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Form No
SCNR580/3414/00/QA10/13(3)
DAILY INSPECTION SHEET
QA 10
MAINTENANCE R580LA-6X4 WO/JO NO
72258727
SHEET

Date 10 December 2021

Code Unit PM5811
S/N Unit YS2R6X400E5363337
SMR 30910
Location Binungan Branch
Inspection Time Start 10/12/2021, 14:30 Time Finish 10/12/2021, 15:00

LOWER STRUCTURE AREA

No Description Condition Note Priority Remark

G. ZONA 2 LOWER STRUCTURE AREA
1 PERIKSA CHASIS DEPAN - BELAKANG Good

2 PERIKSA ANTI ROLL BAR DEPAN Good

3 TORSION BAR Good

4 BUSHING Good

5 BEARING Good

6 LINK Good

7 PERIKSA COOLING SYSTEM Good

8 RADIATOR Good

9 PERIKSA STEERING SYSTEM Good

10 STEERING GEARBOX Good

11 DRAG LINK R1,R2,&R3 Good

12 BALL JOINT Good

13 TIE ROD TYRE 1/2 & 3/4 Good

14 PERIKSA AIR SYSTEM Good

15 PERIKSA ENGINE MOUNTING Good

16 PERIKSA GEARBOX Good

17 GEARBOX HOUSING Good

18 PTO & HYDRAULIC PUMP Good

19 PERIKSA CLUTCH Good

20 PERIKSA FRONT AXLE BEAM TYRE 1, 2 Good

21 PERIKSA BUMP STOPPER TYRE 1, 2 Good

22 PERIKSA FRONT SUSPENSION TYRE NO 1 Good

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No Description Condition Note Priority Remark
23 SHOCK ABSOBER Good

24 LEAFSPRING Good

25 BRACKET SPRING FRONT Good

26 SPRING BOLT FRONT Good

27 BRACKET SPRING REAR Good

28 SPRING BOLT REAR Good

29 PERIKSA BRAKE TYRE NO 1 Good

30 LINING BRAKE Good

31 SLACK ADJUSTER Good

32 BRAKE CHAMBER Good

33 BRAKE DRUM Good

34 CAMSHAFT Good

35 PERIKSA FRONT SUSPENSION TYRE NO 2 Good

36 SHOCK ABSOBER Good

37 LEAFSPRING Good

38 BRACKET SPRING FRONT Good

39 SPRING BOLT FRONT Good

40 BRACKET SPRING REAR Good

41 SPRING BOLT REAR Good

42 U-BOLT Good

43 PERIKSA BRAKE TYRE 2 Good

44 LINING BRAKE Good

45 SLACK ADJUSTER Good

46 BRAKE CHAMBER Good

47 BRAKE DRUM Good

48 CAMSHAFT Good

49 PERIKSA FRONT SUSPENSION TYRE NO 3 Good

50 SHOCK ABSOBER Good

51 LEAFSPRING Good

52 BRACKET SPRING FRONT Good

53 SPRING BOLT FRONT Good

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No Description Condition Note Priority Remark
54 BRACKET SPRING REAR Good

55 SPRING BOLT REAR Good

56 U-BOLT Good

57 BUMP STOPPER TYRE 3, 4 Good

58 PERIKSA FRONT AXLE BEAM TYRE 3, 4 Good

59 PERIKSA BRAKE TYRE NO 3 Good

60 LINING BRAKE Good

61 SLACK ADJUSTER Good

62 BRAKE CHAMBER Good

63 BRAKE DRUM Good

64 CAMSHAFT Good

65 PERIKSA FRONT SUSPENSION TYRE NO 4 Good

66 SHOCK ABSOBER Good

67 LEAFSPRING Good

68 BRACKET SPRING FRONT Good

69 SPRING BOLT FRONT Good

70 BRACKET SPRING REAR Good

71 SPRING BOLT REAR Good

72 U-BOLT Good

73 PERIKSA BRAKE TYRE NO 4 Good

74 LINING BRAKE Good

75 SLACK ADJUSTER Good

76 BRAKE CHAMBER Good

77 BRAKE DRUM Good

78 CAMSHAFT Good

79 PERIKSA RETARDER Good

80 PERIKSA OIL LEVEL Good

81 PROPELLER SHAFT Good

82 UNIVERSAL JOINT CROSS Good

83 SUPPORT BEARING Good

84 PERIKSA REAR FRONT AXLE Good

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No Description Condition Note Priority Remark
85 PERIKSA BUMP STOPPER REAR FRONT Good
AXLE
86 PERIKSA REAR FRONT DIFFERENTIAL Good

