Location

330 Washington AVE Columbus, OH 43215-5525

614-224-5566

[email protected]

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Driveability

Vehicle Information

To provide a quick, complete and accurate diagnosis of your vehicle our technicians need a thorough description of the problem. Please take a few minute to complete this worksheet to the best of your ability. The information you provide will be a tremendous aid to the technician.

Date:

Name: *

Invoice No: *

Year: *

Make: *

Model: *

Engine:

Mileage:

VIN *

Driveability Symptoms

Please check all symptoms that apply to your vehicle

My vehicle's 'CHECK ENGINE' light *

Glows steadily

Glows intermittently

Never comes on

While operating the starter, (my vehicle) *

Will not crank

Cranks slowly

Cranks normally

When starting, my vehicle *

Will not start

Starts normally

Hot

Cold

Starts and dies

Is difficult to start

While Idling, my vehicle *

Will not idle

Idles too low

Idles too high

Idles rough

Surges (up and down)

Backfires

Idles normally

While driving, my vehicle *

Backfires

Pings (Spark knock, detonation)

Smokes excessively

Runs too hot

Runs too cold

Black

Blue

White

Has a fuel or gas odor

Hesitates

Stumbles

Stalls

Surges

Lacks power (sluggish)

Misses

Cuts out

Stalls when slowing or stopping

Vibrates excessively

Other symptoms *

Transmission shifts

Too soon

Too late

Normally

Driveability Worksheet *

Poor fuel mileage

Emissions test failure or "rotten egg" odor

Other (Please explain)

Conditions of Occurrence

Time *

Morning

Midday

Evening

Night

Speed *

Idle

Low speed

Stop and Go

Highway (Cruise)

High speed

Acceleration

Deceleration

Distance *

Less than 2 miles

From 2 to 10 miles

More than 10 miles

Conditions *

Uphill

Downhill

Frequency of Conditions *

Always

Since New

Intermittently

After miles

Environmental conditions *

Cold Weather

Wet/Raining

Fog

Hot Weather

Snow

Dirt/Dust

Engine Conditions *

Engine Cold

While Turning

Engine Hot

While Braking

All Temperatures

With Headlights ON

When Shifting

With A/C ON

Driving Habits *

Start cold engine and drive immediately

Star cold engine and allow to warm up

Mostly highway driving

Mostly city driving

Park in garage

Average miles driven per day

Fuel Quality

Type of fuel used *

Brand of fuel *

Octane rating *

87

89

91

Greater than 91

Last fill-up date *

Miles *

When your car gives you trouble, there’s only one place to go — Petty’s Auto.

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Address & Hours of Operation

Address

330 Washington Ave

Columbus, OH 43215-5525

Hours of Operations

Monday-Friday; 8 a.m.-6 p.m.
Saturday-Sunday: Closed

Contact Info

Phone

Email

[email protected]

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