Information
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Document No.
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Plant Number.
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Contract and Plant Number
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Conducted on
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Assessor
- Rob Hurley
- Ben Hughes
- Scott Doherty
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Location
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Hours of machine
Check Items
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Is there panel damage (dents, scratches)?
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Is there damage to glass or mirrors?
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Is there damage to lights or safety beacon?
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Are Guards damaged or out of place?
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Have all buckets been returned and are they in good order (including teeth)
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Are all hydraulic hoses OK?
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Is the safety pin with the machine?
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Are tyres/ tracks/ rollers OK?
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Have grease gun and/ or tools been returned with machine?
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Is radios & UHF in machine?
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Are aerials OK?
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Is operators manual with machine?<br>
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Has plant book been returned with machine?
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Has fire extinguisher been returned with machine?
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Is machine clean?
Damages if any
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Customer name
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Brief description of issues if any
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Action Required
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Authorized Sign Off: