Mulcher Audit - November 2013

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Mulcher Information

• Photo of Mulcher

  Media

• Operator

• Owner

  GWR

  Contractor, include name

• Unit Number

• Make

• Model

• Hour meter

• Last Maintenance

• Next Scheduled Maintenance

Health Safety & Environment

• ERP

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• High Visibility Outerwear

  Yes

  No

  N/A

• Safety Boots

  Yes

  No

  N/A

• Ear Protection

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• First Aid Kit. if YES, what type?

  Yes

  No

  N/A

• Fire Extinguisher, if YES, what size?

  Yes

  No

  N/A

• Spill Kit

  Yes

  No

  N/A

• Tool Kit

  Yes

  No

  N/A

Items for visual inspection

• Outside Appearance

  Adequate

  Service

  N/A

• Windshield

  Safe

  At Risk

  N/A

• Windshield Wipers

  Working Order

  Out of Order

  Not Present

• Engine Compartment Cleanliness

  Safe

  At Risk

  N/A

• Engine Radiator Cleanliness

  Safe

  At Risk

  N/A

• Track Condition

  Safe

  At Risk

  N/A

• Track Tension

  Adequate

  Service

  N/A

• Drive Sprocket & Wheels

  Safe

  At Risk

  N/A

• Tree Rake and Rams

  Safe

  At Risk

  N/A

• Headlights

  Working Order

  Out of Order

  Not Present

• Rear Lights

  Working Order

  Out of Order

  Not Present

• Oil Levels (engine & hydraulic)

  Adequate

  Service

  N/A

• Winch

  Working Order

  Out of Order

  Not Present

• Winch Cable & Clamps

  Working Order

  Out of Order

  Not Present

• Hydraulic Hoses

  Safe

  At Risk

  N/A

• Hydraulic Rams

  Safe

  At Risk

  N/A

• Belly Pan Cleanliness

  Adequate

  Service

  N/A

• Cutting Teeth and Drum Condtion

  Adequate

  Service

  N/A

• Escape Hatch

  Safe

  At Risk

  N/A

• Seat Belt

  Safe

  At Risk

  N/A

• Radio and antenna

  Working Order

  Out of Order

  Not Present

• GPS and antenna

  Working Order

  Out of Order

  Not Present

• Back-up Alarms

  Working Order

  Out of Order

  Not Present

• Audit performed by

  Sign