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PLATE COMPACTOR INSPECTION FORM

Equipment Model (Specify) :

Registration No. : Location: _________________________________

Identification / Plate No :

Date and Time of Inspection : Company: _________________________________

Location :

First Inspection Second Inspection Third Inspection


S/No.
Items Inspected
Pass Fail Pass Fail Pass Fail

1 Over-all Condition.

2 Machine Controls are Properly Operating

3 Abnormal Sounds or Movements.

4 Exhaust System Condition.

5 Drive Belt Tension.

6 All Parts Of The Machine Properly Tight-Up.

7 Pulley Guard In Position.

8 Engine Oil Level.

9 Engine Oil Leakages.

10 Fuel Line Leakages.

11 Safe Guards For Moving Parts.

Inspected By:

Subcontractor Heavy Equipment Inspector


(Sign/Date) (Sign/Date) (Sign/Date)

Contractor Vehicle / Mobile Equipment Inspector


(Sign/Date) (Sign/Date) (Sign/Date)
Remarks:
__________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

Subcontractor Company: Sticker Number Issued (If pass)

Noted by Contractor HSSE Manager