Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Information

  • Belt Condition

  • Splice Condition

  • Wear Condition

  • Belt Surface Temperature

  • Belt Speed (rpm)

  • Structure-Rails

  • Structure-Floor

  • Spillage-Front

  • Spillage-Mid

  • Spillage-Tail

  • Equipment


  • Pulley Condition

  • Belt Cleaners

  • Belt Tracking Condition

  • Head Noise (dB)

  • Head Bearing 1 Vibration (Hz)

  • Head Bearing 2 Vibration (Hz)

  • Head Section Temperature

  • Motor Temperature

  • Gearbox Temperature


  • Idler Condition

  • What is the condition of the counter weight

  • Noise Level (dB)

  • Skirt Condition

  • Material Build-Up

  • Return Idler Condition

  • General Noise Level (dB)


  • Tail Pulley Condition

  • Tail Noise Level (dB)

Extra Points

  • Grease Points Lubricated

  • Noise

  • Oil Levels

  • Running Analysis

  • Speed

Action Request

  • Comments

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