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Heavy Equipment Inspection
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CMB Erectors Forms
Heavy Equipment Inspection
Heavy Equipment Inspection
Josef Stevens
2023-11-26T12:35:09-05:00
Date
*
MM slash DD slash YYYY
Job # and Job Name
*
Job Supervisor:
*
Select One
Clinton Benn
Zack Belding
Matt Ullman
Unit is to be checked each day of the week and marked either pass or fail. Enter your name at the bottom of the form. If at any of the daily inspections equipment fails, it is to be removed from service until the problem is corrected.
Model and Unit #
*
Select One
FL 10-01
ML 45-01
ML 45-02
ML 45-03
ML 45-04
ML 60-01
ML 60-02
RENTAL
Rental Unit #
*
Hours
Pre-Start Walk Around
Does this unit have a valid annual certificate?
*
(located in the either the black case in the man-basket or a tube in the cab)
Select One
Yes
No
What is the date of certification?
*
If you answered No to the above
NOTIFY YOUR SUPERVISOR IMMEDIATELY
.
Wheels, tires, and axle condition
*
Select
Pass
Fail
Hydraulics, leaks
*
Select
Pass
Fail
Decals and labels
*
Select
Pass
Fail
Hatches: closed and locked
*
Select
Pass
Fail
Engine: belts, hoses, gaskets
*
Select
Pass
Fail
Battery: clean, dry, secure
*
Select
Pass
Fail
Fuel Tank Level
*
Select
≤ 1/4
1/2
3/4
Full
Hydraulic Oil Level
*
Select
Pass
Fail
Lights and strobes
*
Select
Pass
Fail
Lift arms - general condition
*
Select
Pass
Fail
Hydraulic cylinder
*
Select
Pass
Fail
Articulated Joints: wear, cracks
*
Select
Pass
Fail
Power Tracks: lines, hoses
*
Select
Pass
Fail
Air Filter
*
Select
Pass
Fail
After Start Walk Around
Engine Starts
*
Select
Pass
Fail
Lift arms: rise/lower
*
Select
Pass
Fail
Drive: forward/reverse
*
Select
Pass
Fail
Steer: left/right
*
Select
Pass
Fail
Horn operation
*
Select
Pass
Fail
Turret rotate
*
Select
Pass
Fail
Not Applicable
Safety Interlocks
*
Select
Pass
Fail
Changes in equipment, repairs needed or other comments:
Inspectors Name:
*
Inspectors Signature
*
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