FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
Date
Code Unit
S/N Unit
SMR / KM
Location
Inspectin Time Time Start : Time Finish :
Condition Note Priority
G Good Condition 1 Leaking 5 Worn 1 Action Now
B Bad Condition 2 Broken 6 Crack 2 Action at change shift
U Uncheck Condition 3 Missing 7 Others 3 Action on next PS
4 Loosen 4 Action on schedule backlog
Beri tanda (V) pada kolom sesuai dengan kondisi
Pada kolom foto cantumkan nomor image yang sesuai dengan kondisi
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
A. ZONA 1 (FRONT SIDE)
1 PERIKSA KACA DEPAN
2 PERIKSA WIPER
NOZZLE
BLADE
3 PERIKSA GRILL
UPPER GRILL
LOWER GRILL
CAB CORNER RH
CAB CORNER LH
4 PERIKSA LAMPU DEPAN KANAN
LENS
HOUSING
BRACKET
5 PERIKSA LAMPU DEPAN KIRI
LENS
HOUSING
BRACKET
6 PERIKSA BUMPER
7 PERIKSA AC & AC COMPONENT
HOSE
CONDENSER
WIRING
8 PERIKSA COOLING SYSTEM
COOLANT Low : Medium : High :
RADIATOR
10 PERIKSA ENGINE OIL LEVEL Low : Medium : High :
DIPSTICK & HOLDER
HOSE
11 PERIKSA ELECTRICAL COMPONENT
COVER
WIRING
12 PERIKSA SUSPENSI CABIN
13 PERIKSA STEERING SYSTEM
STEERING GEARBOX
STEERING PUMP
FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
B. ZONA 1 (CABIN AREA)
1 PERIKSA INSTRUMENT CLUSTER
2 PERIKSA TACHOGRAPH
3 PERIKSA FUNGSI SWITCH PADA DASHBOARD
SWITCH PADA AREA KANAN ICL
SWITCH PADA AREA KIRI ICL
SWITCH PADA AREA TENGAH DASHBOARD
4 PERIKSA OPERATOR SEAT
5 PERIKSA GEAR SHIFTING LEVER
6 PERIKSA CABIN SUSPENSION (REAR CABIN)
LOCK
AIR BELOW
C. ZONA 1 (ENGINE AREA, TILT CABIN FIRST)
1 ENGINE
FRONT SEAL
REAR SEAL
TURBOCHARGER
FUEL SYSTEM
HOSE AFTERCOOLER
V - BELT
IDLER ROLLER
FAN
INTAKE & EXHAUST MANIFOLD
2 COOLING SYSTEM
WATER PUMP
HOSE
3 AIR SYSTEM
APS
COMPRESSOR
PIPE
4 GEARBOX
GEARBOX LINKAGE
GEARBOX HOUSING
GEARBOX UNIVERSAL JOINT CROSS
GEARBOX OIL COOLER
5 HYDRAULIC
HYDRAULIC TANK
HYDRAULIC OIL LEVEL Low : Medium : High :
HYDRAULIC CYLINDER
PRESSURE GAUGE
CONTROL VALVE
HOSE
BALL VALVE
MOUNTING BOLT
No Additional of Fluida (Coolant, Oil, Grease) Quantity (Liter)
1
2
3
4
5
Operator Name : Sign Mechanic Name : Supervisor Name :
Comment : Sign : Sign :
Sign Date : Sign Date :
FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
Date
Code Unit
S/N Unit
SMR / KM
Location
Inspectin Time Time Start : Time Finish :
Condition Note Priority
G Good Condition 1 Leaking 5 Worn 1 Action Now
B Bad Condition 2 Broken 6 Crack 2 Action at change shift
U Uncheck Condition 3 Missing 7 Others 3 Action on next PS
4 Loosen 4 Action on schedule backlog
Beri tanda (V) pada kolom sesuai dengan kondisi
Pada kolom foto cantumkan nomor image yang sesuai dengan kondisi
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
D. ZONA 1 (RH SIDE)
1 PERIKSA MUDGUARD TYRE NO 2
2 PERIKSA MUDGUARD TYRE NO 4
3 PERIKSA PINTU RH
HANDLE
LOCK
4 PERIKSA MIRROR RH
LENS
BRACKET
5 PERIKSA EXHAUST SYSTEM
SILINCER
FLEXIBLE HOSE
TAIL PIPE
6 PERIKSA FRONT SUSPENSION
SHOCK ABSORBER TYRE 2
SHOCK ABSORBER TYRE 4
7 PERIKSA FUEL TANK
BRACKET
BAND CLAMP
8 PERIKSA FRAME
9 PERIKSA SUB FRAME
10 PERIKSA REAR SUSPENSION RH
LEAF SPRING RH
SHOCK ABSORBER POSITION TYRE 7/8
BOGIE SUSPENSION RH
11 PERIKSA REAR HUB TYRE 7/8
12 PERIKSA REAR HUB TYRE 11/12
No Additional of Fluida (Coolant, Oil, Grease) Quantity (Liter)
1
2
3
4
5
Operator Name : Sign Mechanic Name : Supervisor Name :
Comment : Sign : Sign :
Sign Date : Sign Date :
FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
Date
Code Unit
S/N Unit
SMR / KM
Location
Inspectin Time Time Start : Time Finish :
Condition Note Priority
G Good Condition 1 Leaking 5 Worn 1 Action Now
B Bad Condition 2 Broken 6 Crack 2 Action at change shift
U Uncheck Condition 3 Missing 7 Others 3 Action on next PS
