PT.

DEPRIWANGGA OM
PROJECT ROAD MAINTENANCE
MEDCO BANGKANAI

MONTHLY INSPECTION CHECK LIST

EXCAVATOR
Date of Inspection 20/06/2024
Serial Number DWOM-EXCA-04
Model Kobelco SK 200

NO DESCRIPTION GOOD FAIR POOR N/A REMARKS

1 Kelengkapan Surat ✓
SIO ✓
SILO ✓ Exd. 2025
2 Sistem Pengereman ✓
Rem ✓
Rem Parkir ✓
Rem Swing ✓
Rem Holding ✓
3 Lampu ✓ Lampu kerja tidak lengkap
Lampu Belakang ✓
Lampu Utama ✓ Lampu kerja tidak lengkap
Lampu Rem ✓
4 Safety devices ✓
Lampu Rotary ✓
Alarm Mundur ✓
Alarm Swing ✓
Safety Belt ✓
Klakson ✓
Spion ✓
5 Safety Kit ✓
APAR ✓
P3K ✓
6 Boom ✓
Boom ✓
Cylinder Release ✓
 Bucket ✓
Kuku Bucket ✓ Kuku hilang 2
Pin Bucket ✓ Tidak sesuai
7 Mobile Devices ✓ Track bermasalah
Track Shoe ✓
Roller Atas ✓ Oblak
Roller Bawah ✓ Oblak
8 Oil, fuel, lubricant ✓ Kurang maintenance
Pelumas Engine ✓
Pelumas Hidrolic ✓
Oil leaks ✓ Banyak rembesan oli
Radiator Coolant ✓
Grease ✓ Kurang preventif
Battery ✓
9 Panel ✓
10 Kondisi Cabin ✓
11 Utility ✓ Kotor opt kurang rispace
Wiper ✓
Kaca Kabin ✓
Operator Acces ✓
12 Pin / Bolt ✓ Banyak mempergunakan
besi tonaser
13 Filter Fuel ✓
Filter Hidrolik ✓
Filter oli mesin ✓

Inspected by : Inspected by :
Name FAJAR Name

Position HSE Position

Sign Sign

Acknowledge by :
Name HADID

Position SPV

Sign