SF-013 plant Onsite/Offsite and Inspection report

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Plant Onsite or Offsite

  Onsite

  Offsite

Equipment:

• Supplier

  In House

  Hired

• Company Hired From:

• Plant/serial No:

• Plant On Hire

  Yes

  No

  N/A

• Date & time:

  Date

• Clock Hours:

• Photo of the machine (If the site allows)

  Media

Visual Inspection

• Front Tyres (Inflation, condition & tread remaining)

  New

  75%

  50%

  25%

  N/A

• Comments

• Mid Axle Tyre (Inflation, condition & tread remaining)

  New

  75%

  50%

  25%

  N/A

• Comments

• Rear Axle Tyre(Inflation, condition & tread remaining)

  New

  75%

  50%

  25%

  N/A

• Comments

• Tracks & Pads (Tension and condition)

  Intact

  Missing

  Tight

  Slack

  N/A

• Comments

• Windows and Wipers

  OK

  Broken

  Missing

  N/A

• Comments

• Mirrors - Side, Rear, Front

  OK

  Broken

  Missing

  N/A

• Comments

• CCTV

  OK

  Broken

  Missing

  N/A

• Comments

• Flashing Beacon

  OK

  Broken

  Missing

  N/A

• Comments

• Access Steps and Handrails

  OK

  Broken

  Missing

  N/A

• Comments

• Body/Shell and Cab condition (inc' Drivers Door)

  OK

  Dirty

  Scratched

  Damaged

  N/A

• Comments

• Seat Belt & Seat Condition

  OK

  Broken

  Missing

  N/A

• Comments

• Reversing Siren, Horn, Lights, Instruments/Gauges

  OK

  Broken

  Missing

  N/A

• Comments

• Guards for Moving Parts (inc Belts, Rollers, PTO)

  OK

  Broken

  Missing

  N/A

• Comments

• Anti- Vandal Guards (supplied and adequate)

  Yes

  No

  N/A

• Comments

• Does the machine have any form of leaks

  Excess

  Yes

  No

  N/A

• Where is the leak ?

• Where is the leak ?

• Comments

• Accessories/Equipiment. Quickhitch & hoses

  Select Hitch/Pin Fire Ext'r Buckets Breaker Hammer Selector Grab Sheer Muncher/Cracker

  • Hitch/Pin
  • Fire Ext'r
  • Buckets
  • Breaker
  • Hammer
  • Selector Grab
  • Sheer
  • Muncher/Cracker

• Comments

• Fuel Level

  Select Empty Quater Half 3 Qtr Full N/A

  • Empty
  • Quater
  • Half
  • 3 Qtr
  • Full
  • N/A

• Comments

• Ad Blue Level (If Used.)

  Select Empty Quater Half 3 Qtr Full N/A

  • Empty
  • Quater
  • Half
  • 3 Qtr
  • Full
  • N/A

• Comments

• Maintenance Record / Thorough Examination Certificate

  Yes

  No

  N/A

• Where are they kept ?

• Comments

• Contact the plant manager

• Do you wish to add details of any defects found?

  Yes

  No

  N/A

• Details of defect

• Image fo defect

  Media

• As per section 6(1) of The Health & Safety at Work Act 1974; PUWER 1998 Reg 5 and 6 and LOLER Reg 9 (3)(b), I the operator confirm that the equipment described has been checked/repaired/serviced in accordance with the manufacturer’s recommendations and incorporates no obvious hazards

• Full Name

• Add signature

  Sign

Supervisor / Site Manager Sign Off

• I can confirm, that the above person as carried out all checks on the plant and are correct.

• Full Name

• Add signature

  Sign