
Customer Problem Analysis Check Sheet
SRS AIRBAG System Check Sheet
Inspector's Name
Customer's Name
Registration No.
Registration Year / /
Frame No.
Date Vehicle Brought In / /
Odometer Reading Miles
Date of Problem Occurrence / /
Conditions at Time of Problem Occurrence
Weather
□Fine □Cloudy □Rainy □Snowy □Various/Other
Outdoor Temperature
□Hot □Warm □Cool □Cold (Approx. °C ( °F))
Vehicle Operation
□Starting □Idling
□Driving (□Constant Speed □Acceleration □Deceleration □Other)
Condition of road
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Details of Problem
Vehicle Inspection, Repair History Prior to Occurrence of Malfunction (Including Airbag System)
(Diagnosis System Inspection)
Airbag Warning Light Inspection
1st Time □Remain On □Sometimes Lights Up □Does Not Light Up
2nd Time □Remain On □Sometimes Lights Up □Does Not Light Up
Diagnostic Code Inspection
1st Time □Normal Code □Malfunction Code (Code. )
2nd Time □Normal Code □Malfunction Code (Code. )