McGuire • W194 N11481 McCormick Drive • Germantown, WI 53022 800-624-8473 • fax: 262-255-9399 • www.wbmcguire.com
TPR® VEHICLE RESTRAINTSITE SURVEY
Building Wall (Flush)
“TPR”Vehicle Restraint
DockApproach
Dock Face
Pit Depth
Dock Height
Lower Front Curb Angle
INSTRUCTIONS1. Survey must be completed based upon conditions at time of installation.2. Dock face must be clear of any obstructions prior to installation of the TPR®.3. Lights and signs must be mounted in full view of forklift and tractor-trailer operations.4. Examples of why bracketing may be required:
• Sloped approach greater than 1/2” per foot.• Bumper projection over 4”. (Bumpers are manufactured to nominal sizes; actual projection must be
verified).• Insufficient embedded lower front pit curb angle• 24” deep pits.• Other than solid concrete dock face (6” thick minimum).
5. Hollow “D” and flex steel bumpers not acceptable.
TPR Vehicle RestraintUniLock Vehicle Restraint
NOTE: Enter “NONE” for no leveler.
1. Leveler Type:
2. Leveler Brand: Model:3. Lip Length: Inches4. Safety Lip
5. Pit Depth/Front Frame Depth: Inches
Hydraulic Air Mechanical EODVertical Storing Truck Activated None
Yes No
NOTE: Consult Systems Inc. if leveler is on self standing frame.Enter “NONE” if no leveler or “EOD type leveler (refer to EOD drawing on last page.)
Order #:Surveyed By:
Date:Quantity:
# of Pictures*:
Customer:Job:
Address:City:
State & Zip:* Note pictures are useful in seeing what might be missing from this survey. If at all possible please include with this survey
BUILDING AND DOCK PIT DATA
1. Dock/Door #’s:2. Centerline Dimension between Doors: Inches
*Note adequate space is required for mounting signs and lights.
3. Dock Face/TPR Mounting Surface:
4. Is the pit floor material concrete:
5. If pit does not exist, is the dock floor concrete:
6. Is there an existing pit floor plate bracket:
7. Is there an existing wall embed plate:
8. Lower Front Pit Curb Angle
9. Drive/Approach Material at Dock Face
10. Leveler Sub-Frame Position to Dock Face:
11. Leveler Sub-frame Set back or Protrusion: Inches12. Will this application incorporate Trailer Lifts, Wheel Risers, Existing
Brackets (Aftermarket Upgrade) or obstructions on the dock face?
Yes No
Concrete, solid tilt-up precast, min 6” thick Embed mounting plate, minimum 6” thick concreteBrick/cinder block, hollow tilt-up/precast Stub wall (partial wall w/open pit)Legs/Self Stand Frames - (Consult Factory) Other
Yes No
Yes No
3 x 3 4 x 4 None Pan Material Other
Concrete Asphalt Gravel/Dirt Other
Flush Protruding Set Back Not Applicable
No Existing Brackets (Upgrade) Trailer Lift Wheel RisersDock Face Obstructions - Explain:
Yes No
LEVELER DATA
Leveler Lipto Grade
Enter “NONE” for No Cantilever
CantileverDepth
CantileverOverhang
Dock Faceto Drain
DrainDepth
DrainWidth
Bui
ldin
g W
all
Can
tilev
er
Bum
per
Bumper Projection
Dock Height
Approach Level Line
Bui
ldin
g W
all
Driveway Declineat 50ft.
Driveway Inclineat 50ft.
50 FT
Drain and/or Cantilever Conditon (if applicable)
DRIVEWAY DATADriveway Data is required
1. Bumper Projection: Inches2. Wall Position to Dock Face
3. Is the Approach Level or Sloped?
4. Is there a trench located 12” or less from the faceof the bumpers?
5. Will Systems, LLC supply cantilever bracket? (if necessary)
6. Will Systems, LLC supply loor bracing? (if necessary)
7. Will Systems, LLC supply additional anchors? (if necessary)
Flush Protruding Set Back
Level Sloped
Yes No
Yes No
Yes No
Yes No
Truck Style A Truck Style B Truck Style C
Truck Height (A)
Truck Bed Height (B)
Extension Length (C)
RIG Height (D)
RIG Size (std=4”x4”)
Make Note if Trucks Vary Considerably.use the 90%/10% rule to capture majority of trailers
Side View of Truck
Truck Extension:(Ledge, Taigate, ect.)
RIG
A
C B
D
Yes No1. Yard Jockey use:2. What types of truck are being service:
Lift Gate FlatbedLTL High Cube VanContainer RefrigeratedTruck has an Obstructed RIG (UniLock Recomended)
ELECTRICAL DATALIGHT DATA
What type of light system is required:Exclusive advance communication 3 light system - Red, Green, Amber (std.)2 light system - Red, Green and Audible Alarm (Not Available with UniLock)
CONTROL BOX OPTIONSCombo Box - Specify product combined with Voltage and PhaseRestraint Engaged InterlockingLeveler Stored Interlocking
TRUCK DATA
EOD DATA
Dock Face
Approach
EOD Back Plate
Operating Mechanism
Bumper
Centerlineof Leveler Centerline
of Mechanism
Note: Enter “NONE” ifmechanism is centered oncenterline of leveler
Bum
per P
roje
ctio
n
Bum
per B
lock
out
Lip
Ope
ratin
g M
echa
nism
Approach
Dock Face
Dock Face
Approach
EOD Back Plate
Operating Mechanism
Bumper
Centerlineof Leveler Centerline
of Mechanism
Note: Enter “NONE” ifmechanism is centered oncenterline of leveler
Bum
per P
roje
ctio
n
Bum
per B
lock
out
Lip
Ope
ratin
g M
echa
nism
Approach
Dock Face
Note: Some hydraulic and/or mechanical devices can effect bracket requirements
Rev. 5-2018