4 Loosen 4 Action on schedule backlog
Beri tanda (V) pada kolom sesuai dengan kondisi
Pada kolom foto cantumkan nomor image yang sesuai dengan kondisi
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
E. ZONA 1 (LH SIDE)
1 PERIKSA TILT CABIN
HOSE
PUMP
CYLINDER
2 STEERING CYLINDER *
BALL JOINT *
3 PERIKSA MUDGUARD TYRE NO 1
4 PERIKSA MUDGUARD TYRE NO 3
5 PERIKSA PINTU LH
HANDLE
LOCK
6 PERIKSA MIRROR LH
LENS
BRACKET
7 PERIKSA AIR CLEANER
HOUSING
BRACKET
EVAQUATOR VALVE
8 PERIKSA AIR TANK DEPAN
BRACKET
AIR TANK
9 PERIKSA FRONT SUSPENSION
SHOCK ABSORBER TYRE 1
SHOCK ABSORBER TYRE 3
10 PERIKSA STEERING SYSTEM
STEERING CYLINDER
DRAGLINK TYRE NO 1 & 3
11 PERIKSA BATTERY
BATTERY BOX
VOLTAGE (using battery load tester)
ISOLATOR SWITCH
BATTERY ELECTROLIT LEVEL Low : Medium : High :
12 PERIKSA FUEL TANK
BRACKET
BAND CLAMP
WATER SEPARATOR
13 PERIKSA FRAME
14 PERIKSA SUB FRAME
15 PERIKSA AIR TANK BELAKANG
BRACKET
AIR TANK
16 PERIKSA REAR SUSPENSION LH
LEAF SPRING LH
SHOCK ABSORBER POSITION TYRE 5/6
BOGIE SUSPENSION LH
17 PERIKSA REAR HUB TYRE NO 5/6
18 PERIKSA REAR HUB TYRE NO 9/10
* Ceck if applicable
No Additional of Fluida (Coolant, Oil, Grease) Quantity (Liter)
1
2
3
4
5
Operator Name : Sign Mechanic Name : Supervisor Name :
Comment : Sign : Sign :
Sign Date : Sign Date :
FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
Date
Code Unit
S/N Unit
SMR / KM
Location
Inspectin Time Time Start : Time Finish :
Condition Note Priority
G Good Condition 1 Leaking 5 Worn 1 Action Now
B Bad Condition 2 Broken 6 Crack 2 Action at change shift
U Uncheck Condition 3 Missing 7 Others 3 Action on next PS
4 Loosen 4 Action on schedule backlog
Beri tanda (V) pada kolom sesuai dengan kondisi
Pada kolom foto cantumkan nomor image yang sesuai dengan kondisi
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
F. ZONA 1 (REAR SIDE)
1 PERIKSA LAMPU BELAKANG
REAR LAMP (side marker, brake, reverse, working lamp)
WIRING
2 PERIKSA ANTI ROLL BAR BELAKANG
TORSION BAR
BUSHING
BEARING
LINK
3 BACKUP ALARM
4 VESSEL
PIN
CYLINDER GATE *
CYLINDER TILT *
HOIST CYLINDER *
TAIL GATE *
* Check if applicable
No Additional of Fluida (Coolant, Oil, Grease) Quantity (Liter)
Operator Name : Sign Mechanic Name : Supervisor Name :
Comment : Sign : Sign :
Sign Date : Sign Date :
FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
Date
Code Unit
S/N Unit
SMR / KM
Location
Inspectin Time Time Start : Time Finish :
Condition Note Priority
G Good Condition 1 Leaking 5 Worn 1 Action Now
B Bad Condition 2 Broken 6 Crack 2 Action at change shift
U Uncheck Condition 3 Missing 7 Others 3 Action on next PS
4 Loosen 4 Action on schedule backlog
Beri tanda (V) pada kolom sesuai dengan kondisi
Pada kolom foto cantumkan nomor image yang sesuai dengan kondisi
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
G. ZONA 2 LOWER STRUCTURE AREA
1 PERIKSA CHASIS DEPAN - BELAKANG
2 PERIKSA ANTI ROLL BAR DEPAN
TORSION BAR
BUSHING
BEARING
LINK
3 PERIKSA COOLING SYSTEM
RADIATOR
4 PERIKSA STEERING SYSTEM
STEERING GEARBOX
DRAG LINK R1,R2,&R3
BALL JOINT
TIE ROD TYRE 1/2 & 3/4
5 PERIKSA AIR SYSTEM
6 PERIKSA ENGINE MOUNTING
7 PERIKSA GEARBOX
GEARBOX HOUSING
PTO & HYDRAULIC PUMP
8 PERIKSA CLUTCH
9 PERIKSA FRONT AXLE BEAM TYRE 1, 2
10 PERIKSA BUMP STOPPER TYRE 1, 2
11 PERIKSA FRONT SUSPENSION TYRE NO 1
SHOCK ABSOBER
LEAF SPRING
BRACKET SPRING FRONT
SPRING BOLT FRONT
BRACKET SPRING REAR
SPRING BOLT REAR
12 PERIKSA BRAKE TYRE NO 1
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
13 PERIKSA FRONT SUSPENSION TYRE NO 2
SHOCK ABSOBER
LEAF SPRING
BRACKET SPRING FRONT
SPRING BOLT FRONT
BRACKET SPRING REAR
SPRING BOLT REAR
U-BOLT
FORM NO.
