Title Page

  • Contractor / Company

  • Location
  • Inspection Type

  • Equipment Description

  • Make and Model

  • Registration / Asset number

  • Hour Meter / Odometer reading

  • Conducted on

  • Inspection Completed By

  • Personnel

  • Proposed transfer site

Safety

  • All Compliance Certificates in Cab. Eg: Auto Fire Suppression, BMA Compliance, Brake Test, etc

  • Lockable Battery Isolation point ( Red )

  • Lockable Starter Motor Isolation Point (Yellow).

  • Auto Fire Suppression. Tag Date:-

  • 1 - Hand held Fire Extinguisher. Tag Date and size:-

  • Add Photo

  • 2 - Hand held Fire Extinguisher. Tag Date and size:-

  • Add photo

  • 3 - Hand held Fire Extinguisher. Tag Date and size:-

  • Accident damage?

  • ROPS & FOPS fitted. Cert. Tag: <br>ROPS Serial #:

  • Steps, Ladders, Handrails and Platforms.

  • Guards, Mudflaps, Covers and Latches.

  • Seat Belts: Test operation and check for fraying,<br>Record Seat Belt date: Note - Must be less than 3 years old

  • Seat Safety Strap is in placed and connected

  • Harness Anchor attachment points.

  • Mounted Wheel Chocks and Bracket

  • Test operation of Emergency Shut Downs

  • VHF Two Way Radio and Aerial, Programmed to site, Model and serial no# :

  • UHF Two Way Radio and Aerial, Programmed to site, Model and serial no# :

  • Travel and Max Height , Record heights

  • Effective Guarding: All Belts, Pulleys, Fans, Shafts etc

  • Safety Decals fitted to appropriate places

  • DG3 Reflective Striping (50mm – 75mm)

CAB and OPERATION STATION

  • OEM Operation Manual in cab

  • General condition of inside of Cab.

  • General condition of outside of Cab.

  • Cab Mountings, Bolts and Structure

  • Doors, Panels, Mirrors and Brackets

  • Door Handles, Locks

  • Condition of door seals

  • Condition of Dash Panel and Console

  • Windows, Winders and Rubbers

  • Windscreen Wipers and Washers

  • Floor, Walls, Roof and Linings

  • Heater: Core, Controls and operation

  • Operation of all Controls

  • Decals on Switches and Controls

  • Adequate Access and Egress

  • Seats and Arm Rest(s)

  • Machine seat inspection completed if this is a Onhire

  • First Aid Kit / Decal on Door

  • Is breathsafe installed and operational

ELECTRICAL

  • Batteries, Terminals and Hold Down Clamps

  • General condition of Wiring Harnesses and Clamps

  • Alternator charging circuit

  • Starter Motor(s)

  • Dash/Console gauges, switches and labels

  • Door open / Park Brake off Alarm

  • Reverse Alarm and lights

  • Reverse Camera

  • Interior light, Warning light and Alarm

  • High mounted combination rear lights

  • Work lights: - Rear, Sides, Front

  • Tail lights, Stop lights and Headlights

  • Headlights on with Ignition, and appropriate Decal

  • Indicator / Hazard lights

  • Tray-Up Alarm is illuminating and Audible

  • Revolving Beacon(s), permanent mount

  • Colour of light

  • Workshop and Pit-Horn operation

  • Jump-Start Receptacle, with Voltage Decal

  • High Voltage System, and Decals

  • Cable and Reel condition / operation

  • Electrical Cabinet

  • Electric Motors

  • AM / FM Radio and Aerial

COOLING SYSTEM

  • Coolant leaks

  • Radiator Core, Tanks and Cap

  • Lever-Action Pressure release Radiator Cap(s)

  • Coolant level

  • Conditioner

  • Coolant Pipes, Hoses and clamps

  • Heater Taps and Hoses

  • Fan and Shrouds

  • Fan Bearings, Pulleys and Belts

  • Water Pump, Thermostats and Coolers

  • Sensors and wiring

  • Monitoring system, condition. Type:

