Banyu Urip Project

Production Processing Facilities

PRE-ENTRY INSPECTION CHECKLIST

FORKLIFT
NAME OF SUB CONTRACTOR: ______________________________________________________________

CONTRACTOR EQUIPMENT No: _____________________________________________________________

EQUIPMENT MAKE/MODEL: ______________________ EQUIPMENT SERIAL No: __________________

EQUIPMENT SUPPLIER: _________________________ INSPECTION AREA: _______________________

DATE OF INSPECTION: _____________ TIME START: ___________ TIME FINISH: __________________

TS INSPECTOR: __________________________ TS INSPECTOR SIGNATURE: _____________________

TS MECHANIC: __________________________ TS MECHANIC SIGNATURE: _____________________

CONTRACTOR REPRESENTATIVE: _________________________ BADGE NO: _____________________

AUTHORISED FOR USE IN: _____ OPERATIONAL AREAS (SPARK ARRESTOR FITTED)

SPARK ARRESTOR SERIAL No.: _______________________

_____ NON-OPERATIONAL AREAS

LE CERTIFICATION No.: _____________________ EXPIRY DATE: __________________________

PSA CERTIFICATION No.: ____________________ EXPIRY DATE: __________________________

EXPIRY DATES:

INSURANCE: _____________________________ REGULATORY: ___________________________

PRE-ENTRY INSPECTION RESULT

PASS FAIL Permanent Ban

(S) INSPECTED & (N/A) NOT
(M) MANDATORY ITEM (R) REPAIR REQUIRED
SATISFACTORY APPLICABLE
NOTE: A TICK ON THE (R) COLUMN ON ANY ONE (1) MANDATORY ITEM MEANS OUTRIGHT FAILURE OF THE INSPECTION!
N/A - SUBJECT TO/DEPENDS ON THE RISK ASSESSMENT

A - OPERATOR’S CAB/STATION S R N/A COMMENTS

Cabin/Overhead Guard
Steering Wheel/Steering Wheel Knob
Step, Door Handle, Latch
Operator’s Seat, Mechanism, Mounting
M Windshield, Cab Glass (Check for Cracks)
Windshield Wiper, Washer
Dashboard (Cigarette Lighter removed)
Fan (Air circulation)
Sun Visor
Audio, Visual Alarms
Indicators, Gauges
Switches, Control lever (properly identified –
labelled)
 Banyu Urip Project
Production Processing Facilities

Mirrors, Rear, Left, Right

M Seatbelts in place & in working condition
No loose/ flammable items inside the cab
Anti slip step(pad) for access, egress and
M platform (grill type step is also acceptable)
Throttle Control Pedal
Foot Brake Pedal
Directional Controls (forward, reverse)
Lift Control Lever
Shift, Tilt Control Levers
Stabilizer Control Lever
Neutral Starting
Engine Emergency/Manual Shutoff
Safe Working Load (SWL) Chart

B - ELECTRICAL SYSTEM S R N/A COMMENTS

Work Lights, Front, Rear
Signal / Hazard Lights, Front, Rear
M Beacon Lights, permanently mounted
Tail Lights, Brake Lights
M Back Up Lights / Alarm
Horn in working condition
Alternator Charging Condition
Electrical Wiring Harness Condition
Batteries, Covers, Hold Down bolts
Battery Terminals, Cables

C - ENGINE COMPARTMENT S R N/A COMMENTS

Clean - Free of Dust, Dirt, Oil & Grease
M Oil – Filter, Cooler, Piping Leaks
M Fuel filter, Water-Fuel Separator, Leaks
Fan – Belts & Guards
Air Induction System, Hoses, Clip & Joints
M Turbocharger, Oil Pipe, Fittings, Oil Leaks
Exhaust System, Joints, Gasket Leaks
Radiator – Hoses, Cap, Gasket, Coolant
M Leaks
Spark Arrestor (US Forestry Approved)
M Subject to Base Plant & IRF Requirement

D - FUEL TANK/FUEL SYSTEM S R N/A COMMENTS

Clean, Free of Dust, Dirt, Oil & Grease
M Cap Gasket, Fuel line, Drain Valve, Leaks
Mounting - Bolts, Brackets
M Fuel – Pump, Injectors, Hoses Leaks
Gas Tank, Hose & Fittings (LPG fuel)
M LPG Hoses, Leaks
M Soapy Water for leak testing

E - BRAKE SYSTEM S R N/A COMMENTS

Air Hydraulic
M Brake Tubes, Hoses, Front, Rear, Leaks
Foot Brakes, working Properly
Parking Brakes, working properly
 Banyu Urip Project
Production Processing Facilities

F - TIRES S R N/A COMMENTS

Front/Rear, Condition, Matched, Solid
Wheels, Rims, Lock Rings
Wheel Studs, Lock Nuts

G - SAFETY S R N/A COMMENTS

M Fire Extinguisher
Capacity (2.5 Kg), Date Charged
- Regular Inspection Tag, Current
M - Rigidly Mounted & readily available
Safety Warning Signs at Rear

H - SPILL MITIGATION S R N/A COMMENTS

M Oil Spill Absorbent Pad

I - DRIVE TRAIN (with Wheels) S R N/A COMMENTS

Clean - Free of Dust, Dirt, Oil & Grease
AXLES – Front & Rear
M - Housing, Mounting bolts, Oil Leaks
Steering Knuckle, Hub Frame, Spindle
Bearing
M Differential Gear, Oil Leaks
Drive Shafts, Universal Joint, Front, Rear
M Transmission, Mountings, Noise, Leaks
M Transfer Case, Mountings, Noise, Leaks
M Torque Converter, Drive Shaft, Leaks
Clutch Free Play, Noise

J – STEERING SYSTEM S R N/A COMMENTS

Clean – Free of Dust, Dirt, Oil & Grease
M Steering Wheel, Column
M Drop Arm & Linkages, Tie Rod, Kingpin
M Steering Pump, Hoses, Oil Leaks
M Hose Rubber Insulation, Damage
M Hose Steel Braiding, Damage, Corrosion
M Hose End Fitting, Damage, Bent, Kinked
M Control Valve, Steering Cylinder, Leaks
M Orbital Pump, Hose, Tube, Oil Leaks
M Swivel Joints, Pin, Bearings, Locks

K - HYDRAULIC SYSTEM S R N/A COMMENTS

Clean – Free of Dust, Dirt, Oil & Grease
M Lift Cylinder, Pin, Bushing, Oil Leaks
M Tilt Cylinder, Pin, Bushing, Oil Leaks
M Shift Cylinder, Pin, Bushing, Oil Leaks
M Hydraulic Pump, Noise, Oil Leaks
M Control Valves, Hose, Oil Leaks
M Hydraulic tank, Filters, Capseal, Oil leaks
Tank, Mountings, Bolts
M Hoses, Tubes, Oil Leaks
M Hose Rubber Insulation, Damage
M Hose Steel Braiding, Damage, Corrosion
M Hose End Fitting, Damage, Bent, Kinked
 Banyu Urip Project
Production Processing Facilities

L - MAST ASSEMBLY S R N/A COMMENTS

Clean – Free of Dust, Dirt, Oil & Grease
Mast, Boom Guide, Mountings
Inner Section Rollers & Guide
Lift Chain, Rollers & Backrest
Fork Extension
Counterweight

M - SUSPENSION S R N/A COMMENTS

Clean – Free of Dust, Dirt, Oil & Grease
Kingpin, Track Rod Bushings
Front/Rear Axle Mountings
Axle Stabilizer Bar, Mountings