers
but to improve their performance. This policy would be consistent with the safety programs mentioned in Recs
#2 and #3 above… warnings for violations and rewards for no violations.
07 C It is critical for XXXXXXX Corp to continue preparation for the new FMCSA CSA program
just implemented. Driver training and management awareness are very important to make sure you are in
compliance. There are several information websites on line that could be of assistance to you. In addition, you
are welcome to use our website at www.thornvalleyent.net. Just click on the CSA information link shown to the
left of the home page. The Alabama Trucking Assn or JJ Keller offer training material and speakers specifically
to assist with CSA.
Since you are new into interstate trucking, you may want to consider a safety consultant in you area to perform a
mock DOT audit and help with CSA or other safety issues. I'm sure Alabama Trucking Assn would be willing to
furnish a list of reputable consultants if you are interested.
Please review the following recommendations and contact us in writing to let us know what changes you
anticipate making and the time frame for implementing them. The information provided at the time of the safety
auditor’s visit should help you with your compliance efforts.
Thank you again for your time. If you have any questions or concerns, please feel free to call.
We should have your response within 20 days - please Mail, e-mail, or fax it - Thank you!!
Thorn Valley Enterprises
8498 W Fall Creek Drive, Pendleton, IN 46064
Feel free to contact us at any time with questions.
The information and recommendations provided as a result of this survey are designed to assist you in your
accident prevention efforts. No warranties or guarantees are made by Thorn Valley Enterprises or your
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 2 of 12
THORN VALLEY ENTERPRISES
COMMERCIAL VEHICLE LOSS CONTROL SURVEY
Insured XXXXXXX Corp Date 12-28-10
Address XXXXXXXX Policy Number PIA03073500
City, State Zip XXXXXX, AL ##### Loss Control Engineer Bob Hampton
Moderate Risk… High level of 2
Person(s) Interviewed XXXXX, YYYYY, ZZZZZ Overall Opinion of Risk lane traffic on rural roads. New
entrant into interstate carriage.
Ops/Safety Mgr; Owner/Sec-
Title(s) Agent Alabama Public
Phone Number (###) ###-#### Phone Number 205-324-0406
(I) TABLE of CONTENTS
(I) Risk Summary (IV) Safety Management
(I) (a) Narrative (V) Driver Selection
(II) Account Overview (VI) Driver Safety Training
(III) (a) Operations (VII) Driver Supervision
(b) Vehicles (VIII) Accident Reporting
(c) Inspection, Repair & Maintenance (IX) Premises
(d) Owner/Operators (X) Notes
(e) Cargo & Hazmat (XI) Driver File Review Summary
(I) RISK SUMMARY
ENGINEER OPINION Recommendation
PROGRAM ELEMENT Excels Good Avg. Fair Poor
Notes (see recommendations) Number
Operations and Maintenance
Suggestion: driver 01
Suggestion: safety awards &
incentive program. 02 & 03
Suggestion: periodic/remedial 04
Critical: Increase CSA driver
Important: 100 air mile 05
Driver Supervision 06
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 3 of 12
Total Fleet Size* Total # of Recommendations
Critical Important Suggested Total
Number of Power Units: 48 # Trailers: 48
1 1 5 7
*Fields automatically populate from section 3(b) input
Discuss any Critical Improvements that are required: XXXXXX Corp needs more CSA preparation and training.
There is not much CSA data available due to the 2010 entry into interstate carriage (was intrastate only until
then) so roadside inspections are limited.
List major positive factors: Low driver turnover, good experienced driver base, well paying cargo (+$3.00/mile)…
long-term mgt team.
Overall management safety attitude: Good
Remarks: Well managed company with a strong and specific market for the area.
(I) (a) NARRATIVE
Irregular route truckload carrier using dump vans. Common carrier authority with 97% of cargo
in AL and approximately 3% in MS. Company received Interstate authority in 2010 primarily
for business in MS. Until then, they were a Intrastate AL carrier only. The company is 29 yrs
old with Don Oswalt the Founder/Owner and Sec/Treasurer. YYYYY'S son, ZZZZ is the
President/COO. They are a dedicated dump van carrier with specific customers. They appear to
be well managed with estimated revenue for 2010 at $7.1 million and estimated miles at 2.3
million ($3.09/mile.) The terminal building and shop building are well maintained. Gravel yard
is a little rough but serviceable. Above-ground diesel tanks are in good order and well
maintained. Currently, no DOT audit or safety rating has been awarded. CSA Basic scores are
all within guidelines.
