Equipment Inspection

• Site conducted`

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address
Equipment #

• What kind of equipment are you on

  Select Skidsteer/Telehandler Excavator Dozer Aerial lift Wheel Loader Towable Generator/Light plant Towable Air Compressor Track Loader Fuel Truck/Water Truck/Off Road Truck fork truck/hilo UTV Roller Dust Boss

  • Skidsteer/Telehandler
  • Excavator
  • Dozer
  • Aerial lift
  • Wheel Loader
  • Towable Generator/Light plant
  • Towable Air Compressor
  • Track Loader
  • Fuel Truck/Water Truck/Off Road Truck
  • fork truck/hilo
  • UTV
  • Roller
  • Dust Boss

Exterior

• Windshield, Glass & Screens

  Compliant

  Non-Compliant

  N/A

• Windshield Wipers

  Compliant

  Non-Compliant

  N/A

• Steps

  Compliant

  Non-Compliant

• Are grab bars present and in good condition

  Compliant

  Non-Compliant

• Engine Compartmentt Cleanliness

  Compliant

  Non-Compliant

• Check Engine oil

  Safe

  Added

• How much Engine oil did you add

• Is the air filter clean

  Yes

  No

  N/A

• take necessary steps so that you can answer yes

• Check Hydraulic fluid

  Safe

  Added

• How much Hydraulic fluid did you add

• Are tracks clean

  Yes

  No

• Clean tracks

• Track pads

  Yes

  No

• Track tension

  Yes

  No

• Drive sprocket and wheels (Flat on top, Pointy on top)

  Flat on top

  Pointy on top

• Blade

  Compliant

  Non-Compliant

• Cutting edge condition (more than 1" of cutting edge below base metal)

  Adequate

  Service

• Blade Hoses

  Great Condition

  Good Condition

  Fair condition

  Needs Replaced

• Hydraulic rams and hoses

  Great Condition

  Good Condition

  Fair condition

  Needs Replaced

• Machine Greased

  Yes

  No

  N/A

Interior

• Inside Appearance (housekeeping)

  Compliant

  Non-Compliant

• Is the owners manual with the machine

  Yes

  No

• Is there an current Annual Inspection for this machine

  Yes

  No

• Is the fire extinguisher present and have a current inspection

  Yes

  No

• Take a picture of the tag

  Media

• Seat condition and Seat belt

  Adequate

  Service

• Start Machine

• Travel alarm - Back-up alarm audible when machine is running at full power

  Yes

  No

• Headlights operational

  Working

  Not Working

• Enter the hours

• Are all gauges, switches, and electrical components functioning

  Yes

  No

• Check the Engine oil

  Adequate

  Service

• Is the air filter clean

  Yes

  No

• Engine compartment cleanliness

  Compliant

  Non-Compliant

• Is the operators manual with the machine

  Yes

  No

• Are the tires properly inflated and in acceptable condition

  Yes

  No

  N/A

• Please add a Photo with a brief description of the issue.

• Yes

  No

  N/A

• Is the annual inspection current on this equipment

  Yes

  No

• VISUALLY INSPECT

• FLUIDS - LEAKAGE

  Safe

  At Risk

• Did you address the issue and what steps were taken? Did you notify the appropriate personnel

• CONTROL CABLES

  Safe

  At Risk

• WARNING LIGHTS

  Safe

  At Risk

• LABEL, TAGS OR PLACARDS

  Safe

  At Risk

• Did you Address issue and what steps were taken? Did you notify the appropriate personnel?

  Yes

  No

  N/A

STRUCTURAL DAMAGE

• WELDS

  Safe

  At Risk

• Did you Address issue and what steps were taken? Did you notify the appropriate personnel?

• FASTENERS

  Safe

  At Risk

• Did you Address issue and what steps were taken? Did you notify the appropriate personnel?

FALL PROTECTION EQUIPMENT

• FALL PROTECTION ATTACH PTS

  Yes

  No

  N/A

• What did you do to fix?

