Information

  • Client

  • Site

  • Conducted on

  • Prepared by

  • Location

MACHINE INFORMATION

  • Audit Title

  • Date

  • Date of last inspection

  • Make

  • Model

  • Machine Number

  • Machine Hours

  • Add media

  • MACHINE MUST BE INSPECTED EVERY 250 HOURS

ENGINE

  • Check all fan belts for wear and adjust

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check for oil, fuel and water leaks

  • Is the machine free from leaks?

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check for unusual noise

  • Is the machine operating without any unusual noises?

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check and service breathers

  • Are breathers in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check muffler and joints

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of guards and covers

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

DRIVES

  • Inspect belt tension and condition

  • Are the belts in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Inspect drive bearings for wear and lubrication on all belts

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of guards and covers

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

AIR CLEANERS

  • Check Air Intake System for cracks and leaks

  • Is the air intake system in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check Air Filter element

  • Is this in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

COOLING SYSTEM

  • Check water and conditioner

  • Are they in good condition and correct level ?

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check all hoses, components for leaks and condition

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check fluid level

  • Is the fluid level within safe levels

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of guards and covers

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

SLEW MOTORS

  • Check oil level

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

HYDRAULICS

  • Check oil level

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check all hydraulic hoses

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check system for leaks and damage

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check all support brackets

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check all linkages for wear

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of guards and covers

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

BOOM, STICK, BUCKET - ATTACHMENTS

  • Check for damage or wear to pins

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Inspect Boom, Stick, Bucket or Attachments for cracks, wear or damage.

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

Counterweight and Belly Guards

  • Check for damage, wear or missing parts

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

PLANETARY AND TRACKS

  • Check for leaks

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Inspect track adjustment, rollers for wear and leaks, track plates

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

ELECTRICAL SYSTEM

  • Check battery terminals and check cables

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check for damage or loose cables/ plugs

  • Check all gauges are operating

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of guards and covers

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

CONTROLS

  • Check all controls for return to neutral and leaks

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check all gauges and lights operational

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Condition of remote controls and batteries

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

Cabin Condition

  • Check cab condition

  • Is the cab in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of gauges and warning lights

  • Are they in good condition and showing any faults?

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of control levers and pedals

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of seat

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Inspect aircon system is working

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of UHF Radio

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

  • Check condition of Rotating light and Walking Alarm

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

SAFETY

  • Check operation of emergency stops

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check operation of isolation switches

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of guards and covers

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Check condition of safety warning decals

  • Are they in good condition

  • Faults/Comments

  • Repairs Required

  • Photo

  • Is it safe to operate

  • Corrective Action

  • Person Responsible?

  • Any further issues?

  • Photo

  • Is corrective action required immediately?

  • Person Responsible?

RECOMMENDATIONS ON RECTIFICATIONS

  • Recommendations on Rectifications

  • Recommendations
  • Recommendation

  • Is this a safety issue

  • Photo

  • MACHINE IS TO BE TAGGED OUT AND NOT USED UNTIL ISSUE HAS BEEN RECTIFIED

  • Person responsible

  • Due date

  • Issuance of sticker renewal date

  • This machine has been inspected as per site inspection criteria and all faults and corrective actions noted

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.