Required fields are marked with asterisks (*)

Highway Equipment Maintenance Form

Use this form to request preventivie maintenance on a unit or to report mileage/fuel.

For Emergency Service - contact your supervisor.

Number of the Unit or Units you are reporting for:

What are you reporting?

Service required - explain the issue in box below

Service COMPLETED - enter what was done in the box below

Enter the completed service information or what you are reporting is the problem?

Enter the current miles or hours for the unit.

Enter your name

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