FORM -- 105

Rev. 01/09/07

**VEHICLE INFORMATION / TEST SPECIFICATIONS**

FMVSS No. 105

Vehicle Model Year and Make:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vehicle Model and Body Style:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Manufacturer recommended brake adjustment performed after burnish (if
any):**

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

**[BRAKE SYSTEM WARNING INDICATOR:]{.underline}**

Condition(s) indicated:

( ) Pressure differential switch

( ) Fluid level sensor

Low Fluid: Reservoir Full \_\_\_\_\_\_\_\_\_\_[\_]{.underline} Lamp On
At \_\_\_\_\_\_\_\_\_\_

> Manufacturer recommended safe level of reservoir
> \_\_\_\_\_\_\_\_\_\_\_[\_\_]{.underline}

[**MASTER CYLINDER PISTON DIAMETER:**]{.underline}

Primary \_\_\_\_\_\_\_\_\_\_

Secondary \_\_\_\_\_\_\_\_\_\_

**[SERVICE BRAKE PEDAL RATIO:]{.underline}** \_\_\_\_\_\_\_\_\_\_:1

**[VARIABLE PROPORTIONING SYSTEM:]{.underline}**

( ) Mechanical ( ) Electrical

Procedure to render inoperative:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[HYDRAULIC SPLIT]{.underline}:**

( ) Diagonal ( ) Front/Rear

**[INOPERATIVE BRAKE POWER ASSIST/BRAKE POWER UNITS:]{.underline}**

Procedure to render inoperative:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\[S5.1.3.1 unless otherwise stated\]

**[ANTISKID SYSTEM:]{.underline}**

Procedure to render inoperative:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[REGENERATIVE BRAKE SYSTEM:]{.underline}**

Procedure to render inoperative:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[MASTER CYLINDER RESERVOIR:]{.underline}**

Reservoir Capacity:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid displaced new to worn linings:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Subsystem 1 capacity:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Subsystem 2 capacity:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Primary system fluid output for single stroke of master cylinder:
\_\_\_\_\_\_\_\_\_\_\_\_\_

Secondary system fluid output for single stroke of master cylinder:
\_\_\_\_\_\_\_\_\_\_\_

**[FRONT BRAKES (Disc]{.underline}):**

DISC SIZE:

> Disc Outside Diameter \_\_\_\_\_\_\_\_\_\_ Disc Thickness
> \_\_\_\_\_\_\_\_\_\_

LINING SIZE:

Thickness \_\_\_\_\_\_\_\_\_\_ *Fully Worn Thickness*
\_\_\_\_\_\_\_\_\_\_

CALIPER PISTON BORE DIAMETER:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[REAR BRAKES]{.underline}**

TYPE: ( ) Disc

DISC SIZE:

Disc Outside Diameter \_\_\_\_\_\_\_\_\_\_ Disc Thickness
\_\_\_\_\_\_\_\_\_\_

LINING SIZE:

Thickness \_\_\_\_\_\_\_\_\_\_ *Fully Worn Thickness*
\_\_\_\_\_\_\_\_\_\_

CALIPER PISTON BORE DIAMETER: \_\_\_\_\_\_\_\_\_\_

OR

TYPE: ( ) Drum

WHEEL CYLINDER BORE DIAMETER: \_\_\_\_\_\_\_\_\_\_

SIZE: Drum Inside Diameter

LINING SIZE:

Thickness \_\_\_\_\_\_\_\_\_\_ *Fully Worn Thickness*
\_\_\_\_\_\_\_\_\_\_

LINING INSTALLED DIMENSIONS (Nominal Production Values):

Brake Shoe Cage Diameter \_\_\_\_\_\_\_\_\_\_

***Diametral Clearance*** = [Drum Inside Diameter -- Brake Shoe Cage
Diameter]{.underline} = \_\_\_\_\_\_\_

2

**School Bus (\< 10,000 GVWR)** Option for Parking Brake Test: ( )S5.2.1
or ( )S5.2.2

**FMVSS No. 105 DATA SUMMARY - MANUFACTURER TEST RESULTS**

(Use sample table below or similar to provide results)

MY: \_\_\_\_\_\_/ Make: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_/ Model:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+-------------------+-------+-------+----------+----------+-----------+
| TEST              | Lo    | Speed | Stopping | Shortest | Shortest  |
|                   | ading | (mph) | Distance | Sto      | Sto       |
|                   | Cond  |       | Req      | pMaximum | pStopping |
|                   | ition |       | uirement | Pedal    | Distance  |
|                   |       |       | (ft)     | Force    | (ft)      |
|                   |       |       |          | (lbs.)   |           |
+-------------------+-------+-------+----------+----------+-----------+
| First             | GVWR  | 30    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| First             | GVWR  | 60    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Second            | GVWR  | 30    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Second            | GVWR  | 60    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Second            | GVWR  | 80    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Parking Brake     | LLVW  |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Parking Brake     | GVWR  |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Stability and     | LLVW  |       |          |          |           |
| Control           |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Third             | LLVW  | 60    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Failed Hydraulic  | LLVW  | 60    |          |          |           |
| Circuit #1        |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Failed Hydraulic  | LLVW  | 60    |          |          |           |
| Circuit #2        |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Failed Hydraulic  | GVWR  | 60    |          |          |           |
| Circuit #1        |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Failed Hydraulic  | GVWR  | 60    |          |          |           |
| Circuit #2        |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| ABS INOPERATIVE,  | GVWR  | 60    |          |          |           |
|                   |       |       |          |          |           |
| Signal            |       |       |          |          |           |
| Transmitted       |       |       |          |          |           |
| Electrically,     |       |       |          |          |           |
| RBS, Electrically |       |       |          |          |           |
| Actuated Brakes:  |       |       |          |          |           |
|                   |       |       |          |          |           |
| inoperative       |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Inoperative Power | GVWR  | 60    |          |          |           |
| Assist            |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| First Fade and    | GVWR  | 30    |          |          |           |
| Recovery          |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Second Fade and   | GVWR  | 30    |          |          |           |
| Recovery          |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Fourth            | GVWR  | 30    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Fourth            | GVWR  | 60    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Fourth            | GVWR  | 80    |          |          |           |
| Effectiveness     |       |       |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Water Recovery    | GVWR  | 0     |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+
| Spike Stops       | GVWR  | 60    |          |          |           |
+-------------------+-------+-------+----------+----------+-----------+