Information
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Document No.
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Year - Make - Model - S/N
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Customer
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Conducted on
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Evaluator
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Location
OVERALL
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General Equipment Pictures: Left, Right, Front, and Back
Engine:
GRADING SCALE: 5 - Excellent Condition. New or recently replaced parts. 4 - Operates Well. Shows less than average wear. 3 - Operates. Is in average condition for age and hours. Minimal repairs. 2 - Operates but needs repair 1 - Repairs necessary prior to use
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Engine Hours:
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Fluid Level:
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Fluid Condition:
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Perform Oil Sample:
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Engine Noise:
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Engine Smoke:
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Visible Leaks?
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Condition of Gauge Instruments:
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Condition of Belts and Pulleys?
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Idle and Throttle Quality
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Engine Mounts and Slides:
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Any Missing Parts:
Safety Equipment:
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Seat Belt:
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Operator Presence Switch:
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Safety Switch:
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Red Safety Bars/ E-Stops::
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Work Lights:
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Strike Alert / Ground Wire:
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Decals In Place / Legible:
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Any Missing Parts:
Body Panels:
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Paint:
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Panels Dents:
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Rust:
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Frame:
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Any Missing Parts:
Operation Function:
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Rollers:
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Drilling Fluid Shutoff Ball Valve Operational:
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Throttle Control Front & Rear:
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Front Vice Cylinder:
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Front Vice Pins And Frame:
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Rear Vice Cylinder:
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Rear Vice Pins & Frame:
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Rear Vice Rotate Slides:
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Vice Jaw Wear:
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Rear Rotate Cylinder Condition:
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Right Stake Down Up/ Down:
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Stake Down Rotation:
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Pins & O Rings:
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Left Stake Down Up/ Down:
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Stake Down Rotation:
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Gearbox Rotation At Full RPM:
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Gearbox Rotation LOW/MED/HIGH Functional?
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Pins & O Rings:
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Console Pivots:
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Rotation Lever, Self Center :
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Thrust Lever, Self Center:
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Rod Loader Arms In / Out:
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Water Pump On/Off:
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Water Pump GPM Up/Down:
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Chain & Chain Pins:
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Chain Adjustments: 4/4 = Fully Adjusted
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Wear Pads (Drive Chuck):
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Rack And Pinion:
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Pinion Gears:
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Any Missing Parts:
Track And Frame:
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Right Track Forward/ Reverse:
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Track Chain Rollers:
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Check Track Sprockets:
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Left Track Forward/ Reverse:
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Track Chain Rollers:
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Check Track Sprockets:
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Rollers:
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Rubber Pads:
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Track Adjustments:
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Rear Outrigger Up/Down:
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Track Extension:
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Track Pivot:
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Tilt Cylinder:
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Track Conditon:
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Any Missing Parts:
Under Carriage:
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Track Frame Cracks, Repairs:
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Rollers / Idlers:
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Sprockets:
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Any Missing Parts:
Rod And Rod Box:
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Number Of Rods:
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Size:
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Number Of Bent Rods:
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Check Threads W/Gauge:
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Thread Condition:
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Check Shoulder W/Gauge:
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Shoulder Condition?
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Rod Wipers/ Holder Damage:
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Rod Box:
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Rod Box Condition:
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Top Pins / Bottom Pins:
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Rod Box Cover:
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Condition:
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Any Missing Parts:
Tooling / Locator:
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Drill Head:
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Condition:
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Starter Rod:
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Condition:
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Hex Collar:
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Condition:
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Duck Bills:
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Condition:
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Reamers:
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Condition:
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Reamer Sizes In Inches:
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Wash Wand:
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Condition:
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Locator:
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S/N#
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Remote:
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SN#
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Condition:
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Probe:
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S/N#
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Condition:
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Probes Heat Indicator:
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Cones:
Cab:
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A/C:
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Heater:
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Glass:
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Wipers:
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Doors:
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Multi-Function Display:
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Hydraulic System:
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Hydraulic Fluid Level and Condition:
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Condition:
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Pump Pressure / Flow By PSI:
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Visible Leaks:
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Hoses and Fittings:
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Operation of Controls:
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Hydraulic Tank and Caps:
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Perform Oil Sample:
Mixing System:
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Serial #:
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Model:
MX Engine:
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Hydraulic Fluid Level:
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Condition:
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Engine Noise:
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Engine Smoke:
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Visible Leaks:
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Idle And Throttle Quality:
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Engine Mounts:
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Missing Parts:
Tank:
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Condition Of Tank:
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Hoses:
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Caps:
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Ball Valves:
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Hopper:
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Any Missing Parts:
Pump:
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Condition Of Tank:
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Pump Noise:
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Visible Leaks:
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Packings:
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Any Missing Parts:
Truck:
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Serial:
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Model:
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Milage:
Body:
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Cab And Body:
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Paint:
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Panel Dents:
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Rust:
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Any Missing Parts:
Trailer:
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Serial:
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Model:
Body:
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Paint / Rust:
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Damage:
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Tire:
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Lights:
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Add media
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Brakes:
