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U Waste Management of North America, Inc. r <br /> �( �\ CONTAINER CONDITION REPORT VEHICLE CONDITION REPORT <br /> Date Driver Unit# <br /> Division _ Date <br /> TIME MILEAGE HOURMETER <br /> Reported by START a.m. mi. hrs. <br /> Customer Route# a P.m <br /> .m. <br /> p.m: <br /> . mi. hrs. <br /> Location p.m. <br /> Container: Size Type Unit# Out In Out In <br /> Bound Bound Bound Bound <br /> Condition Checks Checks Amount Fluid Checks Checks Amount Fluid <br /> Needs ❑ ❑ _ Fuel (gals.) ❑ ❑ Coolant <br /> (gals.) <br /> Good Fair Attn. ❑ ❑ Eng.Oil (qts.) ❑ ❑ Auto Trans. (qts.) <br /> ❑ ❑ Hyd.Oil (gals.) ❑ ❑ Other <br /> Covers <br /> ❑ ❑ NO DEFECTS—Condition of Vehicle is satisfactory <br /> Casters <br /> ids/Doors Repairs Further <br /> Work <br /> If items need repair,check below and describe. Completed Scheduled <br /> I"runnions/Pockets U ❑ Body Metal/Damage <br /> Side/Top ❑ ❑ Brakes <br /> Floor ❑ ❑ Cab—Items&Controls <br /> Tailgate ❑ ❑ Clutch <br /> ❑ ❑ Elec.Sys.— <br /> Hinges/Locks ❑ ❑ Engine&Fuel <br /> Frame Rails/Crossmembers ❑ ❑ Exhaust&Cool. <br /> Rollers ❑ ❑ Fifth Wh.—Hitches—Dollies <br /> Pick Up Hook ❑ ❑ Gauges—Radio <br /> ❑ ❑ Hyd.System—Cycle <br /> Tarping Rails ❑ ❑ Lights—Reflectors <br /> Cont. Stops ❑ ❑- Safety Equip. <br /> Safety Chain ❑ ❑ Safety Systems <br /> Appearance/Paint ❑ ❑ Susp iDg Axles,Springs <br /> ❑ ❑ Tires, Rims, Lugs <br /> Remarks: ❑ ❑ Trans.—Driveline <br /> THIS SECTION IS TO BE COMPLETED BY A SUPERVISOR ❑ ❑ Winch,Cable,Chains <br /> ❑ ❑ Other <br /> Explain how damage occurred: <br /> Explanation: <br /> operations incurred customer incurred DRIVER DRIVER <br /> What Happened? INITIALS INITIALS <br /> Repair on Site? yes no <br /> 'flange Cont. yes no <br /> _ .;hanged: Date by Driver Signature Date /___/ <br /> Operations Signoff Maint.Sign Off Date____/___/ <br /> Referred to Sales: yes no Driver Review Date___/ <br /> WMNA 1009 11/88 C) Pdnled on recycled paper. ORIGINAL TO SHOP / COPY TO OPERATIONS / HARD COPY STAYS WITH VEHICLE <br /> WMNA 1010 (REV.5/88) Pr,n,ed on re,ycied paper rd <br />