Title Page
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Date:
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Technician:
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Equipment Description:
Equipment Serial Number
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Attachment Serial Number
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Non-Lampson Owned Equipment Description:
Equipment Service Report
Section 1: Equipment / Project Details
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Lessee (Customer):
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On-Site Contact
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Project Address
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City
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State
- N/A
- AK
- AL
- AR
- AZ
- CA
- CO
- CT
- DC
- DE
- FL
- GA
- HI
- IA
- ID
- IL
- IN
- KS
- KY
- LA
- MA
- MD
- ME
- MI
- MN
- MO
- MS
- MT
- NC
- ND
- NE
- NH
- NJ
- NM
- NV
- NY
- OH
- OK
- OR
- PA
- RI
- SC
- SD
- TN
- TX
- UT
- VA
- VT
- WA
- WI
- WV
- WY
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Phone
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Email
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Hour Meter
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Describe Job Site Conditions:
Equipment Photo's:
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Equipment Photos
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Job Site Photos:
Section 2: Reason For Service
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Customer Complaint
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Describe the Complaint
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Preventative Maintenance
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Scheduled Service
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Other
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Section 2 Remarks
Section 3 Diagnosis / Repair / Service
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Component / System:
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Diagnosis:
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Repairs Made / Service Performed:
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Additional Issues Identified:
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Comments / Remarks
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Technician / Mechanic performing work:
Section 4 Parts / Fluids / Consumables Used:
Parts List
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List of Part / Part Number / Quantity used
Fluid List
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List of Fluids / System / Quantity used
Other Consumable
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List of other Consumables, etc. used
Wire Rope
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Wire Rope Diameter
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Length
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System
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Reel Number or Certification Number
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Section 4 Remarks
Signatures
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Service Technician
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Signature
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Client Representative
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Signature
Additional Photos
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Attach and Describe Photos
