Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Plant Infotmation
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This form to be used by Fletcher personnel on initial plant / equipment delivery to site. Plant / Equipment must not be used until defects are fully rectified, the Plant / Equipment has been re-inspected and defects signed off as rectified. If conditional use is noted then the Supervisor / Foreman is responsible to ensure compliance as soon as is practicable. The term plant includes such items as powered mobile plant including road and off road trucks, boom or scissor lifts, concrete pumps etc
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Plant Description
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Plant Owner
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Model No
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Plant Operator
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Serial No
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Next Service Due
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Date Last Serviced
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Hours/KM
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Rego and Expiry Date
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COF/WOF Expiry
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Plant Photos
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DO NOT include items that are manually powered or designed primarily for hand held support
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Maintenance / service records available
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Operation manual available
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Foot brake and park brake operational
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Steering operational
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Travel and reverse alarms operating (mandatory)
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Flashing amber beacon operational (mandatory)
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Lights and indicators operational (mandatory)
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Warning signs fitted and visible
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Moving parts guarded (mandatory)
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Operator seating and controls
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Seat belt fitted and in good condition (mandatory)
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Windows, mirrors not cracked or broken
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Windscreen wipers functioning properly
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Lifting points marked with a SWL (mandatory)
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Safety bars / props fitted
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Fire protection installed and date compliant
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Air conditioner working
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General bodywork
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Roll Over Protective Structure (ROPS) (mandatory)
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Fall protection when accessing the machinery platform
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Step-hand grips in place, no damage
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No visible oil leaks at hydraulic hoses and connections
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Quick hitches to be positive lock design and in good repair
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Tyres in satisfactory serviceable condition
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Burst protection valves installed on lift rams (mandatory)
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Plant to be cleaned and free of sand, seeds, materials prior to departure and acceptance on site
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Spare tyre and jack installed
Sign Off
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Initial inspection By
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Defects rectified, plant re-inspected and authorised for use by