Tractor Monthly Maintenance Report

This is a Federal Law, D.O.T. requirement, not merely a company policy. This report MUST be completed and submitted to our office no later than the 15th of the following month.


      First Name
      Last Name


            Apt# / PO Box
            StatePostal Code

              This is a combination Repair Record, Lubrication and Grease Record, and Tire Repair & Replacement Record. It must be completed each month in which the maintenance is preformed Repair Record: Any and all repairs completed during the month must be listed. All replacement parts must be listed. This also includes minor items such as lights, reflectors, etc. Lubrication & Grease Record: Each lubrication must be listed and all grease jobs. (Trans., Diff. etc) Tire Repair or Replacement Record: List all tire and tube repairs, replacements, tire switching, rotations, etc.

                              REPAIR SECTION:

                              List all repairs made. List all parts or equipment installed.

                                              TIRE SECTION

                                              List all repairs, replacements, rotations and location.

                                                                  LUBRICATION RECORD

                                                                          Brakes Adjustment Records

                                                                                                By checking this box, I consent to my physical signature and certify that the information is true and correct.


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