PERIODIC MAINTENANCE SERVICE FORM

km in thousand (000) Driver's Name: Date:

10 20 40 Engine Model: Technician:
30 60 80 Chassis Model: Quality Inspected by:
50 100 120 Truck No.: Mileage: Plate #:
70 140 160
UNDERHOOD - (Engine and Emission Control Maintenance)
I I I Leaks, cracks, chafing, abrasion of intake & exhasut manifold
A A A Intake valve clearance ___mm. & exhaust valve clearance __mm.[for applicable models only]
I R R Engine coolant (soft water) anti rust coolant
I I I Cooling System
I I I Fuel lines on piping and hoses
I R R Air cleaner filter (dry type)
I R R Air cleaner filter (viscous paper type)
R R R Engine oil and oil filter
I I I Windshield washer tank fluid level, nozzle and wiper blade
I I I Battery / Battery clamp condition (____v)
DIESEL ENGINE
I/A I/A I/A Injector nozzle (only if engine power dec. black smoke is emitted or engine noise increase)
L L L Diaphram (Governor chamber for injection pump)
I I I Fuel strainer for in-line injector pump only and sealing rings
UNDERCHASSIS AND BODY MAINTENANCE
I I I Brake, clutch, & steering gear fluid level for leaks - add fluid as necessary
R Brake/clutch fluid (bleed system)
I I I Brake booster, vacuum hoses, connections and check valve
I I I Brake linings, drum, disc pad & other components for wear, distortion, leaks in wheel cylinder
I I I Foot brake, parking brake and clutch for free play, stroke and operation
I I I Power steering gear box fluid for leaks & check linkages/bushing for damage
I I I Steering damper (applicable model only)
I I R Oil level, MT, A/T and differential gear oil - add as needed
L Greasing points of steering linkages, propeller shafts, suspension parts
I/T I/T I/T Propeller shafts for damage, loose and missing parts - torque as needed
I I I Front suspension bushing, stabilizer bushing, ball joint, tension rod & shock absorbers - replace as necessary
I I I Axle and rear suspension leaf spring bushing, shock absorbers - replace as necessary
T T Body mountings (Torque Valve ________N-m)
I I I Tires for abnormal wear and tire pressure include spare tire _____psi
I I wheel alignment, if necessary rotate and balance wheels
L L Reapacking of all wheel bearings
I I I Locks, hinges and hood latch
I I I Door glass, lock and control mechanism
I I I Seat belts, buckles, retractors, anchor and adjuster
INSIDE AND OUTSIDE ELECTRICAL
I I I Electrical system/headlights/hazard/horn/wiper/washer/park light/elec. Cooling fans etc.
I I I Operation of switches - combination switches, relay, dome light, backup light switch, etc.
INSTRUCTION: Encircle PMS check items in accordance to the required maintenance schedule. Indicate actual measurement in the spaces provided.
LEGEND: I = Inspect and correct or replace as necessary, R = Replace, A = Adjust, L = Greasing or Lubricate, T = Tighten to specified torque
REMARKS (Other recommendation jobs needed)
SEE YOU ON YOUR NEXT PERIODIC MAINTENANCE SCHEDULE AT 10,000 KM/S or 4 MONTHS WHICH EVER COMES FIRST.

Technician Signature_________________