AIR CONDITIONING SYSTEM

  • Air Con Compressor, Pulley

  • Air Con Condenser, Hoses and Valves

  • Air Con controls and operation

  • Operation of Fan speeds

  • Operation of Air Conditioning System

ENGINE

  • Wiggins Fast-Fill point

  • Oil level. Check for Engine oil leaks

  • Intake and Exhaust Manifolds studs/nuts

  • Pre-Cleaner, Air Cleaner, Induction Pipes and Clamps

  • Exhaust Rings, Pipes and clamps

  • Muffler, Extension and clamps

  • Turbo lagging / heat shield fitted correctly and in good condition

  • Turbo Chargers and Oil lines

  • Fuel Screen, Filters, Lines

  • Fuel Pump / Injection Pump

  • Injection Pipes and clamps

  • Throttle Linkages, Pins/Bushes

  • Sensors and Wiring

  • Blow-By, Exhaust Smoke, Noises

  • Record any other Defects found:

TORQUE CONVERTER and TRANSMISSION

  • Oil levels

  • Oil leaks: Pipes, Hoses, Seals

  • Transmission Oil Pump

  • Transmission Oil Cooler

  • Mountings, Flanges and Bolts

  • Check Gear selection and for any Slippage

  • Linkages and operation

  • Gauges

  • Drive Motors and their Brakes

  • Electronic Control and wiring

TRANSFER BOX / PUMP DRIVE / PTO

  • Oil level(s)

  • Oil Leaks. Seals

  • PTO Shaft and Universal Joints

  • Mountings

  • Sensors and wiring

HYDRAULICS

  • Oil level

  • Oil Filters and Breathers

  • Check for Oil leaks

  • Condition of Hoses / Pipes / Seals or damage

  • Mountings, Flanges, clamps etc

  • Hydraulic Tank / Quick-Fill connector

  • Hydraulic Pump(s)

  • Hydraulic Oil Cooler(s)<br>

  • Hydraulic Control Valve

  • Main Valve Body adjustment. Check for leaks

  • Hand Controls and linkages

ARTICULATION HITCH

  • Pins and Bushes: Upper

  • Pins and Bushes: Lower

  • Grease Lines

  • Articulation Cylinders, Bushes and Pins

  • Articulation Lock, Pins and Keepers

  • Articulation “Warning” Decal

  • Shim Bearing if required

FRONT AXLE ASSEMBLY

  • Diff oil level. Oil Leaks

  • Final Drive Oil levels. Oil leaks

  • Front Wheel Bearings: Oil levels / Oil leaks

  • Breathers for blockage or leaks

  • Spindle assemblies

  • Oscillating Bearings and Seals

  • Mountings and bolts

  • Sensors and wiring

REAR AXLE ASSEMBLY

  • Diff Oil level(s). Oil leaks

  • Final Drive Oil levels. Oil leaks

  • Breathers for blockages or leaks

  • Trunnion(s), Oscillating Bearings and Seals

  • “A” Frame Ball Joint

  • RAX links/ Dog-Bone Bearings and Pins

  • Mountings and Bolts

  • Sensors and Wiring

BRAKES

  • Operation: Test Drive

  • Park Brake

  • Emergency Brake

  • Service Brake

  • Transmission Neutraliser Brake Valve and Switch

  • Retarder

  • Warning Devices: Light, Buzzer

  • Monitoring system: Gauges etc

  • Accumulators: Gauges etc

  • Air Compressor and Governor

  • Air Tank, Relief Valve

  • Drain Valves and “Drain Daily” Decals

  • Air / Oil leaks

  • Hoses, Pipes and clamps

  • Brake Chambers / Master Cylinder

  • Front Brakes: Discs, Calipers, Pads

  • Rear Brakes: Discs, Calipers, Pads or Shoes

  • Park Brake Assembly

STEERING

  • Operation: Test Drive

  • Emergency Steering system: Test

  • Switches, Warning Light, Decals

  • Oil level (Steering Tank)

  • Steering Pump, Reservoir and Vee Belt

  • Steering Box / HMU / Control Valve

  • Steering Wheel. Tilt mechanism. Column

  • Pipes, Hoses and clamps

  • Oil leaks

  • Steering Cylinders and condition of Rods

  • Tie Rod Ends / Ball Joints

  • Bell Crank, Pins and Bushes

SUSPENSION

  • Pos 1 Strut / Spring / Shock absorber/ Pins and Bushes

  • Pos 2 Strut / Spring / Shock absorber/ Pins and Bushes

  • Pos 3 Strut / Spring / Shock absorber/ Pins and Bushes

  • Pos 4 Strut / Spring / Shock absorber/ Pins and Bushes

  • Pos 5 Strut / Spring / Shock absorber/ Pins and Bushes

  • Pos 6 Strut / Spring / Shock absorber/ Pins and Bushes

FRAME / CHASSIS

  • General condition of Chassis

  • Cracks / Rust / damage

  • Bumper Bar / Pads / Bull Bar

  • Tow Hitch / Tow Bar / Pin / All tow points painted red

  • Belly Plates

  • Fuel Tank, Pipes and hoses

  • Fuel leaks

  • Quick-Fill fitted, Dust Cap, Breather and Hose

  • Wiggins Fast-Fill connections

DRIVELINES

  • Movement in Drivelines

  • Driveline alignment, wear in Splines

  • Centre Carrier Bearing

  • Condition of Universal joints

  • Oil leaks from any Input / Output Shaft Seals

WHEELS / RIMS and TYRES

  • Position 1 Tyre and Rim Serial numbers , Tyre Pressure and tread depths

  • Tyre Serial number

  • Rim Serial number

  • Tread Depth inside and outside

  • Position 2 Tyre and Rim Serial numbers , Tyre Pressure and tread depths

  • Tyre Serial number

  • Rim Serial number

  • Tread Depth inside and outside

  • Position 3 Tyre and Rim Serial numbers , Tyre Pressure and tread depths

  • Tyre Serial number

  • Rim Serial number

  • Tread Depth

  • Position 4 Tyre and Rim Serial numbers , Tyre Pressure and tread depths

  • Tyre Serial number

  • Rim Serial number

  • Tread Depth inside and outside

  • Position 5 Tyre and Rim Serial numbers , Tyre Pressure and tread depths

  • Tyre Serial number

  • Rim Serial number

  • Tread Depth inside and outside

  • Position 6 Tyre and Rim Serial numbers , Tyre Pressure and tread depths

  • Tyre Serial number

  • Rim Serial number

  • Tread Depth inside and outside

WHEELS and RIMS GENERAL

  • Is there a Re-torque required (Re-torque Tag fitted in cab)

  • Valve extensions secured correctly

  • Valve Stem Diffuses fitted to all positions

  • Are adapter Plates fitted to Pos 3 and 6 (mount rim to final)

  • Adapter plate secured by capped type studs

  • Adaptor plate secured by screw in studs

  • !! NOTE !! If you answer NO to any of the following questions, you MUST tag out of service and report to your Supervisor

  • Are adaptor plate studs uniform in depth

  • Are all adaptor plate studs present

  • Are Capped head studs flush with the adaptor plate

  • No visual gap between the adaptor plate and the rim

BODY / TRAY / BOWL

  • General condition

  • Lift Cylinders, Bearings, Oil leaks

  • Pipes, Hoses and clamps

  • Floor: Liner Plates

  • Sides: Liner Plates / Hungry Boards

  • Front End: Liner Plate

  • Headboard

  • Cracks, dents or damage

  • Body stop rubbers and adjustment

  • Hoist control mechanism and Kick-Outs

  • Rock Deflectors

  • Rock ejectors

  • Rock ejectors mounts and stops fitted

BUCKET CONTROL ARMS / STICK

  • Bucket control Arms / Pins and Bushes

  • Bucket / Stick / Arm / Pins and Bushes

  • Z Linkage assembly / Bell-Crank

  • Pins and Bushes

  • Bucket Cylinders / Pins and Bushes

  • Bucket linkage

  • Grease Injectors, Lines, Hoses, fasteners

  • Hoses, Pipes, brackets and fasteners

  • Damage / Cracks / Broken Welds

  • Kick Out operation

BUCKET / BLADE ASSEMBLY

  • GET condition, Wear Plates, Bars and Type:

