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UPGRADE BUILDING FOR RISK MITIGATION-RTR

10-02062

Roller Plate Compactor

Equipment Model/Serial #: ________________________/____________
Equipment Certification Expiry Date: _______________
Inspection Month: _________________
# ‫ سیریل‬/ ‫سامان ماڈل‬ ‫سامان تصدیق نامہ ختم ہونے کی تاریخ‬ ‫معائنہ مونٹ‬
Date

Sat Sun Mon Tue Wed Thu Fri

General Body Condition

Fuel Tank Condition

Oil & Fuel Leakage

Engine Compartment Condition

Fan, Belt, Tension(If Applicable)

Items to be Acceleratror Lever Condition

inspected ‫سامان‬
‫معائنہ کیا جائے‬ Moving Part Properly Guarded

Exhaust System

Starter Parts Condition

Compactor Plate Condition

Handle Condition

Monthly Inspection Sticker

Inspected by Inspected by: (Heavy Checklist shall be filled & counter sign by
Equipment Operator) the operator on a daily basis.

Safety Officer Incharge to checked &

Checked & Verified by: (Incharge Safety
verify the condition of Equipment &
Officer)
counter sign on a daily basis.

All the findings of the Checklist has to be fixed. The checklist has to be filed. ‫چیک لسٹ کے تمام نتائج کو طے کرنا ہوگا۔ چیک لسٹ دائر کرنا ہے۔‬
Legend: OK -In Good Condition ‫ٹھیک ہے میں اچھی حالت میں‬
NOT OK - Damaged, for repair/replacement ‫ متبادل کے ل‬/ ‫ مرمت‬، ‫نوٹ ٹھیک ہے نقصان پہنچا‬.
N/A -Not Applicable ‫قابل اطالق نہیں‬
List of Heavy Equipement Deficiencies (if Any) for Immediate Rectification

5
‫آپریٹر کا نام‬

Operator Name: _______________________________________ Verified by (Safety Incharge): __________________

‫ میعاد ختم ہونے کی تاریخ‬/ # ‫آپریٹر کا سرٹیفیکیشن‬ ‫حفاظتی دستخ‬

Operator Certification #/Expiry Date: ____________/_________ Safety Signature: ____________________