PEAK VEHICLE MAINTENANCE REQUEST DRIVER:(Required) TRUCK#:(Required) DATE:(Required) MM slash DD slash YYYY WORK REQUESTED/NEEDED:(Required) NEEDS OIL CHANGE INSPECT BRAKES NEEDS BRAKES TIRES LOW/BALD LEAKS FLUID WINDSHIELD WIPER BLADES NEEDS INSPECTION TAGS DEAD WINDSHIELD (CHIPS, CRACKS) HEAD LIGHTS (TAIL, TURN SIGNALS) HORN ADDITIONAL WORK NEEDED PLEASE DETAIL ADDITIONAL WORK NEEDED:ADDITIONAL DETAILS:HiddenHOKE USE ONLY:DATE WORK COMPLETED: *Please return form to FLEET MGR upon completion of work for filing in vehicle records. MM slash DD slash YYYY