Information
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Document No. US20130415
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Mechanic Name:
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Registration#
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Conducted on
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Vehicle Registration:
- CHI-49D
- CHI-49E
- CHX-61B
- BR-87-AF
- CHI-49U
- CHI-52K
- CHI-52J
- BF-07-JP
- CHI-49C
- YGQ-54A
- BE-27-TR
- YWQ-484
- BB-30-ML
- BA-60-LC
- BP-82-LZ
- CGY-17M
- CGU-92U
- BA-80-VM
- BD-03-MJ
- BA-81-VM
- AZ-08-WH
- BR-86-AF
- BA-79-VM
- BR-88-AF
- CGJ-01Y
- BR-84-AF
- BF-01-SK
- CGJ-01X
- BH-01-DI
- BR-85-AF
- BK-26-CY
- BK-73-PV
- BJ-77-ZO
- BK-75-TR
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Patrol Run: (Call Sign)
- Patrol Forster
- Patrol Lismore
- Patrol Taree
- Supervisor Taree
- Patrol Lismore
- CIT Lismore West
- Patrol Mullumbimby
- CIT Lismore East
- Patrol Ballina East
- Patrol Byron Bay
- Patrol Ballina CBD
- Patrol Coffs North
- Patrol Coffs South
- CIT Coffs North
- CIT Coffs South
- CIT Taree
- CIT Forster
- CIT Newcastle 1
- CIT Newcastle 2
- CIT Newcastle 3
- Patrol Nctle Supervisor
- Patrol Nctle Sandgate 12
- Patrol Nctle Cessnock 11
- Patrol Nctle R/Terrace 10
- Patrol Nctle Maitland 08
- Patrol Nctle N/Bay 05
- Patrol Nctle CBD 04
- Patrol Nctle Hamilton 03
- Patrol Nctle Mayfield 01
LIQUID & OILS
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Oil's and Fluids OK?
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Item Fixed or Replaced
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Cost to Fix $
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Radiator Coolant OK?
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Cost to Fix $
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Window Washer OK?
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Cost to Fix $
MECHANICAL: ENGINE
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Gaskets OK?
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Item Fixed or Replaced
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Cost to Fix $
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Spark Plugs or Leads OK?
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Item Fixed or Replaced
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Cost to Fix $
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Filters OK?
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Item Fixed or Replaced
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Cost to Fix $
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Engine Hoses OK?
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Item Fixed or Replaced
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Cost to Fix $
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Belts (Fan, Aircon) OK?
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Item Fixed or Replaced
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Cost to Fix $
LIGHTING:
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Lighting OK? (Headlights, Indicators, Ally lights, interior lights)
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Item Fixed or Replaced
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Cost to Fix $
TYRES & STEERING
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Tyres OK?
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Item Fixed or Replaced
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Cost to Fix $
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Brake pads OK?
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Item Fixed or Replaced
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Cost to Fix $
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Tyre Rims OK?
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Item Fixed or Replaced
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Cost to Fix $
MAJOR REPAIRS
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Was Major Repairs Completed
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Name of Item Replaced or Repaired
Item #
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Name of Item:
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Cost to Fix $
COMMENTS OR REMARKS:
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Enter Any Comments Or Remarks Here:
COSTING:$
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Total Hours worked on this Vehicle:
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Total Equipment Costs: $
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TOTAL COST $: Total cost of repair/ service. Include wage ( @ $20.00 p/h) + Parts
STATEMENTS
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By Mechanic:
I agree that all information provided is true and correct to the best of my knowledge. I understand that any misleading or fraudulent information may and can be used against me and may result in dismissal. -
Mechanic: Print Name & Signature:
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By Supervisor:
I declare that I have checked all above works and advise that all was completed as per above to the best of my knowledge. I agree that all information provided is true and correct to the best of my knowledge. I understand that any misleading or fraudulent information may and can be used against me and may result in dismissal. -
Mechanic: Print Name & Signature:
