Service Report: Inspector Name:

Delivery Used
Add. Service
Hydrostatic Wheel Loaders

Pre-delivery

2nd Service

3rd Service
1st Service
W41

Delivery
Machine Model Type Complete Serial N°- Including Kin Code Engine Model Serial N°

WA250 6 7426 SAA6D107E-1 26715524 CODE P N 1 2 3 X U

Date of Service SMR Distributor Name Location
21/06/2021 14.4
Customer Name Street Adress City Country Code

Attachment (s)
Make Model Serial N° Make Model Serial N° Applications

Nota:Below are the items related to operation, maintenance and lubrication of this machina to be performed at Pre-delivery, Delivery, Periodic and Add Service.
The Operation & Maintenance Manual details all items to maximize availability. Some items may not apply to certain models

● : Item to be service Result of check: : Good condition × : Bad condition : Correction made
HYDROSTATIC WHEEL LOADERS

S: Service Revisit S: Service Revisit

Check

Check
D: Discuss Delivery D: Discuss Delivery
Pre-delivery Pre-delivery
Item S S D S D Item S S D S D
1 Visual check (damage, loose bolts, rust, leakage, wiring) ● ● ● ● ● G 7 Operation
2 Lubrication or service chart installed ● ● G Monitor panel (instrument panel gauges, warning lights,
● ● ● ● ● G
3 Marks & plates installed (safety, operation, lubricating, etc) ● ● G indicators ) and switches
4 Attachment(s) installed ● ● Unusual machine noise ● ● ● G
5 Fluid Compartment Check Warning horn, lights & window wipers ● ● ● ● G
Fuel tank ● ● ● G Back-up alarm ● ● ● ● G
Battery electrolyte ● ● ● ● G Accelerator control ● ● ● ● G
FLUID COMPARTMENT CHECK

Anti-freeze protection & radiator coolant level ● ● ● ● G Transmission neutral lock & shifting control ● ● ● ● G
Engine oil pan(s) ● ● ● ● G Steering, wheel brakes & parking brake ● ● ● ● G
OPERATION

Transfer case ● ● ● ● G Bucket raise time W/ No load & Max. engine speed
● ● ● G
Differential housings ● ● ● ● G Record_____________sec
Drive Axle Planetaries ● ● ● ● G Engine low idle RPM Record 830 ● ● 3rd ● G
Hydraulic tank ● ● ● ● G Engine high idle RPM Record 2180 ● ● 3rd ● G
HST stall RPM Record__________ ● ● 3rd ● G
Steering Relief Pressure Record 20Mpa ● ● 3rd ● G
Equip. Hyd. relief pressure Record 20Mpa ● ● ● G
Power train oil pressure @ high Idle
6 Service High pressure cut-off Record__________
● ● G
Lubricate per lubrication or service chart ● ● ● G Low pressure relief Record__________
Fuel tank & filter sediment ● ● ● ● G Clutch control Record__________
Drive belt tension(s)- fan, alternator, etc. ● ● ● G 8 Guidance
Air cleaner element(s) & connections ● ● ● G Safe operation & maintenance ● ● G
Radiator core & cooling system connections ● ● ● G Procedure for starting & stopping engine ●
Engine oil filter(s), fuel filter(s) & breather ● ● ● G 50 & 100 hour maintenance service ●
Hydraulic oil filter element(s) & tank breather ● ● ● G 250 hour maintenance service ● 1st
GUIDANCE

1st

Inspect entire machine for broken welds, cracks and distortions ● ● ● ● G 500 hour maintenance service 2nd 1&2
SERVICE

Main frame hinge pin nuts ● ● ● G 1000 hour maintenance service 3rd 2&3

Steering linkage ● ● ● G 2000 ,4000,5000,8000 hour maintenance service ●

Drive shaft slip yokes for free movement ● ● ● G Warranty & service rules ●
Wheel brakes & parking brake ● ● ● G Service tools & publications ●
Wheel mounting nut or tolt torque ● ● ● G Spare parts ordering procedure ●
Tire air pressure ● ● ● G 9 Other
Tire wear ● ● ● G Operation & maintenance manual review ● ●
OTHERS

Cab air filter ● ● ● G Parts book review ● ●

Wear of bucket or blade cutting edges ● ● ● G Safety manual review ● ●
KOMTRAX/VHMS function - if applicable ● ● G ROPS installed condition-if applicable serial No:_________ ● ●

Customer's Comments Equipo con bajo nivel de combustible, se dreno y se encontró ok.
Inspector's Comments

This machine has been serviced and is in satisfactory condition. Adequate information has been given on its operation, care and maintenance.
The Operation & Maintenance Manual has been received. All literature and explanations that pertain to safe machine operation have been received and understood.

Customer Signature: Inspector Signature: