Title Page

  • Client / Site

  • Conducted on

  • Location
  • Prepared by

  • Scan folder qr-code

Machine Specifications

  • Machine Make

  • Machine Model

  • Serial Number

  • Fleet Number

  • Registration

  • Overall Machine Photo

External

  • Buckets/Attachments Fit for Purpose and in Serviceable Condition

  • Compliant Quick Hitch with Positive Lock

  • Anti-Drop Valves Present (or warnings present, if not certified for lifting)

  • Steps, Guardrails, and Handrails Fitted

  • Amber Beacon

  • Brake Lights & Turn Signals

  • Headlights, Tail Lights, & Clearance Lights

  • Rear Reflectors

  • Rear & Side Reflective Tape

  • Battery Isolation Switch - Key Lockable

  • Emergency Stops

  • Load Indicator Visible to Exterior

  • Mechanical Trailer Cover

  • Self-supporting Safety Prop Permanently Attached

  • Central Lubrication Station

  • Ground Accessible Refuelling Point

  • Slew &/or Movement Limiting Devices

  • Harness Anchorage

  • Guarding (lockable door and/or limit switch and/or guarding over parts)

  • Wheel Chocks (for rubber tyred equipment)

  • 3 Points of Contact Decal

  • Fire Extinguisher Decal

  • First Aid Kit Decal

  • Hearing Protection Decal

  • Articulation Joint Crush Hazard Decal

  • Working Load Limit Clearly Visible (Decal)

  • Electrical Hazard Plate

  • Rated Capacity (kg or T) Decal

  • Confined Space Decal

In Cab

  • Rear Vision Mirror(s)

  • Operator Visual Aids (CCTV)

  • Horn

  • Reverse Alarm

  • Travel Alarm (Auto activating)

  • 3" Seat Belt Fitted and in Good Condition

  • ROPS as required

  • TOPS as required

  • FOPS / Operator Guard as required

  • Neutral Start

  • Quick Hitch switch protected

  • Lifting Eye Certification

  • Tie Down Eye Certificate

  • Machine Specific SWMS or Operators Instructions

  • NZ: Design Verification / Aus: Design Registration

  • NZ: Certificate of Inspection / Aus: Item Registration

  • Maintenance and Service History/Records, as per OEM & Applicable Standards

  • Load Lifting Chart

  • Quick Hitch Operating Instructions

  • Log Book

  • Plant Specific and OEM derived Pre-start Criteria

  • NZ: Registration/COF / Aus: Conditional Registration

  • UHF Radio

  • Fire Extinguisher Fitted and Charged

  • Fire Suppression System (Built in)

  • First Aid Kit Fitted

  • Plant Specific Risk Assessment Required

  • Emergency Glass Hammer in Place

  • Rated Capacity Limiter

  • Emergency Steering

  • Hazard/Proximity Detection System

  • Smart Alarm

  • Interlocked Seat Belt

  • Hydrostatic Drive: designed fail-to-safe

  • Left Hand Drive Decal

  • Dual Control Decal

  • Overhead Power Line Clearance Decals

  • Roll-Over Hazard - Wear Seat Belt Decal

  • Hydraulic Steering Warning Decal

  • GVM and Tare Decal

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.