Application Equipment All-IN Audit

• Site conducted

  Select

• Machine Serial Number

• Conducted on

  Date

• Auditor

• Location of where audit was performed?
  Address

Equipment Information

• Unit Make

• Unit Model

• CVA Unit 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

• Has unit received bi-annual pan testing?

  Yes

  No

  Y-Notes

  N/A

First Aid / Emergency Equipment

• First Aid Kit Present, Adequate, and Accessible?

  Yes

  No

  Y-Notes

  N/A

• Eye Wash Solution Present, Sealed, and Accessible?

  Yes

  No

  Y-Notes

  N/A

• Water and Supplies Available for Operator Decontamination?

  Yes

  No

  Y-Notes

  N/A

Fire Extinguisher

• Fire Extinguisher Adequate? (min. 5 lbs, readily accessible, in mounting bracket, properly charged)?

  Yes

  No

  Y-Notes

  N/A

Seat and Seatbelt

• Is operator seat and restraint systems fully functional?

  Yes

  No

  Y-Notes

  N/A

PPE

• Adequate PPE? (Eye protection, gloves, and cover-all suit)

  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 functional (turn signals, brakes, flashers, and headlamps) ?

  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

• Is last service date recorded in cab or on equipment?

  Yes

  No

  Y-Notes

  N/A

• Engine Appearance/Cleanliness?

  Above Average

  Average

  Below Average

• Fuel System Free of Leaks (especially in the engine area)?

  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 gauges indicate 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