Information

  • Document No.

  • Audit Title

  • Client / Site

  • Equipment model and WI #

  • Conducted on

  • Prepared by

  • Location
  • Operator

  • Groundman

  • Operator has hand held radio, or one is mounted in machine and they are charged and working

  • Spotter has hand held radio, charged and working

  • Cab is clean and swept out

  • Loose items on floor board

  • Is weekly maint. report complete and correct, with issues noted

  • Fire extinguisher fully charged

  • Spill kit and first aid kit on equipment

  • Back up alarm working properly

  • Gauges working properly

  • All lights working

  • Equipment Greased

  • Excess grease removed from alimites

  • Excess grease removed from joints

  • Were there any hydraulic hoses with exposed wire or rubbing that could lead to hose failure

  • Check all belts for cracking and wear

  • Clean air filters and pre-cleaners

  • Is engine and pump compartment clean and free of oils

  • Is engine oil at correct level, visually check

  • Is coolant at correct level, Visually check

  • Is transmission oil at correct level, visually check

  • Is the radiator clean

  • Are there any leaks, if yes how many

  • Tires/tracks, and undercarriage inspected for excessive wear and loose components, including valve caps

  • Has undercarriage been cleaned out

  • Equipment damage/malfunctions have been reported to lead person on job. If damage was reported, what was the damage and how/who was it reported to?

  • Is equipment damage/malfunctions recorded on daily/weekly checklist

  • Does operator allow 10 minutes to warm up after starting engine. N/A if not seen at time of inspection.

  • Did operator shut engine down with 10 minute cool down, when approached?

  • Are all compartments and fill caps locked when machines are unattended

  • Has debris been cleaned from machine

  • Parked over bare dirt, end to end or side by side. N/A if not seen at time of audit

  • Power tools are clean, sharp, fueled, oiled and secure

  • Windows have been cleaned with pledge (if lexan)

  • Main power supply disconnected

  • Spare key on engine oil dip stick

  • Is uptime kit on location

  • Is the equipment clean

  • Other comments and Notes

  • Operators Signature

  • Spotter Signature

  • Inspectors Signature

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.