SHE MANAGEMENT SYSTEM DOC NO : CL 05

REV. 00
INSPECTION CHECKLIST FOR EXCAVATOR/BACK HOE
DATE : 01 DECEMBER 2022

ON SITE MOBILIZATION MONTHLY

NO. FROM TO
(Please tick appropriate box)

EQUIPMENT
MODEL NO
COMPANY
PROJECT
DATE OF INSPECTION
NEXT INSPECTION

NO CHECK ITEMS RESULT REMARKS

a Do the indicators of temperature of cooling water, oil
and oil pressure correctly operate?

b Does the engine start smoothly without abnormal sound?

c Is there any trouble for fuel supplying devices?

(jet pump, smudge, leakage)

d Is there trouble for lubricant device?

(Oil volume,smudge, leakage)

e Is there any defect for cooling defect?

(water volume, tension belts, blocking for cores)

f Is the exhaust gas system in good condition?

g Are level handles, brake pedals, brake lock in good

operating condition?

h Are the clutch and brake for driving in good conditon?

I Are the main clutch and mission in good condition?
j Is the winch in good operatable condition?
k Are cables, lamps, alarms free from damage?

l Are tension of truck-link,driving chains adequate?

Seat belt (damage, missing)

m Are hoses, pipes not damaged and no leakage?

n Are there no crack, defacement, or deformation in soil

plates, bucket frame, ripper and arms?

o Are all bolts and fastener surely tightened?

p Reverse / slew audio/visual alarms and side mirrors available?
q Availibility of fire extinguisher

OBJECT : BULLDOZER, SCRAPER, TRACTOR SHOVEL, POWER SHOVEL BACK HOE ETC

Inspected by : ____________
(Name & Signature)
Company Name : _______________________

Witnessed by : ____
(Name & Signature)