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    Form-094-Loader Safety Checklist

    Uploaded by

    shamroz khan
    This document is a loader safety checklist that contains 10 items to inspect including the bucket, wheels, safety forms, controls, lights, weight, and other safety devices. Each item lists the inspection method and includes space to note the inspection results and attach photos. The checklist is to be completed with the project site, subcontractor, equipment number, and inspection date. An inspector and site engineer must sign off on the completed form.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Form-094-Loader Safety Checklist

    Uploaded by

    shamroz khan
    2K views2 pages
    This document is a loader safety checklist that contains 10 items to inspect including the bucket, wheels, safety forms, controls, lights, weight, and other safety devices. Each item lists the inspection method and includes space to note the inspection results and attach photos. The checklist is to be completed with the project site, subcontractor, equipment number, and inspection date. An inspector and site engineer must sign off on the completed form.

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    This document is a loader safety checklist that contains 10 items to inspect including the bucket, wheels, safety forms, controls, lights, weight, and other safety devices. Each item lists the inspection method and includes space to note the inspection results and attach photos. The checklist is to be completed with the project site, subcontractor, equipment number, and inspection date. An inspector and site engineer must sign off on the completed form.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    2K views2 pages

    Form-094-Loader Safety Checklist

    Uploaded by

    shamroz khan
    This document is a loader safety checklist that contains 10 items to inspect including the bucket, wheels, safety forms, controls, lights, weight, and other safety devices. Each item lists the inspection method and includes space to note the inspection results and attach photos. The checklist is to be completed with the project site, subcontractor, equipment number, and inspection date. An inspector and site engineer must sign off on the completed form.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Form-094

    Loader Safety Checklist


    Rev.: AC Date: 19 03 2018

    PJT site: Subcontractor: Register No.: Inspection date:

    ⑤
    ③
    ① ⑦ ④ ⑥ ⑧
    ②

    no. part Item inspection method S S M T W TH inspection photo

    Use standardized bucket and


    ① Bucket connecting part and bucket itself should
    not have any crack, deform and damage

    Track, Wheel (tire) should not have any cracks


    ② wheel (tire) or deformation and has good Bucket Wheel (tire)
    connection status

    Operators Operators Safety Induction Form


    ③ Induction should be signed by the operator.
    form

    Controller Controller, clutch and brakes should


    ④ & brake work fine and seat belt needs to be
    Rear view Controller
    attached camera

    Rear view Rear view mirror needs to be attached


    ⑤ mirror & properly and alarm device should
    alarm function normally

    Hydraulic There shouldn't be problems like


    ⑥ device & leakage, damage or worn-out on
    Alarm device Hydraulic
    cylinder hydraulic motor, cylinder, pipe cylinder

    Function of headlight, Reverse Alarm


    ⑦ Lamp& ,Beconlights, taillight, fog lamp and mars
    Alarms light should work properly

    Counter Extra weight should not be added and


    ⑧ weight connection status of fixing bolt & nut
    should be firm Lamp Counter weight

    Other Side footboard, protection facilities for


    ⑨ safety driver's seat, limit switch for crash
    device protection should be in safe condition

    ⑩ etc
    Screens All screen curtains & view obstructions
    should be removed operators cabin

    Inspector's
    opinion
    Inspector Name: (signature) In
    Site Engineer ec

    Page 1 of 2 M3-FST-FOR-HSE00-GEN-000094
    Page 2 of 2 M3-FST-FOR-HSE00-GEN-000094

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