Mechanic Maintenance Request
Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
UNIT#
*
MILEAGE
*
dRIVER NAME
*
PLEASE EXPLAIN THE DEFECT THAT NEEDS ATTENTION
*
Submit
Mechanic Repair Order - Mechanic Use ONLY
OUT OF SERVICE
Scheduled for repairs- OK to operate at this time
The above defects have been corrected
defect 1
cause
correction taken
Date
-
Month
-
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
defect 2
cause
correction taken
Date
-
Month
-
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
defect 3
cause
correction taken
Date
-
Month
-
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
parts please include: qty, part number, part description, and price.
name of mechanic
Should be Empty: