Banyu Urip Projecy Date :

Production Processing Facilities Rev No. :

Dept :
Excavator Daily Inspection Check List Ref No :

Date of Inspection/Tanggal Pemeriksaan :

Location of Inspection/Lokasi pemeriksaan :

Identification Number/Nomor identifikasi :

Inspected by/Diperiksa Oleh :

Contractor/Kontraktor :

Condition
No Requirement Remarks
Good Bad N/A
1 Wiper/Pembersih Kaca
2 Horn/Klakson
3 ESD. System/Sistem ESD
4 Seat belt/Sabuk Pengaman
5 Hydraulic system and hose condition/ Sistem Hydraulic dan
Kondisi Selang
6 Mirror/Spion
7 Lightings including electrical system/ Lampu-lampu termasuk
sistem elektrik
8 Rotary light/Lampu rotary
9 Cabin condition/Kondisi Kabin
10 Battery connection and protective cover/ Koneksi baterai dan
penutup
11 Engine and fuel system (leaks)/Mesin dan sistem minyak
(Kebocoran)
12 Tires / track condition/Ban/Kondisi track
13 Bucket/Boom and arm condition including joint pin /Kondisi
Baket/boom dan lengan termasuk pin
14 Electrical cable connection, isolation/ Koneksi kabel elektrik,
isolasi
15 Fire extinguisher/Pemadam Kebakaran
16 First aid kit/Kotak P3K
17 Personal Protective equipment/APD
18 Air conditioner/Fan/Pendingin udara/kipas angin
19 Indicator system (Fuel, oil, temp, etc)/Sistem indikasi (Minyak,
oli, panas, dll)
20 Secondary containment (Penampung kebocoran)
Comment and recommendation

Inspected by, Witnessed by, Acknowledged by,

Operator Safety Advisor Site Supervisor