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Equipment Safety Inspection - Daily
Jobsite :
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Baylor
QTS DC3
UTSW Moncrief Medical Center
Jobsite Area :
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CUP
CUP/Trench
Interior Renovation
Exterior/Skin Renovation
Bed Tower
Off-Road Heavy Equipment
INITIAL INSPECTION DATE:
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MAKE/MODEL:
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TYPE OF EQUIPMENT:
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OWNER ID#:
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OWNED BY:
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IN USE BY (Company):
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OPERATED BY (Name of Operator):
*
EMPLOYER:
*
OPERATOR CERTIFIED?
*
YES
NO
CERTIFIED BY DATE:
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INSPECTED BY (Print Name):
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(Sign Name):
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Clear signature
TITLE:
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EMPLOYER:
*
INSPECTED BY (Print Name):
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(Sign Name):
*
Clear signature
TITLE:
*
EMPLOYER:
*
Instruction
YES
NO
N/A
1. Back up alarm is functioning and loud enough for the conditions
2. Operator has reviewed charts & manuals and understands safe operating practices
3. Operator does a Daily Equipment Inspection at the start of the shift
4. Equipment is in proper condition for street use (turn signals, brake lights, etc.)
5. Back up alarm is functioning and loud enough for the conditions
6. Warning horn is functioning and loud enough for the conditions
7. There is a charged fire extinguisher in the cab
8. The Cab Glass is without cracks
9. Steps and seats are in proper condition
10. Seat belts are provided and they are used
11. Riders are not permitted where there are no seats with seat belts
12. Rollover protection is provided
13. Overhead protection is provided
14. Protection from flying debris is provided
15. Adequate lighting is provided for work in low light/dark conditions
16. Brakes are functioning properly
17. Beds of dump trucks are equipped with device for locking body in raised position
18.Tires/tracks are in good condition
19. Pulleys, belts, gears, chains, and other nip and shear points are adequately guarded
20. Fuel tanks are located to prevent spills and overflows from hitting hot parts or electrical equipment
21. Windshield wipers are in good condition
22. Exhaust is located/directed so as not to endanger workers or obstruct operator’s view
23. Fueling cans used with the equipment are the approved safety type
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