General Equipment Maintenance Planner

• Document No.

• Audit Title

• Basin

• Vin Number

• Hour meter

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Exterior

• Walk around equipment

  Safe

  At Risk

  N/A

• Lights

  Safe

  At Risk

  N/A

• Hand Rails

  Safe

  At Risk

  N/A

• Tires / Tracks

  Good

  Needs Improvement

  Bad

• Bald tires

• Deflated

• Damaged tires

• Exhaust

  Working Good

  Failure

• Lifting Mechanism

  Safe

  At Risk

  N/A

• Hoses

  Safe

  At Risk

  N/A

• Walk around equipment

  Safe

  At Risk

  N/A

Engine compartment

• Battery cables

  Yes

  No

  N/A

• Hoses

  Safe

  At Risk

  N/A

• Guards

  Yes

  No

  N/A

Interior

• Breaks, service

  Safe

  At Risk

  N/A

• Breaks, Parking

  Yes

  No

  N/A

• Back up Alarm

  Yes

  No

  N/A

• Fire extinguisher

  Yes

  No

  N/A

• Gauges

  Yes

  No

  N/A

• Horn

  Yes

  No

  N/A

• Windshield

  Yes

  No

  N/A

• Mirror

  Yes

  No

  N/A

• Seat belt / Seat

  Yes

  No

  N/A

Fluids

• Visible leaks

  Yes

  No

  N/A

• Coolant Level

  Good

  Less than good

  Bad

• Hydraulic oil level

  Good

  Less than good

  Bad

• Transmission fluid level

  Good

  Less than good

  Bad

• Oil level

  Good

  Less than good

  Bad

• Fuel level

• Additional Comments/Observations

comments/observations

• I hereby certify that all the information is accurate and that an actual inspection was conducted

• Auditor's Printed name and signature

  Sign