Tire Patch Procedure Form
Employee Evaluation
Employee Name
Store #
Please Select
#1
#2
#3
#4
#5
#6
#7
Date
-
Month
-
Day
Year
Inspection Completed by
Please Select
John Clark
Doug Wagoner
Scott Cook
Inspection Completed by
First Name
Last Name
TIA Patch Procedure Checklist
Yes
No
Notes
Spray Pre-Buff to inner liner
Scrape inner liner of tire until dull black finish is observed
Drill injury with carbide cutter bit inside and outside at least 3 times each
Apply vulcanizing cement to reamer and insert into injury
Apply light amount of vulcanizing cement to plug just around the black area
Insert plug into injury from the inside of tire
Buff inner liner area slightly larger than patch, Do not go through to cords
Brush inner liner once buffing complete. Apply brush in top to bottom motion
Apply thin, even coat of vulcanizing cement to buffed area
Allow ample time for vulcanizing cement to dry
Apply patch to center of prepared are making sure not to touch the back of patch directly
Roll patch with sticher starting from center working outward to remove trapped air
Apply inner liner sealer to entire prepared area including areas that were buffed
Put initial and store # near patch ex. sc2
Take Photo of Completed Patch
Additional Notes If Needed
Technician Signature
Supervisor Signature
Print
Submit
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