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
Equipment:

Pre Start Checklist Completed?

Please provide evidence.

Reason not completed?

Owned?

Hired?

Plant Type?

Supplier?

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:

Downtime:

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.