Cat/Dozer Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Cat Information

• Photo of Cat or Dozer

  Media

• Operator

• Unit Number

• Make

• Model

• Hour meter

Items for visual inspection

• Outside Appearance

  Safe

  At Risk

  N/A

• Windshield, Glass & Screens

  Safe

  At Risk

  N/A

• Windshield wipers

  Safe

  At Risk

  N/A

• Steps

  Safe

  At Risk

  N/A

• Engine Compartment Cleanliness

  Safe

  At Risk

  N/A

• Track Pads

  Safe

  At Risk

  N/A

• Track Tension

  Adequate

  Service

  N/A

• Drive Sprocket and Wheels

  Safe

  At Risk

  N/A

• Blade

  Safe

  At Risk

  N/A

• Blade hoses

  Safe

  At Risk

  N/A

• Headlights

  Working Order

  Out of Order

  Not Present

• Rear Lights

  Working Order

  Out of Order

  Not Present

• Beacon

  Working Order

  Out of Order

  Not Present

• Back Up Signal

  Working Order

  Out of Order

  Not Present

• Hydraulic Rams & Hoses

  Safe

  At Risk

  N/A

• Inside Appearance

  Safe

  At Risk

  N/A

• Escape Hatch

  Safe

  At Risk

  N/A

• Seat Belt

  Safe

  At Risk

  N/A

• Radio and antenna

  Working Order

  Out of Order

  Not Present

• GPS and antenna

  Working Order

  Out of Order

  Not Present

• Winch and Cable

  Working Order

  Out of Order

  Not Present

PPE, Safety, and Emergency

• ERP & Map

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• High Visibility Outerwear

  Yes

  No

  N/A

• Safety Boots

  Yes

  No

  N/A

• Ear Protection

  Yes

  No

  N/A

• Eye Protection

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• First Aid Kit. If YES, what type?

  Yes

  No

  N/A

• Fire Extinguisher. If YES, what size?

  Yes

  No

  N/A

• Tool Kit

  Yes

  No

  N/A

• Spill Kit

  Yes

  No

  N/A

• Audit performed by

  Sign