Title Page

  • Job Site conducted on

  • Conducted on

  • Prepared by

  • Forman

  • Location
  • Unit Number

  • Serial Number

  • Model Number

  • Machine Performance

General

  • Engine Oil

  • Fuel level

  • Coolant Level

  • Engine Compartment Hoses

  • Air Filter

  • Tires Inflation / lug nuts

  • Electrical 'Connection

  • Lights

  • Brakes

  • turn signals

  • Hazard Flashers

  • Hitch Tonge

  • Pin

  • Chains (cross on hookup)

  • Wheel Chalks x 2

  • Jack Leg Operational

  • Ground Fault Interface in good condition (GFCI)

Signature

  • Signature of Inspector

  • Name of person checking out

  • Additional Notes:

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.