Air Curtain Burner Rent & Return Inspection Report

• Address of ACB Deployment Site or Name of Mitigation Project

• Renting Agency & Representative Name

• Renting Agency Representative Signature

  Sign

• LFRA Representative Completing Inspection

• LFRA Representative Signature (If Available)

  Sign

• ACB Make/Model/Year/Serial Number

  Select Burn Boss, T-24, Year 2023, Serial #T24FDN23407 Other (Provide details in notes section)

  • Burn Boss, T-24, Year 2023, Serial #T24FDN23407
  • Other (Provide details in notes section)

• Pick Up Location

• Date/Time of ACB Rental

  Date

• Date/Time of ACB Return

  Date

FLUIDS & FUNCTION CHECK

• Fuel Level % (Pick Up)

• Fuel Level % (Return)

• Coolant Level % (Pick Up)

• Coolant Level % (Return)

• Engine Oil Level % (Pick Up)

• Engine Oil Level % (Return)

• Diesel Engine Hours (Pick Up)

• Diesel Engine Hours (Return)

• Hydraulic System Function (Pick Up)

  Pass

  Fail

  Other

• Hydraulic System Function (Return)

  Pass

  Fail

  Other

• Towing System (Lights, Trailer Brake, Chains, Jack Stand, Tongue Pin, Burn Box Pins x2) (Pick Up)

  Pass

  Fail

  Other

• Towing System (Lights, Trailer Brake, Chains, Jack Stand, Tongue Pin, Burn Box Pins x2) (Return)

  Pass

  Fail

  Other

VISUAL INSPECTION

• Complete 360 Degree Walk-Around Inspection of ACB for Damage (Attach Photos & Notes) Mark Photos or Drawings: D=Dent, P=Paint Damage, S=Scratches, C=Crack, T=Tire Damage

• 360 Degree Inspection Photos & Notes (Pick Up)

  Media

• 360 Degree Inspection Photos & Notes (Return)

  Media

• Right Side

  

• NOTES:

• Left Side

  

• NOTES:

• Top Side

  

• NOTES: