Mower Damage Report

Location & Work Type

Customer Site:

Work Area:

Work Being Undertaken:

Operator Details

Employee Name:

Job Title/Position:

Has the Operator been assessed as competent to operate this equipment?

Why was this employee operating this machine?

Please provide details?

Equipment Details

Pre Start Checklist Completed?

Please provide evidence.

Reason not completed?



Plant Type?


Incident Details
What was damaged:

Please provide details:

Photographic Evidence Must Be Provided.

Describe what happened:

Taken For Repair:

Which Supplier & By Who?

Please provide details.

Please provide details.

Damage Reported To:

Manager To Complete

Cost Of Repair:


Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.