• MAN/BASKET/PLATFORM

  Yes

  No

  N/A

• STEERING COMPONENTS

  Safe

  Unsafe

  N/A

• BATTERY COVER/ENGINE COVER

  Yes

  No

  N/A

FLUID - LEVEL CHECKS

• TIRES

  Safe

  At Risk

• Hoses

  Safe

  At Risk

GROUND CONTROLS

• DRIVE (forward & reverse)

  Yes

  No

  N/A

• STEER

  left

  right

• ROTATE

  left

  right

• EXTEND AND RETRACT (boom in & out)

  Yes

  No

  N/A

• BOOM (raise & lower)

  Yes

  No

  N/A

• BASKET/PLATFORM (level, rotate & extend)

  Yes

  No

  N/A

• AUXILIARY POWER

  Yes

  No

  N/A

• EMERGENCY STOP(S)

  Yes

  No

  N/A

• EMERGENCY DESCENT VALVES

  Yes

  No

  N/A

• OUTRIGGER

  Yes

  No

  N/A

• Enter the hours

PLATFORM / BASKET CONTROLS

• DRIVE (forward & reverse)

  Safe

  At Risk

• STEER

  Safe

  At Risk

• ROTATE

  left

  right

• EXTEND AND RETRACT (boom in & out)

  Yes

  No

  N/A

• BOOM (raise & lower)

  Yes

  No

  N/A

• BASKET/PLATFORM ( level, rotate & extend)

  Yes

  No

  N/A

• AUXILIARY POWER

  Yes

  No

  N/A

• EMERGENCY STOP(S)

  Yes

  No

  N/A

Exterior

• Are tracks clean and in good operational condition

  Yes

  No

• Is the any Damage to the exterior of the machine (that has been not addressed previously)

  Yes

  No

• Are there any loose bolts or loose or missing clamps?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are there 4 Swing Stickers on the counterweight? (2 facing the rear of the machine and one on each side)

  Yes

  No

• Are there any signs of fluids leaking under the machine

  Yes

  No

• Please take photos of the exterior of the equipment (so the pictures show all sides)

  Media

Engine Compartment

• Check Engine oil

  Safe

  Added

• How much Engine oil did you add

• Check antifreeze/coolant

  Safe

  Added

• How much coolant did you add

• Check swing oil

  Safe

  Added

• How much swing oil did you add

• Inspect fire extinguisher

  Acceptable

  Unacceptable

• please take a picture of the fire extinguisher tag

• Inspect and knock out air filter

  Yes

  No

• Inspect fan belts for any visible damage/fraying/check tension

  Acceptable

  Unacceptable

• Are all lights, and wiring free of visible damage

  Yes

  No

Interior

• General Vehicle Condition

  Good

  Fair

  Poor

• Is the annual inspection current on this equipment

  Yes

  No

• Please take a photo of the sticker

  Media

• Is the hydraulic kit in the proper mode for current attachment

  Yes

  No

• Is seat and safety restraint in good working condition

  Yes

  No

• Is the glass in good condition and no damage since your last inspection on this equipment

  Yes

  No

  N/A

• Start the machine

• Are instruments functioning and within normal ranges?

  Yes

  No

• Enter the Machine Hours

• Is the proper attachment number selected in the monitor?

  Yes

  No

• Is the safety interlock device working? (safety lever)

  Yes

  No

• Do the wipers and wiper fluid function as usual?

  Yes

  No

  N/A

• is the horn working?

  Yes

  No

• is the travel alarm audible when the machine is at full RPM's

  Yes

  No

• Do all levers function and respond as normal

  Yes

  No

• Are there any warning alarms

  Yes

  No

• Check Hydraulic oil (may have to revisit this question after you start and reposition the machine)

  Safe

  Added

• How much Hydraulic fluid did you add

• Verify that all lights are working

  Acceptable

  Unacceptable

Exterior

• Windshield, Glass & Screens

  Compliant

  Non-Compliant

  N/A

• Windshield wipers

  Yes

  No

  N/A

• Steps

  Compliant

  Non-Compliant

• Are grab bars present and in good condition

  Compliant

  Non-Compliant

• Engine Compartment Cleanliness

  Compliant

  Non-Compliant

  N/A

• Check Engine Oil

  Compliant

  Non-Compliant

  N/A

• Is air filter clean

  Yes

  No

• Check Hydraulic Fluid

  Compliant

  Non-Compliant

  N/A

• Are Tracks cleaned out

  Yes

  No

  N/A

• Track Pads

  Compliant

  Non-Compliant

  N/A

• Track Tension

  Compliant

  Non-Compliant

  N/A

• Drive Sprocket and Wheels

  Flat on top

  Pointy on top

• Are all lights, and wiring free of visible damage

  Yes

  No

• Blade

  Compliant

  Non-Compliant

  N/A

• Cutting edge condition (more than 1" of cutting edge below base metal)

