Title Page

  • Client / Site

  • Conducted on

  • Location
  • Prepared by

  • Scan folder qr-code

Machine Specifications

  • Machine Make

  • Machine Model

  • Serial Number

  • Client Fleet Number

  • Registration

  • Overall Machine Photo

External

  • Attachments Fit for Purpose, e.g. bucket size, etc.

  • Compliant Quick Hitch with Positive Lock

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

  • Safe Access, i.e. 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 (typically applicable to cranes)

  • Mechanical Trailer Cover (typically applicable to trucks and trailers)

  • Self-supporting Safety Prop Permanently Attached (typically applicable to trucks, for tip decks and cabs)

  • Central Lubrication Station

  • Ground Accessible Refuelling Point

  • Slew &/or Movement Limiting Devices (typically applicable to cranes)

  • Harness Anchorage (typically applicable to mobile elevating work platforms)

  • 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 (Plate or Decal)

  • Electrical Hazard Plate (typically located at machine power plant)

  • Rated Capacity (kg or T) Decal (typically applicable to cranes)

  • Confined Space Decal (typically applicable if whole body access is through a single point only)

In Cab

  • Rear Vision Mirror(s)

  • Operator Visual Aids (e.g. CCTV, additional mirrors, etc.)

  • Horn

  • Reverse Alarm

  • Travel Alarm (supersedes reverse alarm)

  • 3" Seat Belt Fitted and in Good Condition

  • ROPS as required (negates need for TOPS)

  • Roll-Over Warning - Wear Seat Belt Decal

  • TOPS as required

  • FOPS / Operator Guard as required

  • Neutral Start

  • Quick Hitch Switch protected

  • Lifting Point Certification (typically applicable to excavators and loaders)

  • Tie Down Eye Certificate (if not factory fitted)

  • Machine Specific SWMS or Operators Instructions/Manual

  • NZ: Design Verification / Aus: Design Registration (applicable to cranes)

  • NZ: Certificate of Inspection / Aus: Item Registration (applicable to cranes)

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

  • Load Lifting Chart (applicable to cranes and excavators fitted with lifting points)

  • 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 Exit and Implement in Place

  • Rated Capacity Limiter (typically applicable to cranes)

  • Emergency Steering (in case of hydraulic, electrical, or other system failure)

  • Hazard/Proximity Detection System (not dependent on operator vision, e.g. radar)

  • Smart Alarm (supersedes reverse and travel alarms)

  • Interlocked Seat Belt

  • Hydrostatic Drive: designed fail-to-safe

  • Left Hand Drive Decal

  • Dual Control Decal

  • Overhead Power Line Clearance Decals

  • Hydraulic Steering Warning Decal

  • GVM and Tare Decal (typically applicable to road-going vehicles)

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.