Listen for knocking in the engine. This can be either an injector problem, or on early 2003 trucks there was a TSB for a clutch knocking noise. In the case of the injector, the problem can be fatal. In the case of the clutch, it's harmless but some find it annoying. The way to tell the difference is the clutch noise disappears when you depress the clutch. An injector knock won't.
Check the injector pump (CP-3) for leaks at the front seal. Some have reported some problem.
Check the lower passenger side radiator at the fan clutch electrical connector. Be sure it's not wearing a hole in the radiator. If the connector is rubbing, you should be able to identify a shiny spot between the shroud and the radiator without having to remove the shroud.
Check the filter minder. If it has numbers on it, it's the old style and is not correctly calibrated. It will read 35% restriction even with a new filter.
Listen carefully for any rear end howl. It may indicate a rear end problem, if it's a loud howl.
Check the edges of all the tires for cupping and uneven wear that could indicate bad ball joints.
Check the steering gear for any leakage. Same for the power steering pump.
If it's an automatic, there was a problem early with the 48re that required a new anti-drainback valve. Trucks without the valve would drain the fluid from the torque convertor after sitting for a couple days. As a result, the vehicle would not move for a minute or so after being put into gear while the front pump refilled the convertor. Hard to check, unless you can have the truck sit for awhile.
Check the vent nipples atop the fuel tank. There are 2 of them: one at the front and one at the back. On LWB trucks they sit in depressions in the tank. SWB trucks they are actually on small raised areas on the tank. They are supposed to be plugged for the diesels (we think), but some trucks have them open and bad things can get into them.
Be sure you hear the lift pump kick on when you turn the key on. It should run for 2 seconds. Bump the starter (without starting the engine), and the pump should come on for 25 seconds. Make sure it makes a pleasant "whirring" sound.
Check for leaks at the valve cover.
Check for leaking coolant at the allen-head plugs on the exhaust side of the engine.
That's all I can think of for now...
-Ryan
