Diesel Hydraulic Repairs- WA

• Document No.

• Unit number.

• Client

• Conducted on

  Date

• Prepared by

• Location
  Address

• Date unit serviced.

  Date

VEHICLE DESCRIPTION

• Photograph of Vehicle

  Media

• Vehicle Unit Number

  Yes

  No

  N/A

• VIN/Information plate

  Media

• Check for visible US DOT door sticker & current DOT inspection sticker

  Yes

  No

  N/A

• Kilometres / Hours

• Kilometres/Hours

• Next Service Kilometres/Hours

Vital Vehicle Fluid Levels and Condition

• Image of readings

  Media

• Engine Oil Level

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Transmission Fluid Condition

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Power Steering Fluid

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Brake Fluid

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Differential Fluid

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Engine Coolant

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Transfer Case Level

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Window Washer Water

  Good

  Need T Fill Up

  Need To Replace

  N/A

• Additional information.

EXTERIOR LIGHTING

• Check Turn Signals & Brake Lights

  Working

  Not Working

  Need Some Repairs

• Left and Right Back-Up Lights, Back up Alarm

  Working

  Not Working

  Need Some Repairs

• Clearance, Marker Lights, Tail Lights

  Working

  Not Working

  Need Some Repairs

• High and Low Beams Operational

  Working

  Not Working

  Need Some Repairs

• Beacons and Safety Lights

  Yes

  No

  N/A

• Additional Information

EXTERIOR BODY AND GLASS (Take Photos of any noted damage)

• Images if needed.

  Media

• Windshield Free of Cracks and Chips

  Yes

  No

  Good

  At risk

  N/A

• Front Hood, Grill and Bumper free of Damage

  Yes

  No

  Good

  At risk

  N/A

• Check for damage to all Doors, Mirrors, Windows and Fender

  Yes

  No

  Good

  At risk

  N/A

• Rear WIndow Free of Cracks and Chips

  Yes

  No

  Good

  At risk

  N/A

• Rear of Vehicle and Bumper Free of Damage (Tailgate if included)

  Yes

  No

  Good

  At risk

  N/A

• Vehicle is Clean and Free of Road Grime and Dirt

  Yes

  No

  Good

  At risk

  N/A

• Additional Information

TIRES

• Select Need Replacement. Less than 20%. Between 30% & 60%. 60% + tread on. Some damage. See comments.

  • Need Replacement.
  • Less than 20%.
  • Between 30% & 60%.
  • 60% + tread on.
  • Some damage. See comments.

• Comments

BRAKES

• Left front brake percentage remaining

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Right front brake percentage remaining

  Select 100 percent 75 percent 50 percent 25 percent 10 percent requires immediate service

  • 100 percent
  • 75 percent
  • 50 percent
  • 25 percent
  • 10 percent
  • requires immediate service

• Left rear brake percentage remaining

  Yes

  No

  N/A

• Right rear brake percentage remaining

  Yes

  No

  N/A

• Additional information

INTERIOR

• Check Driver and passenger Seat and seatbelt are in good safe operating condition

  Safe

  At Risk

  N/A

• Windshield Wipers and washer fluid are Functioning Properly; replace wiper blades if necessary and top up fluid

  Yes

  No

  N/A

• Heater and Defroster plus Air Conditioning is Operational

  Yes

  No

  N/A

• All Gauges are Operating and Show within Appropriate Ranges

  Yes

  No

  N/A

• Interior Compartment Lights Operational

  Yes

  No

  N/A

• Interior is Clean and Free of Loose Objects

  Yes

  No

  N/A

• Comments

Under Carriage Inspection

• Check Driveline & U Joints

  Safe

  At Risk

  N/A

• Check Ball Joints

  Yes

  No

  N/A

• Check Springs, Hangers, Shocks

  Yes

  No

  N/A

• Grease Complete Chassis

  Yes

  No

  N/A

• Comments

SAFETY EQUIPMENT

• Securely mounted First Aid kit

  Safe

  At Risk

  N/A

• Highway Safety Triangles available

  Yes

  No

  N/A

• Fire Extinguisher

  Safe

  At Risk

  N/A

• Comments

REQUIRED DOCUMENTATION

• Valid Vehicle Registration is located in Vehicle (Note where kept)

  Yes

  No

  N/A

• Valid Vehicle Insurance Certificate is Located in Vehicle (Note where kept)

  Yes

  No

  N/A

• Comments

Repairs completed.

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• 15

Repairs to be completed.

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SIGNATURES

• Comments?

  Yes

  No

  N/A

• Signature of Mechanic Performing Service

  Sign