Title Page

  • Prepared by

  • Conducted on

  • Client / Site

  • Location

Equipment

  • Equipment Inspected

  • Fluid Levels

  • Hoses/Belts

  • Operator's Manual

  • Pot Hole Protection

  • Batteries

  • Outriggers/Stabilizers

  • Wheels/Tires/Tracks

  • Pins and Bushings

  • ROPS

  • Seat-belt and Safety Devices

  • Horn and Alarms

  • Gauges and Controls

  • Boom/Scissor

  • Hook/Block/Ball

  • Boom and Cylinders

  • Deck/Basket/Carriage

  • Guardrails

  • Bucket/Blade

  • Hoist Cable

  • Forks/Attachments

  • Other

Site Inspection

  • Slippery Surfaces

  • Material Obstructions

  • Pedestrians

  • Water/Spills

  • Overhead Obstructions

  • Ruts/Holes

  • Trucks/Equipment

  • "Do Not Enter" Zones

  • Rain

  • Strong Wind

  • Lightning

  • Narrow Passageways

  • Powerlines

  • Confined Spaces

  • Hazardous Atmoshphere

  • Slopes/Ramps/Hills

  • Obstructed Vision

  • Hazardous Material

  • Public Roads/Traffic

  • Trenches

  • Other

Sign Off

  • Select date

  • Completed By

  • Signature

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.