Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Office Name
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Truck #
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1. Change Engine Oil (Note: Increase frequency of engine oil change with severe working conditions or working hours.)
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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2. Replace Engine Oil Filter (Record Date on Filter)
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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3. Replace Fuel Filters
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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4. Replace/Clean Air Intake Filters
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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5. Replace Hydraulic Oil Filters
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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6. Inspect All Grease Fittings (Note: Some grease fittings may require servicing more frequently, depending on workload conditions, weather conditions and working environment conditions.)
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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7. Hoisting Mast Sheaves
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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8. All Hoist Shafts
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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9. Kelly Bar Bearing (Top)
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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10. 4-Rotary Box Bearings
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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11. Mast Tilt Hinge Pins
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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12. Tilt Cylinder Pivot Pins
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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13. Hydraulic Pump Drive Shaft U-Joint
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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14. Moyno Pump Packing Glands
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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15. Bean Pump Piston Rod and Packing Gland
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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16. Slide Base Cylinder Pivot Pin Sideway (wiggle tail) Cylinder Pivot Pin
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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17. PTO Bearing Block to Cathead
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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18. Auto Hammer Sprocket Shaft Bearings
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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19. Pivot Pin on Holding Clamps
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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20. Pivot Pin on Breakout Tool
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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21. Engine Clutch Leaver Bushing
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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22. PTO Shifter
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Was vehicle placed back into service?
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Why was vehicle placed back into service before maintenance or repair was completed?
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23. Have all guards and/or safety devices been reinstalled after any maintenance activity?
Approvals
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Maintenance Performed by
