Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Location of Inspection:
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Select date
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What type of Vehicle was stopped?
- Scoop
- Truck
- Forklift
- Kubota
- Scissor-Lift
- Jumbo
- Shotcrete Sprayer
- Transmixer
- Other
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Vehicle Identification #:
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Operators Name and Payroll #:
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Is the operator wearing his/her seatbelt?
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Are wheel chocks present?
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Is the operator trained and authorized on this equipment?
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Has a pre-op form been filled out for the equipment being operated? (may be necessary to conduct a pre-op with the operator at this time)
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Is the operators cab clean?
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Has the equipment been washed recently?
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Are there any noticeable oil leaks?
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If so, where?
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Has the equipment been properly greased?
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Is there a screen filter in the fuel tank and hydraulic tank?
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Have the operator perform a brake test. Does it pass?
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Do all of the lights function correctly?
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Do the back-up cameras work correctly?
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Does the Back-Up Alarm function correctly?
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Has the fire suppression system been checked and in good condition?
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List any other areas of concern regarding the equipment or operator:
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Photo:
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Inspector:
