004 TW Plant Health & Safety Audit

• Site

• Plant Audit document number

• Conducted on

  Date

• Equipment type

  Select Dumper truck Excavator Roller Telehandler Trackair

  • Dumper truck
  • Excavator
  • Roller
  • Telehandler
  • Trackair

Equipment Identification

• Equipment picture

  Media

• Serial No

• Fleet/Plant No

Dumper

• Is the plant being inspected a Dumper?

  Yes

  No

• Has a daily/weekly plant check been carried out for this plant?

  Yes

  No

• Is the dumper cabbed or standard?

  Cabbed

  Standard

• Does the engine have sufficient oil and free from leaks?

  Yes

  No

• Are coolant levels sufficient and free from leaks?

  Select Yes No

  • Yes
  • No

• Are hydraulic oils levels sufficient and free from leaks?

  Yes

  No

• Is the seat belt working with green flashing light?

  Yes

  No

• Does the amber light work sufficiently?

  Yes

  No

• Are all fitted lights working and in good order?

  Yes

  No

• Are steps and handrails in good order?

  Yes

  No

• Does the foot break and hand break work correctly?

  Yes

  No

• Does the horn work?

  Yes

  No

• Are the tires inflated and checked on a regular basis?

  Yes

  No

• If road legal, does the plant have break lights, headlights, indicators and number plate?

  Yes

  No

  N/A

• Are the ROPS correctly installed and pinned?

  Yes

  No

• Are safety/thumbs up stickers present?

  Yes

  No

• Is preventative maintenance carried out weekly?

  Yes

  No

Excavator

• Is the plant being inspected an Excavator?

  Yes

  No

• Has daily/weekly plant checks been carried out for this plant?

  Yes

  No

• Has the operator signed on to the quick hitch register?

  Yes

  No

• Are Lifting certs available for this plant and in date?

  Yes

  No

• Is the operators manual in the cab?

  Yes

  No

• Is the engine oil sufficient and free from leaks?

  Yes

  No

• Are coolant levels sufficient and free from leaks?

  Yes

  No

• Are hydraulic oils levels sufficient and free from leaks?

  Yes

  No

• Are windscreen washers and wipers working correctly?

  Yes

  No

• Is the seat belt working with green flashing light?

  Yes

  No

• Is the amber light working?

  Yes

  No

• Are all fitted lights working and in good order?

  Yes

  No

• Is the horn working?

  Yes

  No

• Are hydraulic hoses and couplers in good condition?

  Yes

  No

• Are tracks and sprockets in good overall condition?

  Yes

  No

• Is any fall protection fitted in good order?

  Yes

  No

• Are steps and handrails in good order?

  Yes

  No

• Is all round visibility maintained, mirrors and cameras positioned correctly ?

  Yes

  No

• Are safety/thumbs up stickers present?

  Select Yes No

  • Yes
  • No

• Is preventive maintenance carried out on a regular basis?

  Yes

  No

• Is the operators manual in the cab?

  Yes

  No

Roller

• Is the plant being inspected a Roller?

  Yes

  No

• Has daily/weekly plant checks been carried out for this plant?

  Yes

  No

• Does the engine have sufficient oil and free from leaks?

  Yes

  No

• Are coolant levels sufficient and free from leaks?

  Yes

  No

• Are hydraulic oils levels sufficient and free from leaks?

  Yes

  No

• Is the seat belt working with green flashing light?

  Yes

  No

• Is the amber light working sufficiently?

  Yes

  No

• Are all fitted lights working and in good order?

  Yes

  No

• Does the horns work?

  Yes

  No

• Are roller scrapers adjusted correctly?

  Yes

  No

• Are water systems full and free from leaks?

  Yes

  No

• Are steps and handrails in good order?

  Yes

  No

• Is all round visibility maintained, mirrors and cameras positioned correctly ?

  Yes

  No

• Are the ROPS correctly installed and pinned?

  Select Yes No

  • Yes
  • No

• Are safety/thumbs up stickers present?

  Yes

  No

• Is preventative maintenance carried out on a regular basis?

  Yes

  No

Telehandler

• Is the plant inspected a Telehandler?

  Yes

  No

• Has daily/weekly plant checks been carried out for this plant?

  Yes

  No

• Does the engine have sufficient oil and free from leaks?

  Yes

  No

• Are coolant levels sufficient and free from leaks?

  Yes

  No

• Are Lifting certs available for this plant available and in date?

  Yes

  No

• Are brake fluid levels sufficient and free from leaks?

  Yes

  No

• Are hydraulic oils levels sufficient and free from leaks?

  Yes

  No

• Are windscreen washers and wipers working correctly?

  Yes

  No

• Is the seat belt working with green flashing light?

  Yes

  No

• Is the amber light working sufficiently?

  Yes

  No

• Are all fitted lights working and in good order?

  Yes

  No

• Are tires inflated and checked on a regular basis?

  Yes

  No

• Does the reverse alarm work?

  Yes

  No

• Does the foot break and parking break operate correctly?

  Yes

  No

• Does the safe load indicator work correctly?

  Yes

  No

• Are blind spot removal and cameras working correctly?

  Yes

  No

• Are lifting accessories such as forks certified and in good condition?

  Yes

  No

• Is the towing pin correctly fitted?

  Yes

  No

• Is the operators manual in the cab?

  Yes

  No

• Are safety/thumbs up stickers present?

  Yes

  No

• Is preventive maintenance carried out on a regular basis?

  Yes

  No

Trackair

• Is the plant inspected a Trackair

  Yes

  No

• Has daily/weekly plant checks been carried out for this plant?

  Yes

  No

• Does the engine have sufficient oil and free from leaks?

  Yes

  No

• Are coolant levels sufficient and free from leaks?

  Yes

  No

• Are brake fluid levels sufficient and free from leaks?

  Yes

  No

• Are hydraulic oils levels sufficient and free from leaks?

  Yes

  No

• Are windscreen washers and wipers working correctly?

  Yes

  No

• Is the seat belt working with green flashing light?

  Yes

  No

• Does the amber flashing light work sufficiently?

  Yes

  No

• If road legal, does the plant have break lights, headlights, indicators and number plate?

  Yes

  No

• Does the horn work?

  Yes

  No

• Does the reverse alarm work?

  Yes

  No

• Does the foot break and parking break operate correctly?

  Yes

  No

• Are blind spot removal and cameras working correctly?

  Yes

  No

• Is the towing pin correctly fitted?

  Yes

  No

• Is the operators manual in the cab?

  Yes

  No

• Is preventive maintenance carried out on a regular basis?

  Yes

  No

Sign Off

• Assessor Name

• Assessor Signature

  Sign

• Plant operatives name

• Plant operatives signature

  Sign