Basically a 7am-5pm operation with dispatch on call if any drivers are out past normal office
hrs. Don-Dell is a short haul carrier with 70% of total miles in the 0-50 mile range and the
remaining 30% in the 50-200. Avg length of haul is about 75 miles. Approximately 97% of the
IFTA miles are in AL with 3% in MS. Drivers return home same day except in very rare
occasions when they remain out overnight. They received their Interstate authority in 2010 to
expand into MS, they were strictly an Intrastate AL carrier until then. Deadhead runs about
40% due to cargo restrictions and limited backhauls. Commodities consist of raw coal, gravel
and sand. They have no brokerage authority, haul no haz mat and have no owner-operators.
Vehicles and Equipment:
46 company tractors- age range '90 (1) -'08 (4). 3 older tractors will be sold when the market
improves. 14 are over 10 yrs old. 48 dump van trailers- age range '82 (1) - '09 (2), 27 exceed 10
Inspection, Repair and Maintenance:
All of the equipment appears to be in good shape and well maintained, almost entirely by their
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 4 of 12
shop. The Vehicle Maintenance Basic stands at 69.1% (80% is the intervention threshold) and
the Vehicle Safer OOS is 15.2% (22.3% is the natl avg.) These numbers indicate a good
maintenance program; however, limited roadside inspections have been performed. 50% of the
violations discovered were for improperly functioning lights. They are working to install a
better lighting system. Individual equipment files are organized and in good order… Annual
inspections are current.
No DOT audit has been performed and no safety rating has been assigned. XXXXX is the
Ops/Safety Mgr with about 6 yrs experience. XXXX is assisted by the company President,
ZZZZZ, on safety/operations issues with most duties shared. The operation is small with
consistent runs to consistent customers leaving time from dispatch for both to work on safety.
Each driver receives a copy of a written safety manual but no acknowledgement is required by
the driver. Note: Will mention in recs to get a signature sheet.
They have no formal safety awards program and no monetary safety incentives for "clean"
roadside inspections. Note: Will discuss both in recs.
Staffing and Personnel:
Office: 1- Owner/Sec/Treasurer, 1- President/COO, 1- Operations/Safety Mgr, 1- HR
Mgr/Secretary, 1- Payroll/Office Asst (5 total)
Shop: 1- Lead Mechanic, 4 mechanics (5 total)
Drivers: 35- company singles (35 total)
Driver Selection, Hiring and Orientation:
No drivers under age 24, 1 over 65. Written hiring criteria with insurance company to screen
questionable MVR's. Must be at least 23 yrs of age and 2 yrs experience with dump trailers.
MVR review, interview process and past employment verifications appear adequate. Driver
turnover rate is about 40%. MVR's and physicals are current but some annual reviews are a
little late they will complete them by 1/3/11. Driver qualification files are ok. Driver data
sheets were not used but they will begin in '11 with new hires. Drug and alcohol testing
programs are current and well managed.
Orientation lasts about 6 hrs and covers the basics of safety and operations appears adequate.
PSP program to screen new drivers is being utilized.
Driver Safety Training and Awards Program:
Driver safety meetings are held annually and documented. Attendance is required if no
emergency exists. No regular re-occurring/periodic or remedial training except for accident
follow-up. Note: Will mention in recs.
It is critical for CSA training to be increased to prepare drivers and mgt. Note: Will mention in
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 5 of 12
Trucks are governed at 70mph. Matt manually audits the logs that are required for the interstate
operation (about 3% of the total.) The majority of the drivers run local with a time sheet and
use the 100 mile exemption; however, some locals are exceeding the 12 hr requirement and not
logging. Note: Will discuss in recs.
All though log errors and roadside violations are minimal, a progressive disciplinary program
should be implemented in conjunction with CSA to correct recurring problems that may arise.
Note: Will discuss in recs.
All other CSA BASICS other than Vehicle Maintenance are "Inconclusive" or "Not Available"
with only 34 inspections to gauge compliance due to being a new interstate entrant in '10.
Note: Don-Dell may want to seek an outside safety consultant to perform a mock DOT audit
and assist with CSA training. I'll mention as a comment in the recs.
Crash Countermeasures and Controls:
DOT accidents for '09 and '10 are minimal. No extra countermeasures or controls exist except
normal counseling for minor preventable accidents or termination for major preventable
accidents involving serious injury or property damage.
Accident register is current.
No serious DOT compliance issues are apparent; however, a complete mock audit may be in
order since they are a new interstate carrier entrant.
