Information

  • Document No.

  • Equipment # and Group Abbreviation

  • Equipment attached to dolly/buffalo

  • Customer

  • Location

  • Work Group

  • EMC/IRT

  • Foreman and or Superintendent

  • Conducted on

  • Auditor

  • Location
  • 1. Current Registration and Insurance Card

  • 2. Valid KSI Trailer Backing Card ?

  • 3. Valid KSI Load Securement Card ? (Pipe Dolly Only)

  • 4. Is Trailer Hitched Up Correctly ?

  • 5. Is the Electrical Plug in Good Shape ?

  • 6. Is the Break Away Cable in Good Shape ?

  • 7. Are there 2 Safety Chains ? (Good Condition)

  • 8. Are the Safety Chains Crossed ?

  • 9. Are there Chalks and Cones available for the Trailer ?

  • 10. Tires and Wheels in Good Shape ?

  • 11. Are the Brakes Working ?

  • 12. Any Frame or Structural Damage ? (Cracked Welds or Broken Bolts)

  • 13. Any Spring Damage ?

  • 14. Are Hub Seals Leaking or have free play ?

  • 15. Has the Bolster and Pin Been Inspected ?

  • 15.1 Does bolster rotate feely ?

  • 16. All Controls Working Smoothly and Properly ?

  • 17. All Necessary Hoses and Fittings Present ?

  • 18. Any Major Water Leaks ?

  • 19. Pump in Good Working Order ?

  • 20. Hoses and Fittings In Proper Working Order ?

  • 21. Is This Equipment In Good Working Order ?

  • 22. Does This Equipment Look Clean and Well Cared For ?

  • Photo of preshift if there are repairs or if not filled out correctly

Employee Information

  • EE #

  • Add signature

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