Information

  • Document No.

  • Year - Make - Model - S/N

  • Customer

  • Conducted on

  • Evaluator

  • Location

Engine

  • Fluid Level and Condition:

  • Describe Condition

  • Add media

  • Perform Oil Sample:

  • Engine Noise:

  • Engine Smoke:

  • Visible Leaks?

  • Condition of Gauge Instruments:

  • Add media

  • Condition of Belts and Pulleys?

  • Add media

  • Idle and Throttle Quality

  • Add media

  • Engine Mounts and Slides:

  • Add media

  • Radiator / Hoses:

  • Add media

  • Any Missing Parts:

Safety Equipment

  • Seat Belt:

  • Add media

  • Operator Presence Switch:

  • Add media

  • Safety Switch:

  • Add media

  • Red Safety Bars/ E-stops:

  • Add media

  • Work Lights:

  • Add media

  • Decals in Place/ Legible:

  • Any Missing Parts:

Body Panels:

  • Paint:

  • Add media

  • Panels Dents:

  • Add media

  • Safety Shield/ Glass:

  • Rust:

  • Frame:

  • Add media

  • Any Missing Parts:

Operation Function:

  • Throttle Control Front & Rear:

  • Add media

  • Drive Belt/ Drive Chain:

  • Add media

  • Drive Shaft:

  • Add media

  • Blades and Cutter Bar:

  • Add media

  • Cutter Drum/ Disc;

  • Add media

  • Cutter Drum Bearings/ Disc:

  • Add media

  • Hammers:

  • Add media

  • Feed Rollers:

  • Add media

  • Feed Roller Slides:

  • Add media

  • Feed Roller Springs:

  • Add media

  • Feed Table Door:

  • Add media

  • Discharge Conveyor:

  • Add media

  • Conveyor Rollers:

  • Add media

  • Conveyor Belts:

  • Add media

  • Chute Turns:

  • Add media

  • Chute Deflector:

  • Add media

  • Winch/ Winch Line:

  • Add media

  • Smart Feed:

  • Auto Feed:

  • Auto Sweep:

  • Clutch/ Actuator:

  • Add media

  • Cutter Wheel/ Bearings Top/ Bottom:

  • Add media

  • Teeth:

  • Add media

  • Pockets / Bolts:

  • Add media

  • Console Pivots:

  • Add media

  • Levers Self-Center:

  • All Control Function:

  • Add media

  • Chip Blade:

  • Add media

  • Hitch Type?

  • Jack an Handle:

  • Add media

  • Lights:

  • Add media

  • Any Missing Parts:

Track and Frame

  • Right Track Forward/ Reverse:

  • Add media

  • Track Chain Rollers:

  • Add media

  • Check Track Sprockets:

  • Add media

  • Left Track Forward/ Reverse:

  • Add media

  • Track Chain Rollers:

  • Add media

  • Check Track Sprockets:

  • Add media

  • Rollers:

  • Add media

  • Rubber Pads:

  • Add media

  • Track Adjustments:

  • Add media

  • Track Extensions:

  • Add media

  • Tilt Pivot/ Pin Wear:

  • Add media

  • Tilt Cylinder:

  • Add media

  • Track Conditon:

  • Add media

  • Track Frame Cracks, Repairs:

  • Rollers/ Idlers:

  • Add media

  • Sprockets:

  • Add media

  • Tires and Size:

  • Add media

  • Mud Flaps:

  • Brakes:

  • Add media

  • Any Missing Parts:

Hydraulic System:

  • Hydraulic Fluid Condition:

  • Add media

  • Pump/ Pressure/ Flow Measured in PSI:

  • Visible Leaks:

  • Cylinders:

  • Add media

  • Hydraulic Motors:

  • Add media

  • Hoses And Fittings:

  • Add media

  • Operation of Controls:

  • Add media

  • Hydraulic Tank and Caps:

  • Add media

  • Perform Oil Sample:

  • Notes:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.