Lenoir County EMS
Department of Emergency Services
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Fleet Maintenance Form
*Fleet #
-Select a choice-
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*Date:
Weekly Maintenance Checklist
Inspection Sticker:
OEMS Inspection Sticker:
Current Mileage:
Oil Level:
Normal
Below Normal
Amount of Oil Added:
Transmission Fluid:
Normal
Below Normal
Amount of Transmission Fluid Added
Lights:
Normal
Replaced Lights
We replaced the following lights:
Brake Fluid
Normal
Below Normal
Amount of Brake Fluid Added:
Tires:
Normal
Below Normal
Coolant:
Normal
Below Normal
Amount of Coolant Added:
Other Maintenance Required:
Next PM Due:
Next PM Mileage
Repair Request
Description of the Problem
Repair Requested by:
Supervisor Notified:
Action Taken:
PM-A
PM-B
PM-C
PM-D
Mileage at PM
Vehicle sent to Popes Automotive on :
By:
Mileage: