Preventive Maintenance Template Excel Free Download 32701 | Ia Equipment Operation Data Form 23 Iam 11 Final

Partial file snippet.
Sheet 1: Template

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		EQUIPMENT OPERATION DATA
		

		For Month of:
		

		, YEAR
		

		

		VEHICLE MAINTENANCE OPERATIONS
PERFORMED DURING PERIOD
		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		Class:
		

		Make:
		

		

		

		

		OPERATING AND MAINTENANCE EXPENSES:
		

		

		

		

		

		Property No.
		

		    End of Month
		

		    Beginning
		Odometer Reading
	
	
		Vehicle or Equipment Number:
		

		

		

		

		

		Fuel Costs _ _ _ _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		     of Month
		
	
		

		

		

		

		

		

		

		

		1.  Number of complete lubrication jobs_ _ _ _ _ _ 
		

		0
		

		

		Lubricating Oil Costs_ _ _ _ _ _
		$0.00 
		

		

		
	
		DATE
		Utilization
		Fuel and Oil
		Government Services
		Contractual Services
		Accident Costs
		Remarks
		

		

		2.  Oil filter checked_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		
 
		
		

		

		Labor Costs  _ _ _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		
	
		Hours Operated
		Odometer Reading
		Fuel
		Oil
		Maintenance and Repair
		Maintenance and Repair
		

		

		3.  Air cleaner serviced  _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ 
		Yes
		

		No
		

		

		Material Costs_ _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		

		
	
		Gallons
		Cost
		Quarts
		Cost
		Labor Cost
		Material Cost
		Description of Work
		Cost
		Description of Work
		

		

		4.  Vehicle washed and cleaned_ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		

		Materials & Labor_ _ _ _ _ _ _ _
		$0.00 
		

		

		Manual Entry
		Manual Entry
		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		5.  Radiator drained, cleaned if dirty, and refilled
		

		

		

		
 
		
		

		

		Contractual Services _ _ _ _ _ _
		$0.00 
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		          with water and antifreeze as required_ _ _ _
		Yes
		

		No
		

		

		Depreciation  _ _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		6.  Preventive maintenance and general tune-up
		

		

		

		

		

		Accident Costs  _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		          and adjustments performed_ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		

		Total Direct Cost  _ _ _ _ _ _ _ _
		$0.00 
		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		7.  Safety inspections made  _ _ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		8.  Major repairs to vehicle_ _ _ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		STATISTICAL DATA:
		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Condition of vehicle at end of period in opinion of operator
		

		

		

		Number of miles traveled  _ _
		

		

		

		REPORT -- EQUIPMENT OPERATION DATA
		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Number of days used  _ _ _ _ _
		Manual Entry
		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Fuel Used -- gallons  _ _ _ _ _ _
		0.00
		

		

		

		Indian Affairs
		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Lube oil used -- quarts_ _ _ _ _
		0.00
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Miles per gallon -- fuel  _ _ _ _
		#VALUE!
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Good
		

		Bad
		

		Poor
		

		

		

		Miles per quart -- lube oil_ _ _
		#VALUE!
		

		

		

		U.S. DOI
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (a)  Tires _ _ _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		Units hauled (unit _ _ _ )_ _ _ _
		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		(number)
		
 
		
		(number)
		
 
		
		(number)
		
 
		
		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (b)  Body _ _ _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		ACCOUNT ASSIGNMENT FOR GSA VEHICLES:
		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (c)  Fenders _ _ _ _ _ _ 
		

		

		

		

		

		

		

		Cost Center _ _ _ _ _ _
		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		(number)
		(number)
		(number)
		

		

		

		Fund  _ _ _ _ _ _ _ _ _ _ 
		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (d)  Paint_ _ _ _ _ _ _ _
		

		

		

		

		

		

		

		Functional Area_ _ _ _
		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		

		WBS   _ _ _ _ _ _ _ _ _ _ 
		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (e)  Engine_ _ _ _ _ _ _ 
		

		

		

		

		

		

		

		

		

		Field Station
		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		NOTES:
		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (f) Brakes  _ _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (g) Transmission  _ _ _
		

		

		

		

		

		

		

		

		

		

		Month
		Make
		Class
		License No.
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (h)  Clutch_ _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		0
		0
		0
		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (i)  Differential _ _ _ _
		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		0
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (j)  Steering _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		

		"I CERTIFY that the above record is correct."
		

		

		

		

		

		
	
		Total:
		0.00
		

		0.00
		$0.00 
		0.00
		$0.00 
		$0.00 
		$0.00 
		

		$0.00 
		

		$0.00 
		

		

		

		     (k)  Other (specify) _ _
		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		, YEAR
		
	
		Odometer reading (end of month):
		Manual Entry
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		0
		

		

		
	
		Odometer reading (beginning of month):
		Manual Entry
		

		

		Operator (Printed Name):
		

		

		

		

		

		

		

		

		

		

		

		

		

		(See Reverse)
		

		

		

		

		

		

		

	
	
		Total miles traveled during month:
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Total days used during month:
		Manual Entry
		

		

		Period:
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Form Owner: Indian Affairs Division of Property Management
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Version: February 2018
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 




Sheet 2: Example (IA Owned)

	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		EQUIPMENT OPERATION DATA
		

		For Month of:
		Feb 20 - Mar 19
		, 2015
		

		

		VEHICLE MAINTENANCE OPERATIONS
PERFORMED DURING PERIOD
		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		Class:
		Light Truck
		Make:
		Chevy
		

		

		

		OPERATING AND MAINTENANCE EXPENSES:
		

		

		

		

		

		Property No.
		

		    End of Month
		

		    Beginning
		Odometer Reading
	
	
		Vehicle or Equipment Number:
		I451711
		

		

		

		

		Fuel Costs _ _ _ _ _ _ _ _ _ _ _ _
		$407.07 
		

		

		     of Month
		
	
		

		

		

		

		

		

		

		

		1.  Number of complete lubrication jobs_ _ _ _ _ _ _ 
		

		1
		

		

		Lubricating Oil Costs_ _ _ _ _ _
		$25.50 
		

		

		
	
		DATE
		Utilization
		Fuel and Oil
		Government Services
		Contractual Services
		Accident Costs
		Remarks
		

		

		2.  Oil filter checked _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		
 
		
		

		

		Labor Costs  _ _ _ _ _ _ _ _ _ _ _
		$125.00 
		

		

		
	
		Hours Operated
		Odometer Reading
		Fuel
		Oil
		Maintenance and Repair
		Maintenance and Repair
		

		

		3.  Air cleaner serviced  _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ 
		Yes
		

		No
		

		

		Material Costs_ _ _ _ _ _ _ _ _ _
		$1,019.28 
		

		N/A
		

		
	
		Gallons
		Cost
		Quarts
		Cost
		Labor Cost
		Material Cost
		Description of Work
		Cost
		Description of Work
		

		

		4.  Vehicle washed and cleaned_ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		

		Materials & Labor_ _ _ _ _ _ _ _
		$1,144.28 
		

		

		15,515
		14,264
		

		
	
		2/21/15
		8.00
		14,292
		23.78
		$68.00 
		

		

		

		

		

		

		

		

		

		

		

		5.  Radiator drained, cleaned if dirty, and refilled
		

		

		

		
 
		
		

		

		Contractual Services _ _ _ _ _ _
		$0.00 
		

		

		

		

	
	
		2/28/15
		3.00
		14,438
		19.99
		$58.57 
		

		

		

		

		

		

		

		

		

		

		

		          with water and antifreeze as required _ _ _ _
		Yes
		

		No
		

		

		Depreciation  _ _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		

		

	
	
		3/2/15
		8.00
		14,607
		23.94
		$67.00 
		

		

		

		

		

		

		

		

		

		

		

		6.  Preventive maintenance and general tune-up
		

		

		

		

		

		Accident Costs  _ _ _ _ _ _ _ _ _
		$0.00 
		

		

		

		

	
	
		3/6/15
		8.00
		14,811
		19.11
		$56.00 
		

		

		

		

		

		

		

		

		

		

		

		          and adjustments performed _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		

		Total Direct Cost  _ _ _ _ _ _ _ _
		$1,576.85 
		

		

		

		

		

		

	
	
		3/6/15
		

		14,817
		

		

		6
		$25.50 
		

		

		oil change
		

		

		

		

		

		

		7.  Safety inspections made  _ _ _ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		

		

		

		

		

		

		

		

		

		

		

	
	
		3/10/15
		8.00
		14,967
		14.44
		$41.00 
		

		

		

		

		

		

		

		

		

		

		

		8.  Major repairs to vehicle_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
		Yes
		

		No
		

		STATISTICAL DATA:
		

		

		

		

		

		

		

		

		

		

	
	
		3/15/15
		8.00
		15,217
		21.38
		$63.50 
		

		

		

		

		

		

		

		

		

		

		

		Condition of vehicle at end of period in opinion of operator
		

		

		

		Number of miles traveled  _ _
		1,251
		

		

		REPORT -- EQUIPMENT OPERATION DATA
		

		

	
	
		3/15/15
		

		15,231
		

		

		

		

		$80.00 
		$974.29 
		4 tires
		

		

		

		

		

		

		Good. Rear fender damage from Jun 09 accident.
		

