Title Page
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Job Site conducted on
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Conducted on
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Prepared by
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Forman
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Location
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Unit Number
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Serial Number
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Model Number
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Machine Performance
General
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Engine Oil
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Fuel level
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Coolant Level
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Engine Compartment Hoses
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Air Filter
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Tires Inflation / lug nuts
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Electrical 'Connection
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Lights
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Brakes
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turn signals
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Hazard Flashers
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Hitch Tonge
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Pin
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Chains (cross on hookup)
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Wheel Chalks x 2
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Jack Leg Operational
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Ground Fault Interface in good condition (GFCI)
Signature
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Signature of Inspector
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Name of person checking out
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Additional Notes: