Application for Individual Vehicle Approval (IVA) for Category N2 and N3 Vehicles

Application for Individual Vehicle Approval (IVA) for Category N2 and N3 vehicles

Items to be included with this form are:

 For vehicles as a result of End-Of-Series derogation: - All EC/UN-ECE type approvals available for the vehicle. - Test reports for those areas for which the vehicle does not have an EC or UN- ECE type approval. - Breakdown of the VIN.

 For vehicles as a result of completion / modification / conversion: - Copy of the Certificate of Conformity (COC) for the original vehicle. - All EC/UN-ECE type approvals granted for the base vehicle (see pages 8 & 9), if Certificate of Conformity is not available. - Test reports for those areas for which the vehicle does not have an EC or UN- ECE type approval, if applicable. - Drawings, specifications, bill of materials, photographs describing the completion / modification / conversion (before, during and after). - Photograph of the Statutory Plate. -Weighmaster’s certificate after completion / modification / conversion. (please state fuel level when weighed when submitting weight docket and also ensure the vehicle is weighed without driver in vehicle)

 Please tick stage of vehicle: Complete  Incomplete  Completed  0. GENERAL Applicant’s Name

0.1. Applicant’sMake Address trade name of manufacturer

0.2. Type:

Variant: No. of Employees Version:

Telephone number 0.3 Commercial name(s) if available:

0.4. Fax numberMeans of identification of type, if marked on the vehicle: Email 0.5. Location of that marking: Web address 0.6. Category of vehicle: Applicant is a 0.7. subsidiaryIf applicable, of classifications according to the dangerous goods which the vehicle is intended to transport: VIN 0.8. Name and address of manufacturer:

CO2 Emissions Value (g/km) Page 1 of 9 Rev.01 0.9. Addresses of assembly plants:

1. GENERAL CONSTRUCTION CHARACTERISTICS OF THE VEHICLE

1.1. Photographs and/or drawings of a representative vehicle: 1.2. Number of axles and wheels:

1.3. Number and position of steered axles:

1.4. Powered axles (number, position, interconnection):

1.5. Chassis, if any, overall drawing:

1.6. Position and arrangement of the engine:

1.7. Hand of drive: (left/right)

1.8. Vehicle is equipped to be driven in right/left hand traffic:

2. MASSES AND DIMENSIONS in kg and mm. Refer to drawings where applicable.

2.1. Wheelbases For two axle vehicles: mm

For multi-axle vehicles: mm (More than to axles) 2.2. Track of each steered axle: mm

2.3. Track of all other axles:

Axle 1: mm

Axle 2: mm

Axle 3: mm

Axle 4: mm

Axle 5: mm 2.4. Range of vehicle dimensions (overall)

of 9 Rev.01 Length: mm Length of the loading area: mm Width: mm Height (in running order): mm

For suspensions adjustable for height, indicate normal running position: mm

2.5. Mass of the vehicle with bodywork in running order: kg 2.6. Distribution of this mass among the axles: Axle 1: kg. Axle 2: kg. (Axles numbered front to rear) Axle 3: kg. Axle 4: kg.

Axle 5: kg. 2.7. Technically permissible maximum laden mass stated kg by the manufacturer: 2.8. Distribution of this mass among the axles: Axle 1: kg. Axle 2: kg. (Axles numbered front to rear) Axle 3: kg. Axle 4: kg.

Axle 5: kg. 2.9. Technically permissible maximum mass on each axle: Axle 1: kg. Axle 2: kg.

Axle 3: kg. Axle 4: kg.

Axle 5: kg. 2.10. Technically permissible maximum mass on each axle group (if applicable): kg.

2.11. Vehicle is suitable for towing loads: (Yes / No) 2.12. Technically permissible maximum towable mass of the motor vehicle in case of Drawbar trailer: kg Semi-trailer: kg Centre-axle trailer: kg 2.13. Technically permissible maximum mass of the combination: kg 2.14. Maximum mass of unbraked trailer: kg

Maximum mass of braked trailer: kg

2.15. Technically permissible maximum static vertical kg load/mass on the vehicles coupling point:

of 9 Rev.01 3. POWER PLANT (in the case of a vehicle that can run either on petrol, diesel, or also, in combination with another fuel, items shall be repeated 3.1. Manufacturer:

3.2. Manufacturers engine code as marked on the engine:

Location of engine code:

3.3. Internal combustion engine

3.4. Working principle: positive ignition / compression ignition, four stroke / two stroke:

3.5. Number and arrangement of cylinders:

3.6. Engine Capacity: …...cm3

3.7. Maximum net power: …... kW at …... min -1 (manufacturers declared value) 3.8. Fuel: Diesel oil / petrol / LPG / NG / Ethanol / Other:

3.9. Location of the absorption coefficient symbol (compression ignition engines only):

4. TRANSMISSION

4.1. Type (mechanical, hydraulic, electric, etc.)

4.2. Gearbox

Manual / Automatic / CVT (Continuous Variable Transmission): 4.3. Maximum vehicle speed (in km/h):

5. SUSPENSION

5.1. Level adjustment: (Yes/No)

5.2. Air-suspension for driving axles: (Yes/No)

5.3. Tyre / wheel combinations: (for tyres indicate size designation, minimum load-capacity index, minimum speed category symbol, suspension)

of 9 Rev.01 Axle (numbered Tyre size and Load Index Speed Rating Twin or Suspension front to rear) Type Single Type (air, steel, hydraulic etc) Axle 1: Axle 2: Axle 3: Axle 4: Axle 5: 5.4 Which tyre use condition applies: (2B, 2J, 2R etc)

5.5. Upper and lower limits of rolling radii:

Axle 1: mm

Axle 2: mm

Axle 3: mm

Axle 4: mm

6. STEERING

6.1 Type of steering transmission (specify for front and rear, if applicable): 6.2. Method of assistance, if any:

7. BRAKES

7.1. Is vehicle fitted with an anti-lock braking system: (Yes/No): 7.1.1 If yes state category of ABS (1, 2 or 3): Category 1:  Category 2:  Category 3:  7.2 What type of brake system is fitted:

Full Air  Air/Vacuum Hydraulic  Hydraulic  Electric  Other  7.3 Which axles have parking brakes fitted:

Axle 1  Axle 2  Axle 3  Axle 4  Axle 5  7.4 Is a transmission brake fitted: (Yes / No)

8. BASE VEHICLE BODYWORK

of 9 Rev.01 8.1. Seats

8.2. Number: 8.3. Position and arrangement: 8.4. Number of seating positions: 8.4.1. Number of seat rows:

8.5 Vehicle is fitted with a statutory plate in accordance with EC Directive 76/114/EC: (Yes / No) 9. FITTED BODY

9.1. Name of Body Builder(s):

9.2. Address of Body Builder(s):

9.3. For completed vehicle, type of bodywork: (BA, BB, BC, BD, BE,)1 9.4. Brief description of body:

Body identification marking:

Method of attachment to base vehicle:

Mounting plates Number of:

Material specification:

Method of attachment:

Number of bolts used:

Bolts Size of bolts:

Specification of bolts:

Welding Specify welding method:

1 BA= Lorry, BB= Van, BC=Tractor unit, BD=Road tractor, BE= Pick up truck

of 9 Rev.01 9.5. Weight of finished body: kg

9.6. Specification supplied to body builder for mounting Yes  No  body on base vehicle: -If not, specification developed in conjunction with Yes  No  base vehicle manufacturer: 9.7. Brief description of interference, modification of already approved systems (eg. exhaust system moved, mirrors, braking etc.) :

9.8. Coupling device (if fitted):

EC approval number of coupling device:

Class of coupling device:

D-value: kN

S-value: kg

V-value: kN

U-value: tonnes Table of compliance with IVA Requirements

Please indicate in the table below the EC or UN-ECE approvals and/or test reports in support of application for Individual Vehicle Approval.

Where an EC approval or test report is not available for any item, an inspection or test will be required at an Approved Test Centre (ATC) of your choice. Please see a list of ATCs at: http://www.nsai.ie/Our-Services/Certification/Transport-Certification/Motor-Vehicle-Approval- Schemes/Approved-Test-Centers.aspx

Item Subject Base Yes:  UN-ECE Yes:  Test Report No. Directive No: X Regulation No: X Yes:  Number Number No: X 1 Noise 70/157/EEC R51 2 Emissions 70/220/EEC R83 2005/55/EC R49 3 Fuel tanks 70/221/EEC R34, R67, R110 Rear under run R58 4 Rear registration plate space 70/222/EEC -- 5 Steering effort 70/311/EEC R79 6 Door latches and hinges 70/387/EEC R11 7 Audible warning 70/388/EEC R28

of 9 Rev.01 8 Rear visibility (Indirect 2003/97/EC R46 Vision Devices) 9 Braking 71/320/EEC R13, R13H 10 Suppression (radio) 72/245/EEC R10 11 Diesel Smoke 72/306/EEC R24 13 Anti-theft and immobiliser 74/61/EEC R18, R97, R116 15 Seat Strength 74/408/EEC R17 17 Speedometer and reverse 75/443/EEC R39 gear 18 Plates (statutory) 76/114/EEC -- 19 Seat belt anchorages 76/115EEC R14 20 Installation of lighting and 76/756/EEC R48 light signalling devices 21 Retro reflectors 76/757/EEC R3 22 End-outline front-position 76/758/EEC R7 (side), rear-position (side), stop, side marker, daytime running lamps 23 Direction indicators 76/759/EEC R6 24 Rear registration plate lamps 76/760/EEC R4 25 Headlamps (including 76/761/EEC R1, R5, bulbs) R8, R20, R31, R37, R98, R99, R112, R123 26 Front fog lamps 76/762/EEC R19 27 Towing hooks 77/389/EEC -- 28 Rear fog lamps 77/538/EEC R38 29 Reversing lamps 77/539/EEC R23 30 Parking lamps 77/540/EEC R77 31 Seat belts 77/541/EEC R16 33 Identification of controls 78/316/EEC R121 34 Defrost / demist Vehicles shall be fitted with an adequate windscreen defrosting and demisting device. 35 Wash / wipe Vehicles shall be fitted with an adequate windscreen

of 9 Rev.01 washing and wiping devices. 36 Heating systems 2001/56/EEC R122 40 Engine power 80/1269/EEC R85 41 Diesel emissions 88/77/EEC R49 42 Lateral protection 89/297/EEC R73 43 Spray-suppression systems 91/226/EEC -- 45 Safety glass 92/22/EEC R43 46 Tyres 92/23/EEC R30, R54, R117 47 Speed limiters 92/24/EEC R89 48 Masses and dimensions 97/27/EC -- 49 External projections of cabs 92/114/EEC R61 50 Couplings 94/20/EC R55, R102 57 Front underrun protection 2000/40/EC R93

of 9 Rev.01