  Adequate

  Service

• Blade hoses

  Great Condition

  Good Condition

  Fair condition

  Needs Replaced

• Hydraulic Rams & Hoses

  Great Condition

  Good Condition

  Fair condition

  Needs Replaced

• Beacon

  Compliant

  Non-Compliant

  N/A

• Machine Greased

  Yes

  No

  N/A

Interior

• Inside Appearance

  Compliant

  Non-Compliant

• Headlights

  Working Order

  Out of Order

  Not Present

• Rear Lights

  Working Order

  Out of Order

  Not Present

• Back Up Alarm (audible at full-throttle)

  Working Order

  Out of Order

  Not Present

• Operator Seat

  Adequate

  Service

• Seat Belt

  Working

  Not Working

• Are guages, switches, electricial working as normal

  Yes

  No

• Fire Extinguisher.

  Compliant

  Non-Compliant

• Is the operators manual with the equipment

  Yes

  No

• Is the annual inspection current on this equipment

  Yes

  No

• Enter the hours

Exterior

• TIRES OR TRACKS CUTS / WEAR / ETC

  Compliant

  Non-Compliant

  N/A

• Assign an action to the appropriate personnel

• Check Engine oil level

  Compliant

  Non-Compliant

  N/A

• Make necessary adjustments to make this item compliant and if you cannot remedy then create an action item

• HOSES (Hydraulic, coolant)

  Good

  Fair

  Poor

• Fuel System

  No visible leaks

  Visible leaks

• Air filter

  Clean

  Dirty

• Check Antifreeze overflow tank level or check radiator when cold if not equipped with an overflow

  Compliant

  Non-Compliant

  N/A

• Belts

  Compliant

  Non-Compliant

  N/A

• Check Hydraulic oil

  Compliant

  Non-Compliant

  N/A

• Make necessary adjustments to make this item compliant and if you cannot remedy then create an action item

• Check Transmission oil

  Compliant

  Non-Compliant

  N/A

• Make necessary adjustments to make this item compliant and if you cannot remedy then create an action item

• Are the any visible leaks

  Yes

  No

• EXHAUST SYSTEM

  Compliant

  Non-Compliant

  N/A

• FRAME / SHEET METAL/BACK DOOR

  Select Good Fair Poor

  • Good
  • Fair
  • Poor

• GRAB HANDLES

  Compliant

  Non-Compliant

  N/A

• MACHINE STEPS / BUCKET STEPS / NONSKID TAPE

  Compliant

  Non-Compliant

  N/A

• LIGHTS / BEACON Present and free of damage

  Compliant

  Non-Compliant

  N/A

• CAB / ROPS / FOP

  Compliant

  Non-Compliant

  N/A

• AUXILIARY HYDRAULIC QUICK COUPLERS

  Compliant

  Non-Compliant

  N/A

• ATTACHMENTS

  Yes

  No

Inside Cab

• OPERATOR’S MANUAL

  Compliant

  Non-Compliant

  N/A

• Is the annual inspection current on this equipment

  Yes

  No

• FIRE EXTINGUISHER

  Compliant

  Non-Compliant

  N/A

• Take a picture of the inspection tag including the gauge

• SAFETY DECALS PRESENT

  Compliant

  Non-Compliant

  N/A

• Start Machine

  Compliant

  Non-Compliant

  N/A

• Is the glass free of cracks

  Compliant

  Non-Compliant

  N/A

• OPERATOR'S SEAT BELT

  Compliant

  Non-Compliant

  N/A

• EQUIPMENT HOURS

• GAUGES / SWITCHES / ELECTRICAL

  Working

  Not Working

• HORN

  Compliant

  Non-Compliant

  N/A

• LIGHTS/BEACON

  Compliant

  Non-Compliant

  N/A

• ANY DASH/DISPLAY WARNING LIGHTS OR CODE

  Compliant

  Non-Compliant

  N/A

• STEERING / BRAKES / LEVERS functioning normally

  Compliant

  Non-Compliant

  N/A

• BACKUP ALARM

  Compliant

  Non-Compliant

  N/A

• Loader is in acceptable working condition

  Yes

  No

Exterior

• 2 Wheel chocks present if required

  Yes

  No

  N/A

• Are Jack stands present and in working order

  Yes

  No

  N/A

• Safety chains present

  Yes

  No

  N/A

• Is the unit properly grounded? (Generator only)