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 6 of 12
(II) ACCOUNT OVERVIEW
1) Type of Organization: Corporation Partnership Sole Proprietorship LLC
2) Years in Business: 29 Years under current management: 29
3) If < 2 yrs, describe management qualifications: N/A
4) US DOT#: ###### MC#: ###### Other regulatory identifications: None
5) USDOT Safety Rating: Satisfactory Conditional Unsatisfactory Most recent rating date: NA
6) Out of Service Rates: Driver 2.9 % Vehicle 15.2 % HAZMAT 0 %
7) Carrier Safety Management (SMS) BASICs On-Road Investigation “Alert” Status
Unsafe Driving Inconclusive
Fatigued Driving "
Driver Fitness "
Controlled Substances & Alcohol No Violations
Vehicle Maintenance 69.1%
Cargo Related Not Available
Total Crashes 4 Tow away 3 Injury/Fatality 1
8) Gross Receipts Dollars Fleet Miles Revenue/Mile
Rev/Mi in normal Guidelines:
Current Year (Est) $ 7.1 Million 2.3 million $ 3.09 Yes No
If no, please include Remarks.
Prior Year $ 4.9 Million 1.6 Million $ 3.06
9) Significant company changes past 12 months: None
10) Number of power units added or deleted in past 12 months: 2 added Explain: Added business in MS
Remarks: No safety rating as yet… Received Interstate authority in '10 (Was AL Intrastate only until then.) Fatality
accident was a "no fault" (driver was rear-ended while sitting still.) Minimal inspections so BASICS are within
thresholds or inconclusive. Only major issues were light problems that inflated "Vehicle Maint". New light systems
are now being installed to correct the problem… Safer OOS %'s are all within established guidelines.
(III) (a) OPERATIONS*
Van Reefer Flatbed Tanker Container Bulk Dump Other Total
0% 0% 0% 0% 0% 0% 100 % 0% 100%
Radius: 0-50 Miles 50-200 Miles 201 – 500 Miles 501+ Miles Total
70 % 30 % 0% 0% 100%
*Enter all fields
1) Average number of power units on the road on any given day: 35
Trucks: Mostly 6am- Office: 7am-5pm Garage: 7am-5pm Dispatch: 7am-5pm
2) Hrs of Operation
3) Average Trip Length One Way: 75 Number of days drivers are normally out: 1
4) Percent Metropolitan Areas: 30 % Major Cities Operated in: Birmingham
5) Percent Mountain Driving: 0% Percent Night Driving: 20 %
6) Carrier Type: For-Hire Common Contract Private Service Use Retail Delivery
Irregular Route Regular Route Private Other
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 7 of 12
7) Percent LTL Freight: 0 % Percentage JIT Freight: 0 %
8) On Premise Activity Other than Trucking: Yes No Remarks:
9) Brokerage Operation: Yes No MC/DOT # of brokerage: NA (Note: Request copy of brokerage insurance policy)
10) Revenue from Brokerage: NA Number of Brokered Loads per Week: NA
11) Long Term Equipment Leasing to Others: Yes No Remarks:
12) Owner/operators: Yes No Length of Lease: NA
13) O/O Lease Renewal Date: NA Automatically Renews: Yes No
14) Bobtail Insurance Required: Yes No Amount: $NA Named as additional insured: Yes No
15) Backhauls: Yes No Company Freight: 10% Brokered Freight: 0% Deadhead: 35%
16) Auth. Passengers Allowed: Yes No (Note: Request copy of passenger insurance policy)
17) Passenger Identities: NA Hold Harmless/Release: Yes No Expires: NA
Remarks: Short-haul dump shipments of raw coal, gravel and sand… No brokerage… No owner-operators… No
passengers allowed… Company drivers return same day except in very rare instances into MS. Deadhead high
due to type of cargo and availablity of backhauls.
POWER UNITS TRACTOR STRAIGHT TK SERVICE TK DUMP OTHER
1) Company 46 0 2 0 0
2) Owner/OP 0 0 0 0 0
3) Short Term Lease 0 0 0 0 0
TRAILERS VAN REEFER FLAT TANK CHASSIS DUMP BULK DOUBLE
4) Company 0 0 0 0 0 48 0 0
5) Owner/OP 0 0 0 0 0 0 0 0
6) Short Term Lease 0 0 0 0 0 0 0 0
7) Number of Units Subject to a Single Loss: 46 trac/30 trailers
Remarks: 3 tracs are for sale… 2 limited use (41 active)
*enter all fields
(c) INSPECTION, REPAIR & MAINTENANCE
1) Oldest Vehicle in Fleet: '90 Number Vehicles this Age: 1 Scheduled Fleet Update Plan Yes No
2) Equipment in Fleet > Ten Years Old: Yes No How Many: 14
3) Preventive maintenance intervals: 15,000 or mfg specs
4) Condition of Equipment on Yard: Good
5) Unusual Equipment: None
6) Maintenance performed by: Company Vendor Some major work is done by outside vendors/dealers
7) Maintenance records maintained by: Company Vendor
8) Safety Inspection Lane: Yes No Driver Inspections completed and documented: Yes No
Remarks: Maint programs appear adequate.