		

		Number of days used  _ _ _ _ _
		14
		

		

		

		

		

	
	
		3/18/15
		6.00
		15,396
		18.93
		$53.00 
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Fuel Used -- gallons  _ _ _ _ _ _
		141.57
		

		

		

		Indian Affairs
		

	
	
		3/19/15
		6.00
		15,473
		

		

		

		

		$45.00 
		$34.99 
		Tune-up and Wiper Blades
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Lube oil used -- quarts_ _ _ _ _
		6.00
		

		

		

		

	
	
		3/19/15
		

		15,474
		

		

		

		

		

		$10.00 
		car wash
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Miles per gallon -- fuel  _ _ _ _
		8.84 
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Good
		

		Bad
		

		Poor
		

		

		

		Miles per quart -- lube oil_ _ _
		208.50 
		

		

		

		U.S. DOI
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (a)  Tires _ _ _ _ _ _ _ _
		

		5
		

		

		

		

		

		

		

		

		Units hauled (unit _ _ _ )_ _ _ _
		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		(number)
		
 
		
		(number)
		
 
		
		(number)
		
 
		
		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (b)  Body _ _ _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		ACCOUNT ASSIGNMENT FOR GSA VEHICLES:
		

		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (c)  Fenders _ _ _ _ _ _ 
		

		1
		

		1
		

		

		

		Cost Center _ _ _ _ _ _
		N/A
		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		(number)
		(number)
		(number)
		

		

		

		Fund  _ _ _ _ _ _ _ _ _ _ 
		N/A
		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (d)  Paint_ _ _ _ _ _ _ _
		

		

		

		

		

		

		

		Functional Area_ _ _ _
		N/A
		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		

		WBS   _ _ _ _ _ _ _ _ _ _ 
		N/A
		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (e)  Engine_ _ _ _ _ _ _ 
		

		

		

		

		

		

		

		

		

		Field Station
		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		NOTES:
		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (f) Brakes  _ _ _ _ _ _ _
		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (g) Transmission _ _ _
		

		

		

		

		

		

		

		

		

		

		Month
		Make
		Class
		License No.
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Pine Ridge Agency
		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (h)  Clutch _ _ _ _ _ _ _
		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		Feb 20 - Mar 19
		Chevy
		Light Truck
		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (i)  Differential _ _ _ _
		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		I451711
	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (j)  Steering _ _ _ _ _ _
		

		

		
 
		
		

		
 
		
		

		
 
		
		

		

		

		

		

		

		

		

		

		
	
		Total:
		55.00
		

		141.57
		$407.07 
		6.00
		$25.50 
		$125.00 
		$1,019.28 
		

		$0.00 
		

		$0.00 
		

		

		

		

		

		

		

		

		

		

		

		"I CERTIFY that the above record is correct."
		

		

		

		

		

		
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		     (k)  Other (specify)_ _
		

		

		

		

		

		

		

		

		

		

		
	
		Odometer reading (end of month):
		15,515
		

		

		Dylan Erickson
		

		

		

		

		

		

		

		

		

		

		

		

		, 2015
		
	
		Odometer reading (beginning of month):
		14,264
		

		

		Operator (Printed Name):
		

		

		

		

		

		

		

		

		

		

		

		

		

		Dylan Erickson
		

		

		
	
		Total miles traveled during month:
		1,251
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		(See Reverse)
		

		

		

		

		

		

		

	
	
		Total days used during month:
		14
		

		

		Period:
		3
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Form Owner: Indian Affairs Division of Property Management
		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

		

	
	
		Version: February 2018
The words contained in this file might help you see if this file matches what you are looking for:

...Sheet template equipment operation data for month of year vehicle maintenance operationsperformed during period class make operating and expenses property no end beginning odometer reading or number fuel costs complete lubrication jobs lubricating oil date utilization government services contractual accident remarks filter checked yes labor hours operated repair air cleaner serviced material gallons cost quarts description work washed cleaned materials amp manual entry radiator drained if dirty refilled with water antifreeze as required depreciation preventive general tuneup adjustments performed total direct safety inspections made major repairs to statistical condition at in opinion operator miles traveled report days used indian affairs lube per gallon value good bad poor quart us doi a tires units hauled unit b body account assignment gsa vehicles c fenders center fund d paint functional area wbs e engine field station notes f brakes g transmission license h clutch i differential j...
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