Defective Equipment Form

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• THE FOLLOWING TRUCK (S) HAVE BEEN INSPECTED AND ARE DEEMED TO BE UNSAFE

PALLET TRUCK - DETAILS

• Please Enter Pallet Truck - MAKE / MODEL / SERIAL NUMBER

• Take Photos if required

  Media

PALLET TRUCK - FAULTS

• Details of Pallet Truck Faults

• Take Photos if required

  Media

NOTES AND RECOMMENDATIONS

• NOTES

• RECOMMENDATIONS

PLEASE TAKE ANY ADDITIONAL PHOTOS IF REQUIRED

• Additional Photos

  Media

ENGINEERS SIGNATURE

• Engineer

  Sign