Equipment Inspection Report PRE/POST Application

• This Report Must be filled out Before, Post Application Use.

• Name (person completing inspection)

• Client / MATP Number

• Date and Time

  Date
• Location
  Address

Equipment Inspection

• Equipment Inspection

• Make & Model:

• Hour Meter / Odometer:

• General Equipment Condition: ( if unacceptable explain in comments section )

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

Electronics

• Cleanliness

  Good

  Fair

  Poor

  N/A

• Plug

  Operable

  Needs repair

  N/A

• Gauges and Instruments

  Operable

  Needs repair

  N/A

• Controls and Levers

  Operable

  Needs repair

  N/A

• Emergency Shutdown

  Operable

  Needs repair

  N/A

• Warning Alarms/ Lights

  Operable

  Needs repair

  N/A

• Electrical Box and wiring

  Operable

  Needs repair

  N/A

• Solenoids

  Operable

  Needs repair

  N/A

• Electric Motors

  Operable

  Needs repair

  N/A

• COMMENTS:

Machine

FLUID LEVELS

WALK AROUND VISUAL INSPECTION

• Cleanliness

  Clean

  Needs cleaning

• Fluid Leaks - Check all hoses, clamps, Pipe fittings and valve handles

  No leaks

  Leaking

  Broken handle

• Body or Structural Damage

  Operable

  Needs repair

  N/A

• Tanks - Clean and inspect for damage - filters also

  Operable

  Needs repair

  N/A

• Fire Extinguisher Equipped and Charged

  Operable

  Needs repair

  N/A

• Slurry Flaps

  Operable

  Needs repair

  N/A

• Ladders / Steps and Grab Rails

  Operable

  Needs repair

  N/A

• Decals Installed and Legible

  Yes

  No

  N/A

• Loose Parts or Missing Covers - if applicable include in comments<br>

  OK

  Service/Repair

  Unacceptable

  N/A

• Hydraulic Lines and Cylinders

  Operable

  Needs repair

  N/A

• Plate Condition

  Operable

  Needs repair

  N/A

• COMMENTS:

• Hydraulic Fluid

  Full

  Needs Fluid

  N/A

• Lubricants - Grease points

  OK

  Service/Repair

  Unacceptable

  N/A

• COMMENTS:

• Add pictures of any deficencies.

  Media

• COMMENTS:

SIGNATURES

• Of Person/s who completed the Inspection

  Sign

SIGNATURES

• Sales/Project Manager Signature:

  Sign