Title Page

  • Customer Name

  • Site Name

  • Address
  • Prepared by

  • Date

SERVICE REPORT

GENERAL INFORMATION

  • DATE

  • ORDER NO

  • MAKE

  • MODEL

  • SERIAL / REGISTRATION NO

  • FLEET / ID NO

  • HOURS / MILEAGE

  • JOB NO

RISK ASSESSMENT

  • PERSONS AFFECTED BY ACTIVITY

  • HAZARDS IDENTIFIED

  • OTHER ITEMS IDENTIFIED

  • CORRECTIVE ACTION

  • JOB RISK CATEGORY

JOB DETAILS

  • WORK CARRIED OUT

  • JOB COMPLETED

  • ADDITIONAL COMMENTS

  • PHOTOGRAPH

  • TRAVEL START

  • TIME ON SITE

  • TIME OFF SITE

  • TRAVEL FINISH

  • HOURS ON SITE

  • HOURS ON TRAVEL

  • TOTAL HOURS

  • MILEAGE TO

  • MILEAGE FROM

  • PARTS USED / SUPPLIED
  • Part no, Quantity, description

COMPLETION

  • ACCEPTANCE OF WORK

    I certify that the above work was carried out satisfactorily and that the spares as detailed above were used or delivered.

  • Customer Name and Signature

  • Position

  • ENGINEER

    I have conducted the risk assessment as shown and completed the work specified above.

  • Engineer Name and Signature

  • Position

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.