Application Equipment All-IN Audit

• Machine Serial Number

• Conducted on

  Date

• Auditor

• Location of where audit was performed?
  Address

Equipment Information

• Unit Make

• Unit Model

• CVA Unit Number

• Unit Serial Number

• Unit Hours

• Unit Hours Since Last Audit

• Controller Type

Equipment Photos

• Photo #1 Taken from open entry door looking into cab?

  Media

• Photo #2 View of entire left side of unit (Booms racked if applicable)?

  Media

• Photo #3 View of entire right side of unit (Booms racked if applicable)?

  Media

• Photo #4 View of entire front of unit (Booms racked if applicable)?

  Media

• Photo #5 View of entire rear of unit (Booms racked if applicable)?

  Media

Machine Location Information

• Assigned CVA Agronomy Location

Operator Information

• Name of Primary Operator

• Name of Secondary Operator

• Has this machine been operated by additional locations or operators

  Yes

  No
Additional Operator/Location

• Name of Additional Operator(s)/Location(s)

Record Keeping

• Are Unit Service Records Available?

  Yes

  No

  Y-Notes

  N/A

• Is this unit accident free since last audit?

  Yes

  No

  Y-Notes

  N/A

• Is this unit free of any major repair costs since last audit?

  Yes

  No

  Y-Notes

  N/A

• Are Fluids Condition Reports accessible?

  Yes

  No

  Y-Notes

  N/A

• Has unit received bi-annual pan testing?

  Yes

  No

  Y-Notes

  N/A

First Aid / Emergency Equipment

• First Aid Kit Present and Adequate?

  Yes

  No

  Y-Notes

  N/A

• First Aid Kit Clean and Accessible?

  Yes

  No

  Y-Notes

  N/A

• Eye Wash Solution Present?

  Yes

  No

  Y-Notes

  N/A

• Eye Wash Container Sealed?

  Yes

  No

  Y-Notes

  N/A

• Eye Wash Container Clean and Accessible?

  Yes

  No

  Y-Notes

  N/A

• Soap, Paper Towels, and Water Available for Operator Decontamination?

  Yes

  No

  Y-Notes

  N/A

Fire Extinguisher

• Fire Extinguisher Present on Unit (min. 5 lb)?

  Yes

  No

  N/A

• Is Fire Extinguisher Readily Accessible?

  Yes

  No

  N/A

• Is Fire Extinguisher in a Mounting Bracket?

  Yes

  No

  N/A

• Is Fire Extinguisher Properly Charged?

  Yes

  No

  N/A

Seat and Seatbelt

• Is operator restraint system fully functional?

  Yes

  No

  Y-Notes

  N/A

• Is operator seat fully functional?

  Yes

  No

  Y-Notes

  N/A

PPE

• Chemical Goggle or Face Shield Protection Present?

  Yes

  No

  Y-Notes

  N/A

• Clean Chemical Gloves Present?

  Yes

  No

  Y-Notes

  N/A

• Chemical Cover-all Suit Available?

  Yes

  No

  Y-Notes

  N/A

Appearance & Cleanliness

• Appearance and Cleanliness at time of inspection?

  Above Average

  Average

  Below Average

Cab & Chassis

• Cleanliness of Inside Cab.

  Above Average

  Average

  Below Average

• Is glass free of cracks in drivers operating view?

  Yes

  No

  Y-Notes

  N/A

• Lights all fully functional?

  Yes

  No

  Y-Notes

  N/A

• Battery Box / Cleanliness and Condition?

  Above Average

  Average

  Below Average

• Is battery disconnect functional?

  Yes

  No

  Y-Notes

  N/A

Engine & Drivetrain

• Are liquid filters marked with unit hours or date?

  Yes

  No

  Y-Notes

  N/A

• Is air filter housing marked with hours or date?

  Yes

  No

  Y-Notes

  N/A

• Engine Appearance/Cleanliness?

  Above Average

  Average

  Below Average

• Fuel System Free of Leaks?

  Yes

  No

  Y-Notes

  N/A

• Engine bay free of Oil leaks?

  Yes

  No

  Y-Notes

  N/A

• Engine bay free of Coolant leaks?

  Yes

  No

  Y-Notes

  N/A

• Radiator/Cooler Cleanliness and Condition?

  Yes

  No

  Y-Notes

  N/A

• Hydraulic Site guage indicates proper fluid level?

  Yes

  No

  Y-Notes

  N/A

• Tires in safe operating condition?

  Yes

  No

  Y-Notes

  N/A

Chassis/Applicator

• Condition of Grease Points at pivot points?

  Above Average

  Average

  Below Average

• Product Compartment Cleanliness?

  Above Average

  Average

  Below Average

• Does this machine have a boom system?

  Yes

  No

• Condition of Boom?

  Above Average

  Average

  Below Average

• Additional Auditor Comments or Notes

• Signature of Auditor

  Sign