FML Plumbing and Civil Equipment/Plant Pre-start Checklist

• Document No.

• Task

• Job No./ Site Address

• Conducted on

  Date

• Prepared by

Pre-operational checklist & logbook Case Excavator

• Operator name

  insert

• Machine hours

  insert

• Make & model check<br>CASE CX145C Serial# 100340

  Yes

  No

  N/A

• Yes

  No

  N/A

Fluids

• Engine oil ok?

  Yes

  No

  N/A

• Engine oil ok

  Yes

  No

  N/A

• Transmission oil ok

  Yes

  No

  N/A

• Coolant level ok

  Yes

  No

  N/A

• Fuel level ok

  Yes

  No

  N/A

• Any visually seen leaks or signs of cracking/rust

  Yes

  No

  N/A

External inspection

• Fire extinguisher present & full

  Yes

  No

  N/A

• All lights & reflectors are in good working order

  Yes

  No

  N/A

• Amber beacon available

  Yes

  No

  N/A

• OPG ( operator protective guard ) present, sturdily attached and free of damage

  Yes

  No

  N/A

• All hydraulic hoses are connected properly & free from leaks & damage ( never use your hand for leaks, always use wood or cardboard )

  Yes

  No

  N/A

• All tracks & track components are in safe working condition

  Yes

  No

  N/A

• Bucket changing pin, check if pin is free from cracking or damage & also surclip is in good working order

  Yes

  No

  N/A

• Check all structural components are in safe working condition

  Yes

  No

  N/A

Operator work area

• Operator floor non slip & free from damage

  Yes

  No

  N/A

• All operator access non-slip, sturdily attached & free from damage with three points of contact

  Yes

  No

  N/A

• Seat, attached & free from damage

  Yes

  No

  N/A

• Seat belt present, sturdily attached & free from damage

  Yes

  No

  N/A

• Two exits available<br>

  Yes

  No

  N/A

• All controls are fully functional & clearly & legibly labelled as to purpose & method of operation

  Yes

  No

  N/A

• Operator warning device functional ( horn )

  Yes

  No

  N/A

• Movement awareness alarm present & fully functional

  Yes

  No

  N/A

• Any site obstacles present (eg: power lines, temporary fencing )

  Yes

  No

  N/A

• Load chart present & legible

  Yes

  No

  N/A

Machine function & information

• Machine functions as per manufacturers operating instruction & all manufacturers operational & safety information is available

  Yes

  No

  N/A

Witness if workers are on site whilst machine is in operation

Worker

• I the undersigned have been consulted in relation to the pre-operational checklist & logbook and have been advised of all safety awareness whilst machine is in use

• Sign off

  Sign

Sign Off

• Have you eliminated all potential risks from any other hazards identified on site that may affect your work tasks?

  Yes

  No

  N/A

• Contact Shaun White prior to proceeding

• Signature of person completing this assessment

  Sign