Title Page

  • Conducted on:

  • Inspected Plant:

  • Employees Performing Inspection:

  • This form pertains to the weekly inspection of Tilcon's asphalt plants. Employees are required to identify whether there are any problems with the components of the asphalt plant listed on this form. If there are any existing problems, describe them in depth. When repairs are completed on documented problems, employees may edit previously submitted forms and include the date said repairs were performed.

Feeders

Belts (condition, splice)

  • Is there a visual risk/problem?

  • Problems

  • Date Repaired

Tail (pulley take-ups, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, reducer belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (pulley, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Conveyors

Belts (condition, splice)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Idlers (troughing, return)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tail (pulley take-ups, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, reducer belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (pulley, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Exhauster

Drive (motor, reducer belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bearings

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Fugitive System

Drive (motor, reducer belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bearings

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Dryer

Vibrators

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Trunnions

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, Shv/spr, belts/chain)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Burner

Valves (gas, oil, air)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, belts, drive motor)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Hot Elevator

Boot (shaft, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (shaft, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, Shv/spr, belts/chain)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Screen

Bearings (leaks, etc.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, sheaves, belts)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Hot Bins

Gates (cylinders, valves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Mixer

Weighhopper (gate, cylinder, valve)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Kettle (gate, cylinder, valve)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Injection Pump (cylinder, valve, drive)

  • Is there a visual risk/problem?

  • Date Repaired

  • Problems:

Drive (motor, red., coup., belts, shv.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bearings

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bullgears

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Air Compressors

Drive (motor, coupling, air end)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Filters (air, oil, separator, leaks)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Air Dryer

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Baghouse

Drive (motor, red., belts, shv.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bearings (tail, hard iron)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Rotary Valve

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Actuators

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Inclined Screws

Drive (motor, red., belts, shv.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bearings (tail, hard iron)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

A/C System

Pump Drive (motor, red., belts, shv.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tank Heater (motor, valves, controls)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Oil Heater (motor, valves, controls)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Hot Oil Pump (motor, coupling)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Silos

Batchers (cyl., valves, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Gates (cyl., valves, oilers, seals)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Transfer Slatt

Drive (motor, shv/spr, coup, belt/chain)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tail (sprocket, bearings, shaft)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (red., sprocket, bearings, shaft)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Main Slatt

Drive (motor, shv/spr, coup, belt/chain)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tail (sprocket, bearings, shaft)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (red., sprocket, bearings, shaft)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

RAP Main Bin

Belts (condition, splice)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tail (pulley, take-ups, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, reducer, belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (pulley, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bin (gates, skirts, vibrator, air cannon)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

RAP Conveyors

Belts (condition, splice)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Idlers (troughing, return)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tail (pulley, take-ups, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, reducer, belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (pulley, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

RAP Screen

Bearing (leaks, etc.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Screen Cloth

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

RAP Scavenger System

Drive (motor, belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bearing (leaks, etc.)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Fan (blade, housing, duct-work)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

RAP Weigh Hopper

Belt (condition, splice)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bin (cyl., valve, skirts, liner)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tail (pulley, take-ups, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Drive (motor, reducer, belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Head (pulley, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Chute (liners, vibrators)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

RAP Crusher

Drive (motor, belts, sheaves)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

  • Employee Name:

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.