Form 5 Probation Period 2 Benchmark Certification

Safe Driver Apprenticeship Pilot Program

Attachment J_SafeDriverAPP_Probation Period 2_BenchmarkCert

IC-4: Performance Benchmark Certifications

OMB: 2126-0075

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Apprentice Driver Safety Benchmark Certification Form: 280-hour Certification

Carrier name (please print): _________________________

Apprentice driver’s name (please print): _________________________



Benchmark

Representative’s Initials

Date

Backing and maneuvering in close quarters



Pretrip inspections



Fueling procedures



Weighing loads, weight distribution, and sliding tandems



Coupling and uncoupling procedures



Trip planning, truck routes, map reading, navigation, and permits





Carrier representative’s name (please print): ____________________



Carrier representative’s signature: _____________________________ Date: ____________

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