Information
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Document No.
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Task
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Job No./ Site Address
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Conducted on
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Prepared by
Internal Assessment
Pre-operational checklist & logbook Bobcat
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Operator name
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Machine hours
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Make & model check<br>Bobcat 1999 skidsteer 763
Equipment Assessment
Fluids
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Engine oil ok?
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Engine oil ok
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Transmission oil ok
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Coolant level ok
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Fuel level ok
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Any visually seen leaks or signs of cracking/rust
Site Assessment
External inspection
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Fire extinguisher present & full
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All lights & reflectors are in good working order
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Amber beacon available
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OPG ( operator protective guard ) present, sturdily attached and free of damage
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All hydraulic hoses are connected properly & free from leaks & damage ( never use your hand for leaks, always use wood or cardboard )
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All tyres & tyre components are in safe working condition
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Check all structural components are in safe working condition
Operator work area
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Operator floor non slip & free from damage
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All operator access non-slip, sturdily attached & free from damage with three points of contact
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Seat, attached & free from damage
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Seat belt present, sturdily attached & free from damage
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All controls are fully functional & clearly & legibly labelled as to purpose & method of operation
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Operator warning device functional ( horn )
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Any site obstacles present (eg: power lines, temporary fencing )
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Load chart present & legible
Machine function & information
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Machine functions as per manufacturers operating instruction & all manufacturers operational & safety information is available
Worker Consulation
Witness if workers are on site whilst machine is in operation
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Worker
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I the undersigned have been consulted in relation to the pre-operational checklist & logbook and have been advised of all safety awareness whilst machine is in use
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Sign off
Sign Off
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Have you eliminated all potential risks from any other hazards identified on site that may affect your work tasks?
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Contact Shaun White prior to proceeding
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Signature of person completing this assessment