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 8 of 12
1) Restriction on Age of Owner Operator Vehicles: Yes No Describe: NA
2) Tractor Garaging Location: Company Owner/Operator Other: NA
3) O/O Maintenance performed by: Owner/Operator Company Vendor Name: NA
4) O/O Maintenance records maintained by: Owner/Operator Company Vendor Name: NA
5) O/O equipment inspected by company: Yes No Frequency: NA
6) Preventive maintenance intervals: NA
7) Safety Inspection Lane: Yes No Driver Inspections completed and documented: Yes No
Remarks: No owner-operators…
(e) CARGO & HAZMAT
1) Cargo Description: Coal, gravel and sand
2) Oversize/Overweight: Yes No Length: NA Height: NA Weight: NA Percent of Total Haul: NA
3) Hazardous Materials: Yes No Hazardous Waste: Yes No Type:
4) Does Safer list Hazmat Authority or any Hazmat Inspections? Yes No Type:
HAZMAT TYPE CLASS TRADE NAMES PERCENT of LOAD
N/A N/A N/A N/A
Remarks: All dump cargo… No haz mat
(IV) SAFETY MANAGEMENT
1) Safety Department: Yes No F/T Safety Director: Yes No Name: XXXXXX
2) Safety Manager Certified/Trained: Yes No Courses: JJ Keller, Ala Trking Assn
3) Written Safety Policy: Yes No Driver Manual: Yes No Driver Acknowledgement: Yes No
4) Defensive driving provided as part of orientation: Yes No
5) Driver Safety Awards Program: Yes No Other safety incentive programs: Yes No
6) Company/Management has received Safety Award(s) or Recognition: Yes No Describe: NA
Remarks: XXXXXXX is the Ops Mgr/Safety Mgr. He is assisted by ZZZZZZ on operations and safety issues with
most duties pretty much shared. The arrangement seems to work ok. The operation is small with consistent runs
to consistent customers so drivers are familiar with their assignments leaving more mgt time outside dispatch for
duties in safety. They were awarded Interstate authority in 2010. Up until then, they were an Ala Intrastate
carrier only. They have a written Safety Manual but not a written Driver Manual, XXXX is working on one but
has a ways to go. Most critical info is covered in safety manual. Receipt of the Safety Manual is not acknowleged
by the driver. No written Safety Awards program and no other safety incentive programs in place. Note: Will
mention receipt of Safety Manual and awards/incentive programs in recs.
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 9 of 12
(V) DRIVER SELECTION
Full Time Part Time Team Owner/Operator Total
1) # Drivers
35 0 0 0 35
2) Number of Drivers Under 24: 0 Over 65: 1
3) Number of Drivers Hired Last 12 Months: 15 Percent Turnover Last 12 Months: 40%
4) Written Hiring Criteria: Yes No Minimum: Age: 23 Experience: 2 yrs with dump trailers
5) Maximum Allowable: Convictions: 2 in past 3 yrs Collisions: Not specified Jobs: Not specified
6) Exceptions to these requirements: Yes No Who and When:
7) # Prior year(s) background checked: 1 yr 2 yr 3 yr 4 yr 5 yr 6 yr More: 10 if
8) Prior employment checks completed before first dispatch: Yes No
9) Who interviews new drivers? XXX/YYY/ZZZ Describe interview process review MVR, past emp and experience
10) Road Test: Yes No Number of miles: Varies Administered by: YYYY/XXXXX
11) Probation period for new drivers: Yes No Describe: 90 days
12) Leased Drivers: Yes No DQ Files are at: Company Driver Leasing Firm Name of Firm: NA
13) Drug & Alcohol testing program: Yes No Program Administrator: EDPM- Birmingham, AL & Labcorp
14) DOT medicals current: Yes No Examining Physician designated by: Company Employee
15) Annual Reviews and MVR current: Yes No
16) Carrier utilizes Pre-Employment Screening Program (PSP): Yes No
17) DOT Compliance deficiencies: MVR's were current but annual reviews are late but should be completed by
Remarks: Driver selection process is good… Driver turnover rate 40% (local operation and home on w/e's are the
main factors that it's fairly low) ... Drug and alcohol testing is current and well managed… MVR's and physicals
are current… Company accepts a current physical… Annual reviews are a little late but they promise to complete
by 1/3/11…. DQ files are complete and adequate except driver data sheets(will begin using in 2011.)
