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SKID LOADER INSPECTION FORM

Equipment Model (Specify) :

Registration No. : Operator Name :

Identification / Plate No : ID No :

Date and Time of Inspection : Certificate No :

Location : Company :

First Inspection Second Inspection Third Inspection


S/No. Items Inspected
Pass Fail Pass Fail Pass Fail
1 Rotary Component Lubrication.

2 Ignition switch / Engine stop mechanism.

3 Head Lights / Rotating Beacon Light Function.

4 Battery Condition.

5 Drive Belt Condition.

6 Preventive Maintenance Records.

7 360 Visibility.

8 Government / 3rd Party Certification provided (if required)

9 Tire Conditions.

10 Fire Extinguisher Charged.

11 Seat Belt Function.

12 Brake System Functions.

13 Bucket Lift and Tilt Cylinders.

14 Engine Oil /Transmission / Hydraulic / Coolant Level.

15 Gauges, Indicators, Switches and Control.

16 Engine / Exhaust System Condition.

17 Bucket/Bucket Pin Condition.

18 Back Up Alarm/ Horn Function

19 Hydraulic / Transmission Oil Leakage.

Inspected By:

Subcontractor Heavy Equipment Inspector


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

Contractor Vehicle / Mobile Equipment Inspector


(Sign/Date) (Sign/Date) (Sign/Date)
Remarks:
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Subcontractor Company: Sticker Number Issued (If pass)

Noted by Contractor HSSE Manager