  Yes

  No

  N/A

• All wiring and bulbs in acceptable condition (light plant)

  Yes

  No

  N/A

• Is bulb housing and stanchions in acceptable condition (light plant)

  Yes

  No

  N/A

Generator Details

• Is the Operator manual present and in legible condition?

  Yes

  No

• Fuel level

  Full

  3/4

  1/2

  1/4

  N/A

• Oil Level (adequate)

  Yes

  No

• DEF fluid level

  Full

  3/4

  1/2

  1/4

  N/A

• Is Coolant fluid level adequate (if no reservoir do not open radiator cap when engine is hot)

  Yes

  No

• Is the battery in good condition with no visible leaks or corrosion?

  Yes

  No

• Verify the voltage is set correctly for your application

  Compliant

  Non-Compliant

  N/A

• Enter the hours

• Is there any damage on the exterior of the vehicle? (New damage that has not been addressed previously)

  Yes

  No

• Please explain and submit a photo.

• Do tires appear to be in good condition?

  Yes

  No

  N/A

• Please notify the service truck personnel.

• Are tires properly inflated?

  Yes

  No

  N/A

• Add air as required

• Are there any glass chips or cracks? (New that has not been addressed previously)

  Yes

  No

  N/A

• Note any chips or cracks

  Media

• Inspect the hose and connections for any visible leaks or deteriorations

  Yes

  No

  N/A

• Verify that there are at least 50 spill pads on board and 1-50lb bag of oil dry

  Yes

  No

  N/A

• Fix the issue so that you can answer yes

• This is the picture for the Question below

  

• Are there stickers on the drivers and passengers sides of the tank that look like the picture above

  Yes

  No

  N/A

• This is the picture for the Question below

  

• Is there a placard on the front bumper that looks like the picture above

  Yes

  No

  N/A

• Is the engine coolant at an acceptable level (do not remove radiator cap while engine is hot)

  Safe

  At Risk

• Is engine oil at an acceptable level

  Safe

  At Risk

• Check the air filter for cleanliness

  Safe

  At Risk

• clean as necessary (create an action item if you can remedy to cause the question to be answered positively)

Interior

• Start the Truck

• Is an oil change required on this vehicle?

  Yes

  No

• Is there a current annual inspection from either DOT or Homrich

  Yes

  No

  N/A

• Take a picture of the Annual inspection

  Media

• Is the a fire extinguisher present with current inspection tags

  Yes

  No

  N/A

• Is the horn audible?

  Yes

  No

  N/A

• Is there at least one seat belt for each seat?

  Yes

  No

  N/A

• Are there any warning lights on the dashboard? (New that has not been addressed previously)

  Yes

  No

  N/A

• Are all gauges within the normal range?

  Yes

  No

  N/A

• Are all turn signals and brake lights operational? You will need a buddy to complete this check.

  Yes

  No

  N/A

• Is there an audible back-up alarm on this vehicle?

  Yes

  No

  N/A

• Enter the mileage

• Are there any other issues you would like addresses.

  Yes

  No

  N/A

• Check the Engine oil

  Compliant

  Non-Compliant

• How much did you add (add until you can answer compliant)

• Is the air filter clean

  Yes

  No

• clean so that you can answer yes

• Engine compartment cleanliness

  Compliant

  Non-Compliant

• clean so that you can make compliant or notify your supervisor

• Is the operators manual with the air ccompressor

  Yes

  No

• Are the tires properly inflated and in acceptable condition

  Yes

  No

• check the fuel level

  Full

  3/4

  1/2

  1/4

  N/A

• add fuel

• add fuel

• Check antifreeze level (visually in overflow tank if possible) (do not remove radiator cap if engine is hot)

  Compliant

  Non-Compliant

• Check compressor oil

  Adequate

  Added

  N/A

• How much was added

General Appearance

• Is there new damage since the last time YOU did an inspection

  Yes

  No

• Are all light free of visible damage

  Yes

  No

• Data plate intact and legible

  Yes

  No

• Fire extinguisher present with current inspection

  Yes

  No

• Take a picture of the tag

  Media

• Is the owners manual on the equipment

  Yes

  No

Chassis

• Mast/Boom Condition

  Acceptable

  Unacceptable

• Carriage rollers and guides

  Acceptable

  Unacceptable

• Load back rest

  Acceptable

  Unacceptable

• Forks

  Adequate

  Service

• Side shift

  Working

  Not Working

Engine

• Type of fuel

  LPG

  Diesel

  Electric

  Petrol

• Check the fuel level (you may need to do this after the machine is running)

  Yes

  No

• Fuel system free of visible leaks

  Yes

  No

• Are there any visible oil leaks

  Yes

  No

• Visually check the radiator and fluid level

  Acceptable

  Unacceptable

• Enter the hours

• Windshield, Glass & Screens

  Compliant

  Non-Compliant

  N/A

• Windshield Wipers

  Compliant

  Non-Compliant

  N/A

• Steps

  Compliant

  Non-Compliant

• Are grab bars present and in good condition

  Compliant

  Non-Compliant

• Engine Compartment Cleanliness

  Compliant

  Non-Compliant

• Check Engine oil

  Safe

  Added

• How much Engine oil did you add

• Is the air filter clean

  Yes

  No

  N/A

• take necessary steps so that you can answer yes

• Check Hydraulic fluid

  Safe

  Added

• How much Hydraulic fluid did you add

• Are tracks clean

  Yes

  No

• Clean tracks

• Track pads

  Yes

  No

• Track tension

  Yes

  No

• Drive sprocket and wheels

  Flat on top

  Pointy on top

• Blade

  Compliant

  Non-Compliant

• Cutting edge condition (more than 1" of cutting edge below base metal)

  Adequate

  Service

• Blade Hoses

  Great Condition

  Good Condition

  Fair condition

  Needs Replaced

• Hydraulic rams and hoses

  Great Condition

  Good Condition

  Fair condition

  Needs Replaced

• Machine Greased

  Yes

  No

  N/A

Interior

• Inside Appearance (housekeeping)

  Compliant

  Non-Compliant

• Is the owners manual with the machine

  Yes

  No

• Is there an current Annual Inspection for this machine

  Yes

  No

• Is the fire extinguisher present and have a current inspection

  Yes

  No

• Take a picture of the tag

  Media

• Seat condition and Seat belt

  Adequate

  Service

• Start Machine

• Travel alarm - Back-up alarm audible when machine is running at full power

  Yes

  No

• Headlights operational

  Working

  Not Working

• Enter the hours

• Are all gauges, switches, and electrical components functioning

  Yes

  No

• Walk around inspection - (Look around and under the vehicle for such items as loose bolts, trash build up, oil or coolant leaks, broken or worn parts)

  Safe

  At Risk

• Check fuel level - Fill when less than 1/4

  Compliant

  Non-Compliant

• Please add proper fuel

• Check engine oil - Check oil before starting engine or at least 5 minutes after engine has stopped. Never mix two different types of oil

  Safe

  At Risk

• Add oil to proper level

• Check brake fluid level - Never operate if brake fluid is below the “MIN” mark. If fluid is spilled on the power steering hose, quickly wash it off with water, brake fluid ruins rubber hoses

  Safe

  At Risk

  N/A

• Add brake fluid to proper level

• Check coolant level

  Safe

  At Risk

  N/A

• Add coolant to proper level

• Clean grill/radiator screen Remove all foreign materials

  Safe

  At Risk

  N/A

• Check brake and speed control pedal - Ensure free travel and smooth operation

  Safe

  At Risk

  N/A

• Check indicators, gauges and meter

  Safe

  At Risk

  N/A

• Enter Hours

• Check lights

  Safe

  At Risk

  N/A

• Check seat belts

  Safe

  At Risk

  N/A

• Check front and rear joint boots - Check boots for cuts, cracks or deterioration