PERIODIC INSPECTION SHEET SCNR620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
G. ZONA 2 LOWER STRUCTURE AREA
14 PERIKSA BRAKE TYRE 2
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
15 PERIKSA FRONT SUSPENSION TYRE NO 3
SHOCK ABSOBER
LEAF SPRING
BRACKET SPRING FRONT
SPRING BOLT FRONT
BRACKET SPRING REAR
SPRING BOLT REAR
U-BOLT
BUMP STOPPER TYRE 3, 4
16 PERIKSA FRONT AXLE BEAM TYRE 3, 4
17 PERIKSA BRAKE TYRE NO 3
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
18 PERIKSA FRONT SUSPENSION TYRE NO 4
SHOCK ABSOBER
LEAF SPRING
BRACKET SPRING FRONT
SPRING BOLT FRONT
BRACKET SPRING REAR
SPRING BOLT REAR
U-BOLT
19 PERIKSA BRAKE TYRE NO 4
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
20 PERIKSA RETARDER
PERIKSA OIL LEVEL
21 PROPELLER SHAFT
UNIVERSAL JOINT CROSS
SUPPORT BEARING
22 PERIKSA REAR FRONT AXLE
23 PERIKSA BUMP STOPPER REAR FRONT AXLE
24 PERIKSA REAR FRONT DIFFERENTIAL
REAR FRONT DIFFERENTIAL
BREATHER
INPUT SHAFT
INTERAXLE CONNECTOR
INTERWHEEL CONNECTOR
OUTPUT SHAFT
25 PERIKSA REAR SUSPENSION LH
SHOCK ABSORBER 5/6
TORQUE ROD TYRE 5/6
TORQUE ROD TYRE 9/10
SEAT SPRING 5/6
SEAT SPRING 9/10
TORQUE ROD UPPER SIDE TYRE 5/6 & 7/8
PERIKSA BOGIE SUSPENSION LH
FORM NO.
PERIODIC INSPECTION SHEET SCNS620/5754/00/QA10/24(0)
QA 10 MAINTENANCE SHEET SCANIA S620 WO/JO NO.
CONDITION NOTE PRIORITY
NO DESCRIPTION REMARK PICT
G B U 1 2 3 4 5 6 7 1 2 3 4
G. ZONA 2 LOWER STRUCTURE AREA
26 PERIKSA BRAKE TYRE NO 5/6
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
27 PERIKSA BRAKE TYRE NO 7/8
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
28 PERIKSA BOGIE PROPELLER SHAFT
29 PERIKSA BUMP STOPPER REAR REAR AXLE
30 PERIKSA REAR REAR DIFFERENTIAL
REAR REAR DIFFERENTIAL
INPUT SHAFT
INTERAXLE CONNECTOR
INTERWHEEL CONNECTOR
31 PERIKSA REAR SUSPENSION RH
SHOCK ABSORBER 7/8
TORQUE ROD TYRE 7/8
TORQUE ROD TYRE 11/12
SEAT SPRING 7/8
SEAT SPRING 11/12
TORQUE ROD UPPER SIDE TYRE 9/10 & 11/2
PERIKSA BOGIE SUSPENSION RH
31 PERIKSA BRAKE TYRE NO 9/10
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
32 PERIKSA BRAKE TYRE NO 11/12
LINING BRAKE
SLACK ADJUSTER
BRAKE CHAMBER
BRAKE DRUM
CAMSHAFT
33 ELECTRICAL WIRING
WIRING BOX
WIRING
No Additional of Fluida (Coolant, Oil, Grease) Quantity (Liter)
1
2
3
4
5
Operator Name : Sign Mechanic Name : Supervisor Name :
Comment : Sign : Sign :
Sign Date : Sign Date :
