Title Page
-
Inspection Date:
-
Inspector:
-
Manufacturer:
-
Type:
-
Serial/Asset Number:
-
Capacity:
-
Location
Inspect each item. Identify any components with deficiencies. Detail deficiencies and corrective actions at the bottom of this form.
Chassis Components
-
Mast
-
Deficiencies:
-
Condition of Forks
-
Deficiencies:
-
Hydraulic Cylinders
-
Hydraulic Hoses
-
Deficiencies:
-
Roll Cage/Carriage
-
Deficiencies:
-
Lights
-
Deficiencies:
-
Steering Mechanism
-
Deficiencies:
-
Control Levers
-
Deficiencies:
-
Lift Capacity Plate/Date Face Plate
-
Deficiencies:
-
Fire Extinguisher
-
Deficiencies:
-
Control Panel Gauges
-
Deficiencies:
-
Backup Alarm
-
Deficiencies:
-
Horn
-
Deficiencies:
-
Chains
-
Deficiencies:
-
Brakes
-
Deficiencies:
-
Parking Brake
-
Deficiencies:
-
Seat Belt
-
Deficiencies:
-
Engine Cover Latches
-
Tires/Wheels/Lugs
-
Lock Out for Damages
Engine Components
-
Radiator (Cold)
-
Deficiencies:
-
Fan Belts
-
Deficiencies:
-
Exhaust System
-
Deficiencies:
-
Battery Terminals
-
Deficiencies:
-
Hydraulic Fluid Levels
-
Deficiencies:
-
Fuel Level
-
Deficiencies:
-
Oil Level
-
Deficiencies:
-
Oil/Hydraulic Leaks
-
Deficiencies:
Other
-
Things noticed that are not listed on the checklist.
Inspector's Signature
-
Signature:
