Wood

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

From the Ground

• Boom cylinder, Lines, Hoses

  Yes

  No

  N/A

• Boomstructures

  Yes

  No

  N/A

• Head attachment

  Yes

  No

  N/A

• Underneath machine

  Yes

  No

  N/A

• Steps and handholds

  Yes

  No

  N/A

• Fuel tank

  Yes

  No

  N/A

• Final drive oil

  Yes

  No

  N/A

• Hydraulic tank

  Yes

  No

  N/A

• Hydraulic tank

  Yes

  No

  N/A

• Lights, front and rear

  Yes

  No

  N/A

• Battery Compartment

  Yes

  No

  N/A

Engine Compartment

• Engine Oil

  Yes

  No

  N/A

• Engine Coolant

  Yes

  No

  N/A

• Pump Drive Box (if equipped)

  Yes

  No

  N/A

• Radiator

  Yes

  No

  N/A

• All hoses

  Yes

  No

  N/A

• Fuel Filters

  Yes

  No

  N/A

• All belts

  Yes

  No

  N/A

• Air Filter

  Yes

  No

  N/A

• Overall Engine Compartment

  Yes

  No

  N/A

On the machine outside the cab

• Handholds

  Yes

  No

  N/A

• ROPS

  Yes

  No

  N/A

• Fire extinguisher/system

  Yes

  No

  N/A

• Windshield, Windows

  Yes

  No

  N/A

• Windshield wipers/Washers

  Yes

  No

  N/A

• Doors

  Yes

  No

  N/A

Inside the Cab

• Escape hatch/exits

  Yes

  No

  N/A

• Seat

  Yes

  No

  N/A

• Seat belt and Mounting

  Yes

  No

  N/A

• Horn, Backup alarm, Lights

  Yes

  No

  N/A

• Mirrors

  Yes

  No

  N/A

• Cab air filter

  Yes

  No

  N/A

• Gauges, Indicators,Switches, Controls

  Yes

  No

  N/A

• Overall cab interior

  Yes

  No

  N/A

Operation

• Overall Operator knowledge and Operation

  poor

  fair

  good

  excellent

• Add signature

  Sign