(VII) DRIVER SUPERVISION
1) Company uses road patrols or has a call in number for the public displayed on the trucks: Yes No
2) Trucks equipped with Qualcomm or similar devices: Yes No Policy for “No Use in Motion”: Yes No
3) Trucks equipped with speed governor: Yes No Maximum speed limit: 70 mph
4) Drivers keep logs: Yes No If logs are not kept, other documentation used: Time sheets are mostly used but
some interstate traffic requires logs for about 3% of the total business.
5) Formal log audit program: Yes No Log audit service or software: Yes No Type:
6) Name of person auditing logs: XXXXXX Person has formal training: Yes No Type: Ala Trking Assn
7) Logs are checked for falsification: Yes No Supporting Docs: GPS Qualcomm ECM
Fuel receipts, tolls, etc Software (PC Miler, Rand McNally, etc.) Other:
8) Adequate Log Violation Disciplinary Program: Yes No
9) Dispatch maintains log recap: Yes No Other method used: Driver keeps
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 10 of 12
10) Daily driver check call: Yes No Penalty for late delivery: Yes No
Remarks: XXXXXX, Ops/Safety Mgr, has about 6 yrs experience and audits the logs manually. They began using
logs in 2010 when they became an interstate carrier and started running in MS. The majority of the drivers use
time sheets due to the 100 mile exemption with MS freight still only about 3% on the total miles. Some drivers on
the time sheet do exceed the less-than 12 hr day requirement. Note: Will mention in recs using logs for locals over
12 hrs and a progressive disciplinary program for log violations. ZZZZZZ may want to consider bringing in a
safety consultant for awhile to assist with their move into interstate carriage.
(VIII) ACCIDENT REPORTING
Total # of Accidents DOT Recordable Register Current Comments
1) Current Yr 3 2 Yes No
2) Prior Year 4 2 Yes No
3) Record kept of all accidents, including non-DOT: Yes No Periodic accident trend analysis: Yes No
4) Name of person tracking accidents: XXXXX/ZZZZZ Has received formal training: Yes No
5) Recent counter-measures taken in response to accidents or accident trends: None
6) Preventability determined: Yes No Preventability Guide: Yes No
7) What remedial actions are taken when a driver has an accident? Counseling or termination depending on severity and
Remarks: Accidents are minimal… 1 fatality in '09 was a non-preventable due to company driver being rear-ended
1) Neighborhood: Rural Suburban Urban Inner City Industrial Other:
2) Condition: Improving Stable Deteriorating
3) General Condition of Facility: Excellent Good Average Poor
4) Fenced main location: Yes No Security lighting: Yes No Recent theft or vandalism: Yes No
5) Other Locations or Terminals: Yes No Describe:
Remarks: Terminal and shop buildings are well maintained… yard is gravel and a little rough.
(X) GENERAL REMARKS AND COMMENTS
1) Sec (VI) Driver Safety Training (omitted in error from form)…
2) Annual group safety meetings on various subjects are held and documented. Attendance is mandatory unless
emergency prevents attendance. CSA training needs to be increased… Note: Will mention in recs.
3) No Smith System, DDC or other formal defensive driving is used but it is covered in orientation and appears
4) No regular re-occurring/periodic or remedial training except for accident follow-up. Note: Will mention in recs.
6) Driver File Review: Some older driver files have incomplete reference inquiries but current from '08-'10.
7) Annual reviews are current except for '10… They are due before 1/3/11 and should be completed without
exception. Driver Data Sheets were not used but will start in '11.
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 11 of 12
(XI) Driver File Review Summary Form
Company Name: XXXXXXXXX Corp.
Employment Date CDL Date Driver Violations
Driver Name Application Reference of MVR CDL Endorse of Annual Data
date Inquiry Birth Date Class -ment Physical Review Sheet Speed Moving Non Moving
1) DRIVER 1 1-12-00 I 4-22-42 9-10-10 A NT 8-9-10 I I 0 1 1
2) DRIVER 2 9-21-04 I 9-4-70 9-10-10 AM N 12-14-09 I I 0 1 1
3) DRIVER 3 10-24-07 I 7-7-79 9-10-10 A N 3-19-10 I I 0 0 0
4) DRIVER 4 6-9-09 S 6-22-84 9-10-10 AMV NONE 8-28-09 S I 2 1 1
5) DRIVER 5 3-10-10 S 3-3-72 9-10-10 AMV PS 8-20-09 S I 1 0 0
CODE S= SATISFACTORY I = INCOMPLETE M = MISSING
Revised 10/12//2010 TVE Commercial Vehicle Loss Control Survey Page 12 of 12