Information

  • Name of report:

  • Document No.

  • Conducted on

  • Equipment #:

  • Prepared by:

  • Location (Drop Pin for GPS & Address):
  • MAKE & MODEL:

  • Hour Meter / Odometer:

  • General Equipment Condition: ( if unacceptable explain in comments section )

WALK AROUND VISUAL INSPECTION

  • Cleanliness

  • Please take photos of the front, rear, left and right side

  • Fluid Leaks

  • Broken Glass

  • Body or Structural Damage

  • Tires / Tracks - Inflated / Adjusted Properly

  • Fire Extinguisher Equipped and Charged

  • Mirrors

  • Mud Flaps

  • Wipers, Lights, Reflectors

  • Ladders / Steps and Grab Rails

  • Decals Installed and Legible

  • Loose Parts or Missing Covers

  • Belts and Hoses Servicable

  • Exhaust System

  • Hydraulic Lines and Cylinders

  • Batteries and Cables

  • Broken Welds

  • Regulatory Inspection Current

  • Lug Nuts / Rims

  • OTHER:

  • COMMENTS:

FLUID LEVELS

  • Engine Oil

  • Transmission Fluid

  • Hydraulic Fluid

  • Coolant

  • Fuel

  • Lubricants

  • COMMENTS:

CAB OPERATIONAL CHECK

  • Please take photos of the interior of the cab and any storage

  • Cleanliness

  • Seat and Seatbelts

  • Gauges and Instruments

  • Controls and Levers

  • Parking Brake

  • Service Brake

  • Limit of Safety Switches

  • Emergency Shutdown

  • Steering System

  • Heater and AC System

  • Horn, Warning Alarms / Devices

  • Clutches

  • Drives

  • Transmission

  • Engine

  • Hydraulic Mechanisms

  • Electrical Wiring

  • Charging System

  • Is equipment in safe operating condition?

  • Is the Operator's Manual in the equipment cab?

  • Are Spill Kits in place?

  • OTHER:

  • COMMENTS:

ATTACHMENTS

  • Cutting Edges / Teeth / Pins / Bushings etc.

  • Buckets / Blades

  • COMMENTS:

SIGNATURES

  • Operator's Signature:

  • Foreman 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.