VEHICLE NUMBER_______________ OPERATORS NAME____________________ DATE__________________
TYPE OF EQUIPMENT: LOADER_____ FORKLIFT______ TRENCHER_____ BOOM_____ OTHER_____
=
OK 
= NEEDS REPAIR
|
DAILY INSPECTION |
|
| TIRES, WHEELS, RIMS, TRACKS | |
| FUEL AND ENGINE OIL | |
| COOLANT LEVEL | |
| SERVICE AND PARK BRAKE | |
| HYDRAULIC OIL AND LINES | |
| BATTERY | |
| BUCKET CONDITION | |
| GREASE PIVOT POINTS | |
| SAFETY AND EMERGENCY EQUIPMENT | |
| CONTROL LEVER OPERATION | |
| LIGHTS AND REFLECTORS | |
| STEERING | |
| MIRRORS | |
| INSTRUMENTS AND GAUGES | |
| BACKUP ALARM AND HORN | |
| BOOM OPERATION | |
| SEAT BELT | |
|
WRITE COMMENTS HERE |
I HAVE INSPECTED EACH ITEM NOTED ABOVE AND I HAVE FOUND EACH ITEM IN PROPER WORKING ORDER, OR I HAVE NOTED THE DEFECTS ABOVE
OPERATOR SIGN_____________________________________ DATE:____________
I CERTIFY THAT:
___ ITEMS NOTED DO NOT AFFECT THE SAFE OPERATION OF THE EQUIPMENT
___ REPAIRS NOTED HAVE BEEN CORRECTED
MECHANIC SIGN______________________________________ DATE:_____________
REPAIR ORDER NUMBER____________________ . DATE:_________________