Information
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Client
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Site
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Conducted on
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Prepared by
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Location
MACHINE INFORMATION
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Date
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Date of last inspection
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Make
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Model
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Machine Number
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Machine Hours
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MACHINE MUST BE INSPECTED EVERY 250 HOURS
ENGINE
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Check all fan belts for wear and adjust
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check for oil, fuel and water leaks
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Is the machine free from leaks?
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check for unusual noise
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Is the machine operating without any unusual noises?
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check and service breathers
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Are breathers in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check muffler and joints
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
DRIVES
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Inspect belt tension and condition
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Are the belts in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Inspect drive bearings for wear and lubrication on all belts
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Inspect drive coupling for wear and damage
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
AIR CLEANERS
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Check Air Intake System for cracks and leaks
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Is the air intake system in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check Air Filter element
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Is this in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
COOLING SYSTEM
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Check water and conditioner
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Are they in good condition and correct level ?
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check all hoses, components for leaks and condition
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check fluid level
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Is the fluid level within safe levels
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
HYDRAULICS
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Check oil level
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check all hydraulic hoses
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check system for leaks and damage
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check all support brackets
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check all linkages for wear
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
PLANETARY AND TRACKS
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Check for leaks
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Inspect track adjustment, rollers for wear and leaks, track plates
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
ELECTRICAL SYSTEM
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Check battery terminals and check cables
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check for damage or loose cables/ plugs
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check all gauges are operating
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
CONTROLS
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Check all controls for return to neutral and leaks
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check all gauges and lights operational
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Condition of remote controls and batteries
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
VIBRATING GRIZZLY FEEDER/APRON FEEDER
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Check feeder wear material condition
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of skirting / trays
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of feeder drive and springs
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of head/tail drum bearings (apron feeder)
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
PRODUCT CONVEYOR (Main)
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Check belt condition
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Are they in good condition
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Faults/Comments
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Check condition of skirting rubbers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of rollers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of head/tail drum bearings
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Inspect conveyor condition and mounting brackets
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
PRODUCT CONVEYOR (Scalping/Dirt)
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Check belt condition
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of skirting rubbers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of rollers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of head/tail drum bearings
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Inspect conveyor condition and mount brackets
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
JAW
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Check wear liners including jaw plates, cheek plates and diverter plate (if fitted)
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check operation of jaw for unusual noise, bearing rumble or toggle knock
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Leaks from Jack Cylinders or wear
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Hydraulic leaks
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Broken Bolts / Fittings
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Screens secured/ Condition of feeder screens
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Capping Rubbers fitted / secured
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
SAFETY
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Check operation of E-Stops and Lanyards
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check operation of isolation switches
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of guards and covers
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Check condition of safety warning decals
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Are they in good condition
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Faults/Comments
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Repairs Required
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Photo
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Is it safe to operate
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Corrective Action
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Person Responsible?
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Any further issues?
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Photo
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Is corrective action required immediately?
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Person Responsible?
RECOMMENDATIONS ON RECTIFICATIONS
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Recommendations on Rectifications
Recommendations
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Recommendation
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Is this a safety issue
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Photo
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MACHINE IS TO BE TAGGED OUT AND NOT USED UNTIL ISSUE HAS BEEN RECTIFIED
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Person responsible
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Due date
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Issuance of sticker renewal date
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This machine has been inspected as per site inspection criteria and all faults and corrective actions noted