Truck Maintenance Form

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This form is in place to provide team members with a streamline process to request vehicle maintenance
ore repairs.

-Please remember a proactive approach helps keep everyone moving.

-The sooner we can identify and correct a problem the less likely the problem is to cause downtime

-Team members are to use this form any time they recognize a potential issue with their vehicle or the need for regular maintenance.

Email *

Name *

Is this an emergency *

Yes

Level of Urgency *

1 - Within a month | Scheduled maintenance

2 - 1-2 Weeks | Maintenance

3 - Within a week | Important issues

4 - 1-2 days | May become an emergency

5 - Immediate Assistance Required | Emergency

Your phone number *

License Plate Number *

Truck Number *

Do you have a current registration and tags in and on your vehicle? *

Yes

Description of Maintenance Needed or Problem *

When did you first recognize this issue? *

YYYY

Do you have any maintenance or repair issues that have not been addressed? *

Yes

Description of outstanding issue

A copy of your responses will be emailed to the address you provided.

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