Header
1. Technician
7. Serial Number
2. W.O Number
8. Equip Number
3. Date Received
9. Received From
4. Make
10. Current Date
5. Model
11. Current Hours
6. Customer Unit
Service Order #
GENERAL INSPECTION - SAFETY
Ok
Unreliable
Critical
N/A
12. Horn
13. Driver's Overhead Guard
14. Load Back Rest
15. Service Brakes
16. Parking Brake
17. Steering System
18. Lights / Warning Device
19. Forks and Pins
20. Lift Chain Condition
21. Warning Decals
22. Pedal Pads
23. Data Plate
24. Operator Restraint
25. Operator Presence System
26. Comments
GENERAL INSPECTION - OPERATOR COMPARTMENT
Ok
Unreliable
Critical
N/A
27. Hour Meter Working
28. Seat Condition
29. Knobs
30. Steering Handwheel
31. Sheet Metal
32. Paint Condition
33. Gauges
34. Comments
GENERAL INSPECTION - TIRES
Ok
Unreliable
Critical
N/A
35. Tire Chunks / Cuts
36. Drive — 0 D /T D R
37. Drive — 0 D /T D L
38. Steer — 0 D /T D R
39. Steer — 0 D /T D L
40. Load Wheels
41. Caster Wheels
42. Comments
GENERAL INSPECTION - COMPONENT MOUNTING SECURITY
Ok
Unreliable
Critical
N/A
43. Steering Gear
44. Steer Axle
45. Wheel Lug Bolts
46. Counter weight Bolts
47. Drive Unit / Differential
48. Comments
GENERAL INSPECTION - UPRIGHT
Ok
Unreliable
Critical
N/A
49. Chain Adjustment
50. Carriage Condition
51. Cylinder Condition
52. Roller Condition
53. Shim Adjustment
54. Upright Drift
55. Tilt Stroke Adjustment
56. Hydraulic Hose Routing/Wear
57. Comments
GAS / LPG EQUIPMENT - TEST DRIVE
Ok
Unreliable
Critical
N/A
58. Drive Train Noise
59. Transmission Operation
60. Inching Operation
61. Hyd Pump / Valve Operation
62. Governor Operation
63. Neutral / Start Switch
64. Engine Exhaust Smoke
65. Levers and Linkage
66. Engine Operation / Performance
67. Comments
GAS / LPG EQUIPMENT - COOLING SYSTEM
Ok
Unreliable
Critical
N/A
68. Water Pump and Fan Blade
69. Fan Belts
70. Comments
ELECTRIC EQUIPMENT -TEST DRIVE
Ok
RELIABLE
Critical
N/A
71. Drive Train Noise
72. Hyd. Pump/Valve Switch Operation
73. Levers and Linkage
74. Steer Angle Sensor
75. Smooth Speed Control
76. Check Proper Creep Speed
77. Plugging Control
78. Brake Switch Operation
79. Comments
ELECTRIC EQUIPMENT - BATTERY
Ok
Unreliable
Critical
N/A
80. Stops
81. General Condition
82. Battery Cables
83. Charge Condition
84. Comments
SWEEPER / SCRUBBER - SWEEPING SYSTEM
Ok
Unreliable
Critical
N/A
85. Side Broom Operation & Adj.
86. Main Broom Length (4” New)
87. Main Broom Pattern (Adjust to 2 1/2")
88. Side Broom Length (6” New)
89. Hopper Operation & Condition
90. Shaker Operation
91. Vacuum Operation
92. Comments
SWEEPER / SCRUBBER - SCRUBBER SYSTEM
Ok
Unreliable
Critical
N/A
93. Squeegee Condition
94. Squeegee Adjustment
95. Brush Lengths (1 3/4” New)
96. Solution Tank Condition
97. Solution Control
98. Vacuum Operation
99. Recovery Tank Operation
100. Recovery Path
101. Drain Hose
102. Drain Tanks
MAINTENANCE LIFTS - TEST DRIVE
Ok
Unreliable
Critical
N/A
103. Outriggers Condition
104. Scissor Condition
105. Smooth Speed Control
106. Check Proper Creep Speed
107. Railing Condition
108. Steering / Hyd. Controls
109. Platform Stability
110. Platform Extension Condition
TOP OFF FLUID LEVELS - CHECK FOR LEAKS
Ok
Seepage or Dampness
Needs Repair Soon
Needs Immediate Repair
111. Engine Oil
112. Transmission Fluid
113. Coolant Level (-20)
114. Battery Water
115. Hydraulic Fluid
116. Master Cylinder
ATTACHMENT
Ok
Unreliable
Critical
N/A
117. Operation / Mounting
OBVIOUS DAMAGE
118. List
119. RECOMMENDED ADDITIONAL WORK
120. STATUS WHEN TURNED IN
Rentable
Non-Rentable
RECOMMENDED ADDITIONAL WORK
121. RECOMMENDED ADDITIONAL WORK