Information
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Document No.
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Conducted on
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Location
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Conveyor Number
General Information
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Belt Condition
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Splice Condition
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Wear Condition
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Belt Surface Temperature (°)
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Belt Speed (fpm)
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Structure - Rails
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Structure - Floor
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Spillage - Front
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Spillage - Mid
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Spillage - Tail
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Gearbox
Head
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Pulley Condition
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Belt Cleaners
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Belt Tracking Condition
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Plow Condition
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Head Noise (dB)
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Head Bearing 1 Vibration (Hz)
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Head Bearing 2 Vibration (Hz)
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Head Section Temp (°)
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Motor Temp (°)
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Gearbox Temp (°)
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Amperage Consumed
PT
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Gearbox Vibration (dB)
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Motor Temperature (°)
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Hydraulic Hose Condition
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Snub Pulley Condition
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V-Belt Condition
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Sheave Condition
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Motor Noise Level (dB)
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Gearbox Noise Level (dB)
Bend
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Pulley Condition
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Take-Up Bearing Condition
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Take-Up Condition
Middle
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Idler Condition
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Noise Level (dB)
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Skirt Condition
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Material Build-Up
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Return Idler Condition
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General Noise Level (dB)
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Conveyed Material Temp (°)
Tail
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Tail Pulley Condition
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Tail Noise Level (dB)
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Tail Section Temperature (°)
Extra Points
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Grease Points Lubricated
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Noise
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Oil Levels
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Running Analysis
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Speed
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Temperature Readings
Travel Information
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Travel Time
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Round Trip Mileage
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Other
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Other
Comments
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Add Ideas, Safety Concerns, Mechanical Concerns, Waste Disposal and other comments.
Comment
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Comment Type
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Details
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Comment Picture
Action Requests
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Enter Action Requests based on your analysis of the conveyor condition.
Action Request
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Part Number
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Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
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Total Labor
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Comments
