Name of who performed service: Model # Serial # Hours Horse Power Motor Amps @ Nameplate Amps A/E Discharge Temp Drive motor bearing temps (Drive end bearings / non-drive end bearings) Fan Motor Bearing Temps (Drive end bearings / non-drive end bearings) Oil Cooler Temps (In and Out) / Cooling water Temps (In and Out) After Cooler Temps (In and Out) / Cooling water Temps (In and Out) Drive Belt Condition, Tension and Alignment Inspect Coupler (Hubs and Shaft seal) Oil Type/ Brand Hours On Oil and Oil Sample Date Air Filter Changed Date / Hours Oil Filter Changed Date / Due Date / Hours On Filter Air/Oil Separator (Changed / Hours and if reused or replaced) Oil Differential Pressure Scavenge Line / Check Valve (Inspected / Replaced) Pressure Settings (Load Pressure / Unload Pressure) Moisture Trap (auto Drain / Condensate treatment) Blow Out Coolers (Yes / No) Remarks Ambient Conditions