Pro-MEC Telehandler Inspection Form

• Job #

• Location

• Person Performing Inspection

• Conducted on

  Date

• Instruction :
  Each forklift will be operationally tested and visually inspected each day. The designated inspector will complete the audit for each item. If there is a problem related to any item leave a brief description of the problem. Immediately notify the Foreman of any lift defects.

Operating Controls (Operational)

• Emergency Stop & Brakes

  Safe

  At Risk

  N/A

• Operation Levers & Controls

  Safe

  At Risk

  N/A

• Foot Controls

  Safe

  At Risk

  N/A

• Safety Signs & Load Charts

  Yes

  No

  N/A

Boom & Forks

• Hydraulic Leaks

  Select Yes No

  • Yes
  • No

• If there is a hydraulic leak, place picture here.

  Media

• Extension Cylinders & Chains

  Safe

  At Risk

  N/A

• Pivot Pins

  Safe

  At Risk

  N/A

• Electrical Lines

  Safe

  At Risk

  N/A

• Vert. Mast Sliding & Rolling Prts.

  Safe

  At Risk

  N/A

Base (Visual)

• Broken, Cracked or Loose Parts

  Yes

  No

• Lights, Mirrors & Windows Clean

  Yes

  No

  N/A

• Seat Belt & It's Mounts

  Safe

  At Risk

  N/A

• Tires & Outriggers

  Safe

  At Risk

  N/A

• Back Up Alarm, Horn & Manual

  Safe

  At Risk

  N/A

Engine Compartment (Visual)

• Oil Level

  Safe

  At Risk

  N/A

• Fuel Level

  Safe

  At Risk

  N/A

• Belt, Hose & Motor Condition

  Safe

  At Risk

  N/A

• Battery & Electrical

  Safe

  At Risk

  N/A

Signature and Verification

• Signature of Person

  Sign

• Date

  Date