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Equipment inspection

Equipment inspection
Equipment Request

MI-APP Equipment
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Equipment Forms

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Operator/Employee Name *

Jobsite *

Date / Time *

Date

Time

Equipment Serial Number *

Equipment Make *

Equipment Type *

Equipment Model (if Other) *

Model

D3 Dozer
D4 Dozer
D5 Dozer
D6 Dozer

Model

120M Motograder
140M Motograder
CAT 12M2 Grader

Operator's Starting Stick

Model

CS11 Compactor
CS54B Compactor
CS56B Compactor
CS66B Compactor

Model

308 Excavator
311 Excavator
323 Excavator
324 Excavator
326 Excavator
330 Excavator
336 Excavator
340 Excavator
349 Excavator
352 Excavator
323LS Excavator
324LS Excavator
326LS Excavator
330LS Excavator
336LS Excavator

Model

930 Loader
938 Loader
950 Loader
966 Loader
972 Loader

Model

279 CAT Skid Steer
299 CAT Skid Steer

Model

6K Telehandler
10K Telehandler

Model

725C Off-road Dump Truck
730C2 Off-road Dump Truck
735 Off-road Dump Truck
740B Off-road Dump Truck
745C Off-road Dump Truck

Model

Water Truck 4000 gallons
Water Truck 5000 gallons
613 CWW 5000 gallons
621 CWW 8000 gallons
725 WW 5000 gallons
730 WW 5000 gallons
740 WW 9000 gallons
Hydrema 912WW

Rental Company

Linder
Newman
Ring Power
Sunbelt
Synergy
United

Before Starting

Inspection Points *

Inspection Points

Body, Cab

OK
Not OK
N/A

Doors

OK
Not OK
N/A

Boarding Steps

OK
Not OK - Foreman Must Inspect
N/A

Track Rails

OK
Not OK
N/A

U-Carriage/Drive Train

OK
Not OK
N/A

Bushings/Pins/Grease Fittings

OK
Not OK
N/A

Hoses/Connections

OK
Not OK
N/A

Safety Guards/Hand Rails

OK
Not OK
N/A

Tires/Tracks

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Battery

OK
Not OK
N/A

Belts/Hoses

OK
Not OK
N/A

Oil - Engine/Hydraulic Levels

OK
Not OK
N/A

Lights - Head/Brake/Tail/Working

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Mirrors

OK
Not OK
N/A

Boom & Stick

OK
Not OK - Foreman Must Inspect
N/A

Fire Extinguisher

OK
Not OK
N/A

Life Ring & 90ft Rope

OK
Not OK
N/A

Cab Inspection

Inspection Points *

Cab Inspection

House Keeping

OK
Not OK
N/A

Windshield/Windows/Wipers

OK
Not OK - Foreman Must Inspect
N/A

Control Markings

OK
Not OK
N/A

Seat Belt/Seat

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Operator's Manual

OK
Not OK
N/A

Break Out Hammer

OK
Not OK
N/A

Load Chart/Placard

OK
Not OK - Foreman Must Inspect
N/A

Other

OK
Not OK - Foreman Must Inspect
N/A

Describe Other Inspection Point

After Starting

Inspection Points *

After Starting

Hydraulic/Air System

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Back-up Alarm

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Horn

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Gauges/Instruments

OK
Not OK
N/A

Parking Brake

OK
Not OK
N/A

System Brakes

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Operating Controls

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Steering

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Exhaust System

OK
Not OK - Foreman Must Inspect
N/A

Outriggers

OK
Not OK
N/A

Attachments

Inspection Points *

Attachments

Forks

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Bucket

OK
Not OK - Contact Foreman. EQUIPMENT OUT OF SERVICE
N/A

Hooks

OK
Not OK
N/A

Inspection Plates

OK
Not OK
N/A

Load Charts/Placard

OK
Not OK - Foreman Must Inspect
N/A

Operator's Manuals

OK
Not OK
N/A

Other

OK
Not OK
N/A

Describe Other Inspection Point

Equipment Ok to Operate? *

OK (Good to Go)
OK to Operate WITH Defects
No (Defects Found, Equipment Down)

Describe Defects

This Equipment is removed from service and tagged out until repairs

YES, Out of Commission

Foreman Signature

Clear Signature

Special notes or additions

Add anything not listed in options

File Upload

Click or drag a file to this area to upload.

Signature

Clear Signature

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Equipment Request Form *

Site Contact *

Foreman/ Proj. Engineers *

Date / Time *

Date

Time

Name of Person Completing Form *

Owned Equipment *

Owned
Rented

Equipment Make *

Equipment Type *

Model

D3 Dozer
D4 Dozer
D5 Dozer
D6 Dozer

Model

120M Motograder
140M Motograder
CAT 12M2 Grader

Model

CS11 Compactor
CS54B Compactor
CS56B Compactor
CS66B Compactor

Model

308 Excavator
311 Excavator
323 Excavator
324 Excavator
326 Excavator
330 Excavator
336 Excavator
340 Excavator
349 Excavator
352 Excavator
323LS Excavator
324LS Excavator
326LS Excavator
330LS Excavator
336LS Excavator

Model

930 Loader
938 Loader
950 Loader
966 Loader
972 Loader

Model

279 CAT Skid Steer
299 CAT Skid Steer

Model

6K Telehandler
10K Telehandler

Model

725C Off-road Dump Truck
730C2 Off-road Dump Truck
735 Off-road Dump Truck
740B Off-road Dump Truck
745C Off-road Dump Truck

Model

Water Truck 4000 gallons
Water Truck 5000 gallons
613 CWW 5000 gallons
621 CWW 8000 gallons
725 WW 5000 gallons
730 WW 5000 gallons
740 WW 9000 gallons
Hydrema 912WW

Rental Company

Linder
Newman
Ring Power
Sunbelt
Synergy
United

Drop Model

Equipment ID *

Equipment Serial Number *

Expected Off Rent/Transport Date *

Pick Up Location Name *

Pick Up Location Job Number *

Pickup Location *

Address Line 1

Address Line 2

City

State

Zip Code

Detailed Delivery Instructions

GPS

Notes

Attachments Needed

Description

Drop Off Location *

Drop Off Location Job Number *

Drop Off Location *

Address Line 1

Address Line 2

City

State

Zip Code

Drop Off Instructions

Special notes or additions

Add anything not listed in options

File Upload

Click or drag a file to this area to upload.

Signature

Clear Signature

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