Title Page
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Conducted on
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Prepared by
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Location
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Customer
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Job #
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Purchase Order Number
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Asset
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Service Type
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Current Hours
Every 10 hours VISUAL INSPECTION
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CHECK FOR OBVIOUS DAMAGE AND LEAKS
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WARNING PLATES AND DECALS
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CONDITION OF TIRES AND WHEELS. AIR PRESSURE
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LIFT CHAIN AND FASTNER
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CARRIAGE OR ATTACHMENT AND FORKS
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FUEL LEVEL
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ENGINE OIL LEVEL
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COOLANT LEVEL (RADIATOR & RESEVOIR TANK)
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WATER SEPARATOR
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HYDRAULIC OIL LEVEL
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FAN BELT DAMAGE
FUNCTION TESTS
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HORN AND LAMP
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GAUGES AND INSTRUMENT PANEL
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WARNING LIGHT
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SERVICE BRAKE AND INCHING OPERATION
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PARKING BRAKE OPERATION
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ACCELERATOR AND ENGINE SPEED CONTROL
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DIRECTIONAL AND SPEED CONTROL OPERATION
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STEERING WHEEL OPERATION
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NOISE AND VIBRATION
Every 50 hours
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AIR CLEANER ELEMENT
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AIR BREATHER FILTER
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ENGINE OIL/ FILTER (INITIAL 50 HOURS ONLY)
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TRANSMISSION OIL LEVEL
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PILOT LINE FILTER ELEMENT (INITIAL 50 HOURS ONLY)
LUBRICATION
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STEERING AXLE LINKAGE PIN
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HYDRAULIC PUMP DRIVE SPLINE
TIGHTENING TORQUES
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PUMP MOUNTING BOLT
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DRIVE AXLE MOUNTING BOLT
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TILT CYLINDER MOUNTING AND TOKE BOLT
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MAST MOUNTING BOLT
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DRIVE & STEERING AXLE WHEEN MOUNTING BOLT & NUT
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COUNTERWEIGHT MOUNTING BOLT
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CABIN MOUNTING BOLT
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MAIN PUMP & MCV MOUNTING BOLT
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ENGINE & RADIATOR MOUNTING BOLT
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TRANSMISSION MOUNTING BOLT
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STEERING AXLE MOUNTING BOLT
Every 250 Hours
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DIFFERENTIAL GEAR OIL
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PILOT LINE FILTER ELEMENT
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BRAKE LINE FILTER (STRAINER)
LUBRICATION
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LIFT CHAIN
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MAST ROLLER AND PIN
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LIFT CYLINDER ROD END
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LIFT CYLINDER TUBE END
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TILT CYLINDER ROD END
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TILT CYLINDER TUBE END
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STEERING CYLINDER ROD END
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STEERING CYLINDER TUBE END
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ATTACHEMENT OPTION CYLINDER ROD END
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ATTACHMENT OPTION CYLINDER TUBE END
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STEERING AXLE WHEEL BEARING
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PEDAL PICOT
EVERY 500 HOURS
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MAST MOUNTING BOLT
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DRIVE AXLE MOUNTING BOLT AND NUT
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AIR CLEANER ELEMENT
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BATTERY
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ENGINE IGINITION AND TIMING
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ENGINE OIL FILTER
- REPLACE
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ENGINE OIL
EVERY 1000 HOURS
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HYDRAULIC OIL RETURN FILTER
HYDRAULIC OIL TANK
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HYDRAULIC OIL
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SUCTION STRAINER
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TRANSMISSION OIL & FILTER
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DIFFERENTAL OIL
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FAN BELT TENSION AND DAMAGE
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BRAKE COOLING OIL
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FUEL FILTER
EVERY 2000 HOURS
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HYD SUCTION STRAINER
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RADIATOR COOLCANT
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HYDRAULIC OIL
EVERY 5000 HOURS
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HYDRAULIC OIL
WHEN REQUIRED
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FUEL TANK
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WATER SEPERATOAR
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FUEL FILTER
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ENGINE OIL
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ENGINE OIL FILTER CARTRIGE
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COOLANT
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RADIATOR
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AIR CLEANER ELEMENT
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HYDRUALIC OIL
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HYDRAULIC OIL SUCTION STRAINER
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RETURN OIL FILETER ELEEMENT
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AIR BREATHER FILTER
HAND PUMP (CABIN TILT)
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HYDRUALIC OIL
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TYRE AIR PRESSURE
SERVICE COMPLETION
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REQUIRED SERVICE COMPLETED
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FITTER
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RIO REPRESENTATIVE NAME
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RIO REPRESENTATIVE SIGNATURE