87 REAR FRONT DIFFERENTIAL Good

88 BREATHER Good

89 INPUT SHAFT Good

90 INTERAXLE CONNECTOR Good

91 INTERWHEEL CONNECTOR Good

92 OUTPUT SHAFT Good

93 PERIKSA REAR SUSPENSION LH Good

94 SHOCK ABSORBER 5/6 Good

95 TORQUE ROD TYRE 5/6 Good

96 TORQUE ROD TYRE 9/10 Good

97 SEAT SPRING 5/6 Good

98 SEAT SPRING 9/10 Good

99 TORQUE ROD UPPER SIDE TYRE 5/6 & 7/8 Good

100 PERIKSA BOGIE SUSPENSION LH Good

101 PERIKSA BRAKE TYRE NO 5/6 Good

102 LINING BRAKE Good

103 SLACK ADJUSTER Good

104 BRAKE CHAMBER Good

105 BRAKE DRUM Good

106 CAMSHAFT Good

107 PERIKSA BRAKE TYRE NO 7/8 Good

108 LINING BRAKE Good

109 SLACK ADJUSTER Good

110 BRAKE CHAMBER Good

111 BRAKE DRUM Good

112 CAMSHAFT Good

113 PERIKSA BOGIE PROPELLER SHAFT Good

114 PERIKSA BUMP STOPPER REAR REAR Good

AXLE
115 PERIKSA REAR REAR DIFFERENTIAL Good

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No Description Condition Note Priority Remark
116 REAR REAR DIFFERENTIAL Good

117 INPUT SHAFT Good

118 INTERAXLE CONNECTOR Good

119 INTERWHEEL CONNECTOR Good

120 PERIKSA REAR SUSPENSION RH Good

121 SHOCK ABSORBER 7/8 Good

122 TORQUE ROD TYRE 7/8 Good

123 TORQUE ROD TYRE 11/12 Good

124 SEAT SPRING 7/8 Good

125 SEAT SPRING 11/12 Good

126 TORQUE ROD UPPER SIDE TYRE 9/10 & Good

11/2
127 PERIKSA BOGIE SUSPENSION RH Good

128 PERIKSA BRAKE TYRE NO 9/10 Good

129 LINING BRAKE Good

130 SLACK ADJUSTER Good

131 BRAKE CHAMBER Good

132 BRAKE DRUM Good

133 CAMSHAFT Good

134 PERIKSA BRAKE TYRE NO 11/12 Good

135 LINING BRAKE Good

136 SLACK ADJUSTER Good

137 BRAKE CHAMBER Good

138 BRAKE DRUM Good

139 CAMSHAFT Good

140 ELECTRICAL WIRING Good

141 WIRING BOX Good

142 WIRING Good

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Form No
SCNR580/3414/00/QA10/13(3)
DAILY INSPECTION SHEET
QA 10
MAINTENANCE R580LA-6X4 WO/JO NO
72258727
SHEET

UPPER AREA

No Description Condition Note Priority Remark

A. ZONA 1 (FRONT SIDE)
1 PERIKSA KACA DEPAN Good

2 PERIKSA WIPER Good

3 NOZZLE Good

4 BLADE Good

5 PERIKSA GRILL Good

6 UPPER GRILL Good

7 LOWER GRILL Good

8 CAB CORNER RH Good

9 CAB CORNER LH Good

10 PERIKSA LAMPU DEPAN KANAN Good

11 LENS Good

12 HOUSING Good

13 BRACKET Good

14 PERIKSA LAMPU DEPAN KIRI Good

15 LENS Good

16 HOUSING Good

17 BRACKET Good

18 PERIKSA BUMPER Good

19 PERIKSA AC & AC COMPONENT Good

20 HOSE Good

21 CONDENSER Good

22 WIRING Good

23 PERIKSA COOLING SYSTEM Good

24 COOLANT Medium

25 RADIATOR Good

26 PERIKSA ENGINE OIL LEVEL Medium

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No Description Condition Note Priority Remark
27 DIPSTICK & HOLDER Good

28 HOSE Good

29 PERIKSA ELECTRICAL COMPONENT Good

30 COVER Good

31 WIRING Good

32 PERIKSA SUSPENSI CABIN Good

33 PERIKSA STEERING SYSTEM Good

34 STEERING GEARBOX Good

35 STEERING PUMP Good

B. ZONA 1 (CABIN AREA)

1 PERIKSA INSTRUMENT CLUSTER Good

2 PERIKSA TACHOGRAPH Good

3 PERIKSA FUNGSI SWITCH PADA Good

DASHBOARD
4 SWITCH PADA AREA KANAN ICL Good

5 SWITCH PADA AREA KIRI ICL Good

6 SWITCH PADA AREA TENGAH Good

DASHBOARD
7 PERIKSA OPERATOR SEAT Good

8 PERIKSA GEAR SHIFTING LEVER Good

9 PERIKSA CABIN SUSPENSION (REAR Good

CABIN)
10 LOCK Good

11 AIR BELOW Good

C. ZONA 1 (ENGINE AREA, TILT CABIN FIRST)

1 ENGINE Good

2 FRONT SEAL Good

3 REAR SEAL Good

4 TURBOCHARGER Good

5 FUEL SYSTEM Good

6 HOSE AFTERCOOLER Good

7 V - BELT Good

8 IDLER ROLLER Good

9 FAN Good

10 INTAKE & EXHAUST MANIFOLD Good

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No Description Condition Note Priority Remark
11 COOLING SYSTEM Good