  • Measure GET for remaining usable height

  • Front edge condition / Corner Tips

  • Floor for wear and straightness

  • Rock guards

  • Mouldboard / wear / U Wear Plates

  • Lift Cylinders / Trunnions / Pins and Bushes

  • Tilt Cylinders / Pins and Bushes

  • Side Shift Cylinder and mechanism

  • Blade Tilt Cylinder

  • Hoses / Seals / fasteners / Oil leaks

  • Circle Shoes and adjustment

  • Circle Drive Gearbox condition and Clutch

  • Circle Drive Gearbox Oil level

RIPPERS / SCARIFIERS

  • GET condition and Type:

  • Mounting brackets / bolts / Pins and Bushes

  • H Frame assembly / Pins and Bushes

  • Wear Plates

  • Damage / Cracks / broken Welds

  • Lift Cylinders / Pins / Oil leaks

  • Tilt Cylinders / Pins / Oil leaks

  • Pipes / hoses / clamps

  • Tynes

BOOM ASSEMBLY

  • Boom mountings, Pins and Bushes

  • Lift Cylinders , Pins and Bushes

  • Damage / cracks / broken Welds

  • Hoses and pipes

LEFT HAND TRACK FRAME

  • Idlers

  • Sprockets

  • Carrier Rollers

  • Track Rollers

  • Track Chain and Track Pads

  • Track Adjuster

  • Bogie’s

  • Travel Motor

  • Travel Brake

  • Pipes, Hoses and clamps

  • Equalizer Bar, Bearings and Oil level

RIGHT HAND TRACK FRAME

  • Idlers

  • Sprockets

  • Carrier Rollers

  • Track Rollers

  • Track Chain and Track Pads

  • Track Adjuster

  • Bogie’s

  • Travel Motor

  • Travel Brake

  • Pipes, Hoses and clamps

EXCAVATOR

  • Slew Motor(S)

  • Slew Gearbox(s)

  • Slew Ring movement:

  • Slew Ring Teeth: Condition / wear / noises

  • Slew Grease: Level / Greasing evenly

  • Machine House

  • Main King Pin

  • Does the access ladder have the ladder in-fills installed

WATER CARTS

  • Safety Signs and Decals

  • Confined Space Decals

  • Pump Control Panel operation / condition

  • Water Canon / Hoses / operation / controls

  • Foam System / Hose Reel

  • Sprays and Spray Bars

  • Hydraulic Pump

  • Hydraulic Motor

  • Water Pump / Coupling / mounting

  • Drive Coupling Guarding

  • Pipes / screw in Hoses etc

  • Steps, Ladders, Handrails

  • General condition of Tank

  • Dents / cracks / leaks

  • Tank internal and external Rust / Anodes

"IT" ATTACHMENTS

  • General condition

  • Certificate Plates in place and legible

  • Working Load Decals installed

  • Lifting Jib Section Pins and Hook/latch condition

  • Fork Tyne condition

  • Limit Stops in place

  • Lock-Out in Cab for Attachment Cylinder operation

  • Quick Hitch Lock-Pin Proximity switch / Warning light and Buzzer in Cab

CHERRY PICKER / EWP'S

  • Ensure all Mandatory Inspections are up to date

  • Inspect Boom for any cracks

  • Basket Control Lever protection. To eliminate inadvertent contact

  • Control Level Levers to be 50mm Min. below Guardrail level. As per AS 1418.10

  • Safety Harness Anchors in place

Sign off Section

  • Customer Representative

  • Customer Approval

  • Customer Signature

  • Date and Time

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.