Information

  • Machine Type

  • Location
  • Machine Operator Name

Checklist

In cab

  • First Aid Kit available & Fire Extinguisher in service?

  • Fuel, oil and water - Are levels sufficiently topped up?

  • Mirrors & Windscreen

  • Horn

  • Washers & Wipers

  • Steering

  • Brakes

Machine - Provide Photos & Notes for any New Damage

  • Fuel / Oil - Select 'No' for any visible leaks/faults

  • Correct Bucket/attachment for job?

  • Wheel nuts & tyres

  • Radiator Level, Grease points lubricated ok?

  • Body - Select 'No' if any other damage to vehicle?

Other

  • For any additional comments please select 'At Risk' - Eg. Info you would like to share with Dispatch or Workshop

  • Consult your dispatch or your manager before use if you think the fault is safety critical.

Signature of operator checking machine

  • Add signature

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.