IME - Mobile Equipment Inspection

• Mobile Equipment Inspection

• Describe Equipment Being Inspected:

• Conducted on

  Date

• Site / Job Number

• Prepared by

• Location
  Address

• Equipment Number If Provided

• Take Photos of any damage or physical condition

  Media

• Milage or hours

• Description of Equipment or Vehicle

• Unit Number or Plate Number

• Driver / or Operator Name:

• Signature:

  Sign

• Headlights working?

• Tail Lights / or Back up Alarm (spotter if rear is obscured)

• Tires including spare

• Windshield and wipers good?

• Heater and Defroster working?

• Seatbelt

• Exterior (list damage below)

• Note any exterior damage:

• Take Pictures and Upload them here

  Media

• Cleanliness good.

• Note any issues or maintenance items:

UNDER THE HOOD

• Transmission Fluid

  Good

  Bad

• Describe problem.

• Radiator / Anti-freeze

  Good

  Bad

• Describe problem.

• Oil Level

  Good

  Bad

• Describe problem.

• Power Steering / Brake Fluids

  Good

  Bad

• Describe problem.

• Window Washer Fluid

  Good

  Bad

• Describe problem.

EQUIPMENT

• Fully Charge

• Fall Protection in place or provided

• Controls Operational

• Comments or Notes:

• Is operator authorized to operate:

• Fire protection - available and checked

• Does this vehicle have AED- checked

• Other items- List:

• Name:

• Signature

  Sign