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Doc No Vibrator Soil Compactor

Contractor: Report No

Doc. No : Location :

Work Description Date:

S No. Description Yes No Remarks

From the ground:

1 Tires, Wheels, Lug Nuts, Stem CapsInflation, Leaks, Damage, Wear

2 Leveling BladeExcessive Wear, Damage, Leaks

3 Cutting Edges (Leveling Blade)Excessive Wear, Damage
4 Drum ScrapersExcessive Wear, Damage
5 Drum Cooling OilLeaks
6 Vibratory SupportLeaks
7 Eccentric Weight HousingLeaks
8 Isolation MountsDamage, Cracking, Splitting
9 Steering Cylinders / EndsDamage, Wear / Leaks
10 Steps and HandholdsCondition, Cleanliness
11 Underneath MachineLeaks, Damage
12 Axles – Final Drives (Axle / Drum)Leaks, Damage, Wear
13 Hydraulic Tank & FiltersFluid Level, Damage, Leaks
14 Fuel TankFuel Level, Damage, Leaks
15 All Covers and GuardsDamage, Securely Attached
Lights, Front and Rear, BeaconFunction, Damage to Lens, Housing,
16
or Wiring
17 Battery CompartmentCleanliness, Loose Nuts & Bolts
Engine Compartment:
18 Engine Oil (Fluid level)
19 Engine Coolant (Fluid level)
20 Radiator /AC Condenser/Oil Cooler ( Fin, Blockage, Leaks)
21 All Hoses (Cracks, wear spots, Leaks)
22 Fuel Filters / Water Separator ( Leaks, Drain water)
23 All Belts (Tension, Wear, Cracks)
24 Air Filter ( Service Indicator)
25 Overall Engine Compartment ( Trashor dirt build up leaks)
On the Machine outside the Cab:
26 Handholds (Condition and Cleanliness)
27 ROPS (Damage, Loose Mounting Bolts)
28 Fire Extinguisher (Charge, Damage)
29 Windshield, Windows (Broken Glass, Cleanliness)
30 Windshield Wipers / Washers (Wear, Damage / Fluid Level)
31 Doors (Open properly, broken glass)
Inside the Cab:
32 Seat (Adjustment-Height, Weight, Able to Reach Pedals)
33 Seat Belt & Mounting (Damage, Wear, Adjustment, Age)
34 Horn, Backup Alarm, Lights (Proper Function)
35 Mirrors (Damage, Adjust for Best Visibility)
36 Gauges, Indicators, Switches, Controls (Damage, function)
37 Overall Cab Interior (Cleanliness)
Contractor's Company Client's
Representative Representative Representative
Signature:

Name:

Date: