Title Page
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Site conducted
Section 1 - Inspection Performed by Qualified Personnel Only
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Project Number
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Location
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Conducted on
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Prepared by
Inbound Equipment Safety Inspection
Section 2 - Equipment
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Type of Equipment Inspecting
- Crane
- Forklift
- Detachable Forks
- Backhoe
- Track Hoe
- Tractor
- Loader
- Skid Steer
- Aerial Lift
- Drill Rig
- Dozer
- Loader
- Scissors Lift
- Welding Machine > 35 hp
- Generator > 35 hp
- Compressor > 35 hp
- Semi Truck
- Semi Trailer
- Pick Up Truck
- Water Truck
- Fuel Truck
- Other
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Manufacturer
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Model Number
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Serial Number
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OSHA Annual Date
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Last Maintenance Date
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Vendor Contact Name
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Vendor Company Name
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Vendor Contact Phone
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Vendor Contact Email
Section 3 - General Categories to Inspect
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Wheel Chocks
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Strobe Lights
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Buggy Whips
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Ignition and Master Keys Present
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Operators Manual Present and Load Chart
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Roll Over Protection Structure
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Tires / Tracks / Drive Chains
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Leaking Fluids Present
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Hydraulic Hoses in Good Condition
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Lights and Mirrors
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Structural Damage Present
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Computer Aids / Operator Controls
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Seat Belt Latches Properly
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Fire Extinguisher with Current Inspection
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Glass Condition
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Back Up Alarm / Bi-directional
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Kill Switch
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Horn
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Operator Controls
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Labels, Voltage & Hand Signal Chart, e.g.
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Wire Rope
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Outriggers
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Aux. Hook and Ball
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Main Hook and Block
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Boom / Mask / Cylinders
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Anti Two Block
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Wedge Socket Plus Cable Length (6 x Diameter)
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Brakes
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Emergency Flares and Triangles
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Fork Lift Assembly Bolts
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Record of Last Performed Maintenance
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C of C Not Having Counterfeit Material
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Periodic Inspection
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DOT Annual Inspection
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OSHA Annual Inspection (if required)
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Generator Circuit Breaker is Open (Off) Position
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Generator has no Electrical Primary Feed or Secondary Load Cables Connected
Section 4 - Fuel
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Fuel Type
Section 5 - Comments
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Additional Comments
Section 6 - Signature Acknowledgments
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Vendor Representative Signature
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PVB Representative Signature