12 WATER PUMP Good

13 HOSE Good

14 AIR SYSTEM Good

15 APS Good

16 COMPRESSOR Good

17 PIPE Good

18 GEARBOX Good

19 GEARBOX LINKAGE Good

20 GEARBOX HOUSING Good

21 GEARBOX UNIVERSAL JOINT CROSS Good

22 GEARBOX OIL COOLER Good

23 HYDRAULIC Good

24 HYDRAULIC TANK Good

25 HYDRAULIC OIL LEVEL Medium

26 HYDRAULIC CYLINDER Good

27 PRESSURE GAUGE Good

28 CONTROL VALVE Good

29 HOSE Good

30 BALL VALVE Good

31 MOUNTING BOLT Good

D. ZONA 1 (RH SIDE)

1 PERIKSA MUDGUARD TYRE NO 2 Good

2 PERIKSA MUDGUARD TYRE NO 4 Good

3 PERIKSA PINTU RH Good

4 HANDLE Good

5 LOCK Good

6 PERIKSA MIRROR RH Good

7 LENS Good

8 BRACKET Good

9 PERIKSA EXHAUST SYSTEM Good

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No Description Condition Note Priority Remark
10 SILINCER Good

11 FLEXIBLE HOSE Good

12 TAIL PIPE Good

13 PERIKSA FRONT SUSPENSION Good

14 SHOCK ABSORBER TYRE 2 Good

15 SHOCK ABSORBER TYRE 4 Good

16 PERIKSA FUEL TANK Good

17 BRACKET Good

18 BAND CLAMP Good

19 PERIKSA FRAME Good

20 PERIKSA SUB FRAME Good

21 PERIKSA REAR SUSPENSION RH Good

22 LEAF SPRING RH Good

23 SHOCK ABSORBER POSITION TYRE 7/8 Good

24 BOGIE SUSPENSION RH Good

25 PERIKSA REAR HUB TYRE 7/8 Good

26 PERIKSA REAR HUB TYRE 11/12 Good

E. ZONA 1 (LH SIDE)

1 PERIKSA TILT CABIN Good

2 HOSE Good

3 PUMP Good

4 CYLINDER Good

5 STEERING CYLINDER * Good

6 BALL JOINT * Good

7 PERIKSA MUDGUARD TYRE NO 1 Good

8 PERIKSA MUDGUARD TYRE NO 3 Good

9 PERIKSA PINTU LH Good

10 HANDLE Good

11 LOCK Good

12 PERIKSA MIRROR LH Good

13 LENS Good

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No Description Condition Note Priority Remark
14 BRACKET Good

15 PERIKSA AIR CLEANER Good

16 HOUSING Good

17 BRACKET Good

18 EVAQUATOR VALVE Good

19 PERIKSA AIR TANK DEPAN Good

20 BRACKET Good

21 AIR TANK Good

22 PERIKSA FRONT SUSPENSION Good

23 SHOCK ABSORBER TYRE 1 Good

24 SHOCK ABSORBER TYRE 3 Good

25 PERIKSA STEERING SYSTEM Good

26 STEERING CYLINDER Good

27 DRAGLINK TYRE NO 1 & 3 Good

28 PERIKSA BATTERY Good

29 BATTERY BOX Good

30 VOLTAGE (using battery load tester) Good

31 ISOLATOR SWITCH Good

32 BATTERY ELECTROLIT LEVEL Medium

33 PERIKSA FUEL TANK Good

34 BRACKET Good

35 BAND CLAMP Good

36 WATER SEPARATOR Good

37 PERIKSA FRAME Good

38 PERIKSA SUB FRAME Good

39 PERIKSA AIR TANK BELAKANG Good

40 BRACKET Good

41 AIR TANK Good

42 PERIKSA REAR SUSPENSION LH Good

43 LEAF SPRING LH Good

44 SHOCK ABSORBER POSITION TYRE 5/6 Good

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No Description Condition Note Priority Remark
45 BOGIE SUSPENSION LH Good

46 PERIKSA REAR HUB TYRE NO 5/6 Good

47 PERIKSA REAR HUB TYRE NO 9/10 Good

F. ZONA 1 (REAR SIDE)

1 PERIKSA LAMPU BELAKANG Good

2 REAR LAMP (side marker, brake, reverse, Good

working lamp)
3 WIRING Good

4 PERIKSA ANTI ROLL BAR BELAKANG Good

5 TORSION BAR Good

6 BUSHING Good

7 BEARING Good

8 LINK Good

9 BACKUP ALARM Good

10 VESSEL Good

11 PIN Good

12 CYLINDER GATE * Good

13 CYLINDER TILT * Good

14 HOIST CYLINDER * Good

15 TAIL GATE * Good

Leader Name : Muhammadong Muhammadong Supervisor Name : Sudiyono Sudiyono

Member Name : Muhammadong Muhammadong

Sobrin Pada Ritonga

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