Company: Hour Meter Reading: Location: Date: MM/DD/YYYY Unit No.: POWER OFF CHECKS Status POWER ON CHECKS Status OK NO N/A OK NO N/A 1) Underneath machine: 11) Unit starts and runs properly M M M a) Wheels & Tires M M M 12) Instruments/Gauges M M M b) Steering rods/links M M M 13) Hour Meter M M M c) Axles M M M 14) Warning lights/audible alarms M M M 2) Lights/Strobes M M M 15) Fuel level M M M 3) Mirrors/Visibility aids M M M 16) Horn/audible warning device(s) M M M 4) Engine/Engine compartment: 17) Function controls: a) Belts/Hoses M M M a) Drive forward/reverse M M M b) Cables/Wires M M M b) Steer left/right M M M c) Debris M M M c) Front bucket controls M M M 5) Battery/Batteries: d) Bucket/Boom/Dipper/Attachment M M M a) Terminals tight M M M e) Accessories M M M b) Clean/Dry/Secure M M M 18) Emergency/auxiliary controls M M M 6) Hydraulics: 19) Wipers M M M a) Cylinders/Rods M M M 20) Seatbelt inspected & fastened M M M b) Hoses/Lines/Fittings M M M GENERAL OK NO N/A c) Pins/Locks M M M 21) Housekeeping M M M 7) Fluids: 22) Manufacturer's operating manuals M M M a) Engine oil Level Leaks M M M 23) Decals/Warnings/Placards M M M b) Engine coolant Level Leaks M M M 24) Misc. parts loose/missing/broken M M M c) Hydraulic oil Level Leaks M M M WORKPLACE INSPECTION OK NO N/A d) Fuel/Battery Level Leaks M M M 25) Drop-offs or holes M M M 8) Chassis: 26) Bumps and floor/ground obstructions M M M a) Cab/Glass/Doors M M M 27) Debris M M M b) Emergency Exit M M M 28) Overhead obstructions M M M c) Entry/Exit steps M M M 29) Energized power lines M M M d) ROPS/FOPS M M M 30) Hazardous locations M M M e) Fire Extinguisher/Suppression System M M M 31) Ground surface and support conditions M M M 9) Digging Assembly: 32) Pedestrian/vehicle traffic M M M a) Boom/Dipper/Bucket/Attachment M M M 33) Wind and weather conditions M M M b) Articulated joints M M M 34) Other possible hazards M M M c) Front bucket & cutting edge M M M M M M d) Bucket/attachment link pins & arms M M M M M M 10) Other: M M M M M M
Report any problems found to your supervisor/employer. ALWAYS lock/tag-out unsafe equipment. Comments
Operators initials: Alternative operators initials: