Information
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Call No.
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Meter Reading
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Customer Info
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Date
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Customer
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Unit No.
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Make
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Model
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Meter Reading
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Technician
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Which Service Interval is Being Preformed
Visual
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Over head Guard
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Mast
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Capacity Plate & Safety Decals
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Tires & Wheels
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Seat & Seat Belt
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Leaks
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Note any bent or damaged parts
Brakes
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Visual Inspection: All Brake Components
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Foot and Park Brake Operation
Steering
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Linkage, King Pins, Tie Rods, Pivot
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Cylinder
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Operation
Frame
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Check all Tires, Rim, Pressures
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Hood, Latch, Struts
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Counter Weight Bolt
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Dash, Floor Board, Coverings
Electrical
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Dash, Display, Switches
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Battery
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Wiring, Connections, Cables
Power Train
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Engine System
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Transmission
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Differential
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Fuel System
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Cooling System
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Clean Radiator
Mast and Hydraulics
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Inspect Forks
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Reason for Failure
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Load Back Rest
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Mast Channels and Rollers and Mounting
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Carriage, Rollers
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Inspect Lift Chains and Anchors
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Reason for Failure
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Pivot - Bushings/Bearings, Mounts
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Attachment
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Cylinders
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Pump(s)
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Hoses and Pulleys
Operational Check and Test Drive
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Seat Switch
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Test Drive and Functional Test
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Lighting and Alarms
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Fire Extinguisher
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Operators Manual
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Horn
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Clean unit and work Area
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Additional Comments
Fluid Levels
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Greased & Lubed
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Coolant
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Trans Oil
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Diff Oil
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Brake Oil
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Hydraulic Oil
Replacements
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Renew Engine Oil and Filter
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Renew Trans Oil Filter (filter only)
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Renew the Fuel Filter
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Renew Air Filter
CSA Annual Inspection
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Attach Maintenance/Inspection Sticker
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Unit Passes Inspection
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Next Annual Inspection Due
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Add signature
Visual
-
Over head Guard
-
Mast
-
Capacity Plate & Safety Decals
-
Tires & Wheels
-
Seat & Seat Belt
-
Leaks
-
Note any bent or damaged parts
Brakes
-
Visual Inspection: All Brake Components
-
Foot and Park Brake Operation
Steering
-
Linkage, King Pins, Tie Rods, Pivot
-
Cylinder
-
Operation
Frame
-
Check all Tires, Rim, Pressures
-
Hood, Latch, Struts
-
Counter Weight Bolt
-
Dash, Floor Board, Coverings
Electrical
-
Dash, Display, Switches
-
Battery
-
Wiring, Connections, Cables
Power Train
-
Engine System
-
Transmission
-
Differential
-
Fuel System
-
Cooling System
-
Clean Radiator
Mast and Hydraulics
-
Inspect Forks
-
Reason for Failure
-
Load Back Rest
-
Mast Channels and Rollers and Mounting
-
Carriage, Rollers
-
Inspect Lift Chains and Anchors
-
Reason for Failure
-
Pivot - Bushings/Bearings, Mounts
-
Attachment
-
Cylinders
-
Pump(s)
-
Hoses and Pulleys
Operational Check and Test Drive
-
Seat Switch
-
Test Drive and Functional Test
-
Lighting and Alarms
-
Fire Extinguisher
-
Operators Manual
-
Horn
-
Clean unit and work Area
-
Additional Comments
Fluid Levels
-
Greased & Lubed
-
Coolant
-
Hydraulic Oil
Replacements
-
Renew Brake Oil
-
Renew Engine Oil and Filter
-
Renew the Fuel Filter
-
Renew Hydraulic Oil Return Filter
-
Renew Differential Gear oil
-
Renew Trans Oil and Filter
-
Renew Air Filter
CSA Annual Inspection
-
Attach Maintenance/Inspection Sticker
-
Unit Passes Inspection
-
Next Annual Inspection Due
-
Add signature
Visual
-
Over head Guard
-
Mast
-
Capacity Plate & Safety Decals
-
Tires & Wheels
-
Seat & Seat Belt
-
Leaks
-
Note any bent or damaged parts
Brakes
-
Visual Inspection: All Brake Components
-
Foot and Park Brake Operation
Steering
-
Linkage, King Pins, Tie Rods, Pivot
-
Cylinder
-
Operation
Frame
-
Check all Tires, Rim, Pressures
-
Hood, Latch, Struts
-
Counter Weight Bolt
-
Dash, Floor Board, Coverings
Electrical
-
Dash, Display, Switches
-
Battery
-
Wiring, Connections, Cables
Power Train
-
Engine System
-
Transmission
-
Differential
-
Fuel System
-
Cooling System
-
Clean Radiator
Mast and Hydraulics
-
Inspect Forks
-
Reason for Failure
-
Load Back Rest
-
Mast Channels and Rollers and Mounting
-
Carriage, Rollers
-
Inspect Lift Chains and Anchors
-
Reason for Failure
-
Pivot - Bushings/Bearings, Mounts
-
Attachment
-
Cylinders
-
Pump(s)
-
Hoses and Pulleys
Operational Check and Test Drive
-
Seat Switch
-
Test Drive and Functional Test
-
Lighting and Alarms
-
Fire Extinguisher
-
Operators Manual
-
Horn
-
Clean unit and work Area
-
Additional Comments
Fluid Levels
-
Greased & Lubed
Replacements
-
Renew Air Filter
-
Renew Engine Oil and Filter
-
Renew the Fuel Filter
-
Renew Coolant
-
Renew Brake Oil
-
Renew Differential Gear Oil
-
Renew Trans Oil and Filter
-
Renew Hydraulic Oil Return Filter
-
Renew Hydraulic Oil and Suction Strainer
CSA Annual Inspection
-
Attach Maintenance/Inspection Sticker
-
Unit Passes Inspection
-
Next Annual Inspection Due
-
Add signature
