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Daily Equipment Inspection
This report will take approximately 6 minutes to complete.
Project:
Operator/Inspector Name
*
First Name
Last Name
Company Name and Superintendent:
*
KLB - Mac Smith
JWT - Jimmy Watterson
PCL - Manny Garcia
Other
Date & Time
Equipment Type
*
Bus
Company Truck/ Rental
Crew Van
Dozer
Drill Rig
Excavator
Flat Bed/ Gooseneck
Forklift
Front End Loader
Grader
Hydrovac Trailer
Panther T8/ Marruka
Pile Driver/ PD-10
Roller
Skid Steer
Tractor
Trencher
UTV
Water Truck
PD-5
Other
Equipment type if not listed above
Equipment #
*
Meter Hours/ Miles
*
Spotter Requirement
Spotters are provided when equipment is operated in congested areas, when reversing, or any time the operator does not have clear view of the travel path (spotters are responsible for preventing the operator from movement that will cause any collisions or impact)
Is a spotter required for your task?
*
YES
NO
Spotter Name:
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Inspection Items
If item is NOT ACCEPTABLE, list description in the comments, notify supervision, and fill out the Equipment Service Form.
Manufacturing Operations Manual
*
Acceptable
Not Acceptable
N/A
Comments
Foot Brakes
*
Acceptable
Not Acceptable
N/A
Comments
Hand Brakes
*
Acceptable
Not Acceptable
N/A
Comments
Reverse Signal Alarm
*
Acceptable
Not Acceptable
N/A
Comments
Horn/ Air Horn
*
Acceptable
Not Acceptable
N/A
Comments
Tires/ Tracks
*
Acceptable
Not Acceptable
N/A
Comments
Steering
*
Acceptable
Not Acceptable
N/A
Comments
Seat Belts
*
Acceptable
Not Acceptable
N/A
Comments
Operating Controls
*
Acceptable
Not Acceptable
N/A
Comments
Access Ladder/ Steps
*
Acceptable
Not Acceptable
N/A
Comments
Fire Extinguisher
*
Acceptable
Not Acceptable
N/A
Comments
Lights
*
Acceptable
Not Acceptable
N/A
Comments
Mirror
*
Acceptable
Not Acceptable
N/A
Comments
Instruments
*
Acceptable
Not Acceptable
N/A
Comments
Coupling Devices
*
Acceptable
Not Acceptable
N/A
Comments
Bed/ Cargo Area/ Tailgate Locking Assembly
*
Acceptable
Not Acceptable
N/A
Comments
Tarps/ Covers
*
Acceptable
Not Acceptable
N/A
Comments
Windshield/ Windshield Glass
*
Acceptable
Not Acceptable
N/A
Comments
Windshield Wipers
*
Acceptable
Not Acceptable
N/A
Comments
Exhaust System
*
Acceptable
Not Acceptable
N/A
Comments
Hitches/ Safety Cable
*
Acceptable
Not Acceptable
N/A
Comments
Hydraulic Lines/ Air Hoses
*
Acceptable
Not Acceptable
N/A
Comments
Engine Oil Level
*
Acceptable
Not Acceptable
N/A
Comments
Hydraulic Oil Level
*
Acceptable
Not Acceptable
N/A
Comments
Rollover Equipment
*
Acceptable
Not Acceptable
N/A
Comments
Cleanliness
*
Acceptable
Not Acceptable
N/A
Comments
Attachment of Any Additional Photos
Upload of any Images
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Any Additional Comments Pertaining for this page
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Inspection Completion
Report any issues to your superintendent for review.
By checking YES, I am stating the inspection performed on the previous page is accurate and correct, and I have completed my PSI for my job task.
*
YES
Signature
*
Email
example@example.com
Submit
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