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General • Inspections

EQUIPMENT PRE-USE CHECKLIST AND SAFETY INSPECTION FORM

This checklist provides a list of items operators must inspect and items they should also be aware of during a pre-use check each day. Operators should record that they’ve completed the check and any issues found.
MaintainX
07/16/2022

EQUIPMENT PRE-USE CHECKLIST AND SAFETY INSPECTION FORM

This checklist provides a list of items operators must inspect and items they should also be aware of during a pre-use check each day. Operators should record that they’ve completed the check and any issues found.

    Section I

    Location/Project:

    Contact Name:

    Contractor:

    Contact Phone:

    Section II - Check Type of Equipment Inspecting

    Type of Equipment

    Manufacturer

    Model Number:

    Serial Number:

    Inspection Item / Day of Week

    Worker Badge Number:

    Worker Initials:

    Date:

    Hour Meter Reading:

    Section III - Mark as Directed

    Structural Damage – none apparent

    • Yes
    • No
    • N / A

    Tires / Tracks – condition acceptable

    • Yes
    • No
    • N / A

    Load Chart – available/readable

    • Yes
    • No
    • N / A

    Glass / Mirrors – clean/clear; unobstructed

    • Yes
    • No
    • N / A

    Electrical Connections (generators)

    • Yes
    • No
    • N / A

    Hydraulic Hoses – good condition/no leaks

    • Yes
    • No
    • N / A

    Check Valves - functional

    • Yes
    • No
    • N / A

    Lubrication – adequate amount

    • Yes
    • No
    • N / A

    Fluid Levels – adequate amounts/no leaks

    • Yes
    • No
    • N / A

    Engine Oil - level/appearance good

    • Yes
    • No
    • N / A

    Cooling Water – adequate amount/no leaks

    • Yes
    • No
    • N / A

    Operating Manual - available

    • Yes
    • No
    • N / A

    Fire Extinguisher – present, charged, dated

    • Yes
    • No
    • N / A

    Seat Belts – functional/latch properly

    • Yes
    • No
    • N / A

    Operating Controls - functional

    • Yes
    • No
    • N / A

    Horn / Gauges - functional

    • Yes
    • No
    • N / A

    Lights and Reflectors – clean/functional

    • Yes
    • No
    • N / A

    Windshield Wipers - functional

    • Yes
    • No
    • N / A

    Air Systems - functional

    • Yes
    • No
    • N / A

    Steering Mechanism - functional

    • Yes
    • No
    • N / A

    Brakes - functional

    • Yes
    • No
    • N / A

    Backup Alarm - functional

    • Yes
    • No
    • N / A

    Kill Switch (if available) - functional

    • Yes
    • No
    • N / A

    Roll-off Truck Cable – no single strand broken; no kinks; no stretching; clamps tight

    • Yes
    • No
    • N / A

    Section IV - Briefly explain items having problems

    Date:

    Repairs:

Source: MaintainX (Community Member)

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