  Safe

  At Risk

  N/A

• Check tire pressure

  Safe

  At Risk

  N/A

• Inflate tires to proper PSI

• Check backup alarm

  Safe

  At Risk

  N/A

• Check DANGER, WARNING CAUTION Labels

  Safe

  At Risk

  N/A

• Sign only:

  Sign

• TIRES OR TRACKS CUTS / WEAR / ETC

  Compliant

  Non-Compliant

  N/A

• Assign an action to the appropriate personnel

• Check Engine oil level

  Compliant

  Non-Compliant

  N/A

• Make necessary adjustments to make this item compliant and if you cannot remedy then create an action item

• HOSES (Hydraulic, coolant)

  Good

  Fair

  Poor

• Fuel System

  No visible leaks

  Visible leaks

• Air filter

  Clean

  Dirty

• Check Antifreeze overflow tank level or check radiator when cold if not equipped with an overflow

  Compliant

  Non-Compliant

  N/A

• Belts

  Compliant

  Non-Compliant

  N/A

• Check Hydraulic oil

  Compliant

  Non-Compliant

  N/A

• Make necessary adjustments to make this item compliant and if you cannot remedy then create an action item

• Check Transmission oil

  Compliant

  Non-Compliant

  N/A

• Make necessary adjustments to make this item compliant and if you cannot remedy then create an action item

• Are the any visible leaks

  Yes

  No

• EXHAUST SYSTEM

  Compliant

  Non-Compliant

  N/A

• FRAME / SHEET METAL/BACK DOOR

  Select Good Fair Poor

  • Good
  • Fair
  • Poor

• GRAB HANDLES

  Compliant

  Non-Compliant

  N/A

• MACHINE STEPS / BUCKET STEPS / NONSKID TAPE

  Compliant

  Non-Compliant

  N/A

• LIGHTS / BEACON Present and free of damage

  Compliant

  Non-Compliant

  N/A

• CAB / ROPS / FOP

  Compliant

  Non-Compliant

  N/A

• AUXILIARY HYDRAULIC QUICK COUPLERS

  Compliant

  Non-Compliant

  N/A

• ATTACHMENTS

  Yes

  No

Inside Cab

• OPERATOR’S MANUAL

  Compliant

  Non-Compliant

  N/A

• Is the annual inspection current on this equipment

  Yes

  No

• FIRE EXTINGUISHER

  Compliant

  Non-Compliant

  N/A

• Take a picture of the inspection tag including the gauge

• SAFETY DECALS PRESENT

  Compliant

  Non-Compliant

  N/A

• Start Machine

  Compliant

  Non-Compliant

  N/A

• Is the glass free of cracks

  Compliant

  Non-Compliant

  N/A

• OPERATOR'S SEAT BELT

  Compliant

  Non-Compliant

  N/A

• EQUIPMENT HOURS

• GAUGES / SWITCHES / ELECTRICAL

  Working

  Not Working

• HORN

  Compliant

  Non-Compliant

  N/A

• LIGHTS/BEACON

  Compliant

  Non-Compliant

  N/A

• ANY DASH/DISPLAY WARNING LIGHTS OR CODE

  Compliant

  Non-Compliant

  N/A

• STEERING / BRAKES / LEVERS functioning normally

  Compliant

  Non-Compliant

  N/A

• BACKUP ALARM

  Compliant

  Non-Compliant

  N/A

• Loader is in acceptable working condition

  Yes

  No

• Is the electrical cable in good condition? (No cuts or exposed wires)

  Yes

  No

• Is the generator properly grounded?

  Yes

  No

• Work with supervisor to obtain a proper ground before continuing use of Dust Boss

  Complete

• Is water source properly connected with no leaks?

  Yes

  No

• Do what is necessary to minimize leaks

  Complete

• Is Pump working properly?

  Yes

  No

• Is Oscillator working properly?

  Yes

  No

• Is Fan working properly?

  Yes

  No

• Are all spray nozzles clean and spraying

  Yes

  No

• Work with supervisor on how to clean the spray nozzles

  Complete

  Requires service

• Please remember to drain the water from the Dust Boss at end of day

  Acknowledged

• If you do not know how to complete, ask your supervisor.

  Acknowledged