Professional Documents
Culture Documents
: Date :
1 Body Condition
⑤
2 Install Automatic Electric Protection Device
5 Quality Certification
⑨
6 Cable Joint & Cable Condition
11 Fire Extinguisher
13 Grounding / Earthing
Insulation Resistance(Ω)
14 * Above 200Ω for Between 120V and 250V / 300Ω for Between 300V and 400V
Ω
Tig/Auto Welding Machine Checklist ID / Serial No. : Date :
②
3 Confirmation & Action Lamp Condition
③
①④
4 Quality Certification
⑤⑥⑦⑧
5 Cable Joint & Cable Condition ⑨⑩⑪
Remote Control or
9
Torch Switch Connector Condition
12 Grounding / Earthing
Insulation Resistance(Ω)
13 * Above 200Ω for Between 120V and 250V / 300Ω for Between 300V and 400V
Ω
Oxygen(Gas) Welding Machine Checklist ID / Serial No. : Date :
③④⑥⑩
2 Oxygen & Acetylene Supply Hose Condition
②
3 Instruments & Valve Condition
6 Authorized Welder
⑤
7 Fire Extinguisher
⑥
3 Nut of Drill Tip condition
④
4 Quality Certification ⑦⑧
Insulation Resistance(Ω)
9 * Above 200Ω for Between 120V and 250V / 300Ω for Between 300V and 400V
Ω
Cutting Machine Checklist ID / Serial No. : Date :
7 Body Condition ④
3 Quality Certification
Insulation Resistance(Ω)
8 * Above 200Ω for Between 120V and 250V / 300Ω for Between 300V and 400V
Ω ①⑤
③④
Extension Cable Checklist ID / Serial No. : Date :
1 Body Condition
5 Quality Certification
Insulation Resistance(Ω)
8 * Above 200Ω for Between 120V and 250V / 300Ω for Between 300V and 400V
Ω
Transformer & Fan Checklist ID / Serial No. : Date :
1 Body Condition
5 Quality Certification
Insulation Resistance(Ω)
8 * Above 200Ω for Between 120V and 250V / 300Ω for Between 300V and 400V
Ω
Excavator Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
④
⑩
③ ①
②
⑦
⑨ ⑤
⑧
⑥
No. Item Inspection Method Result Guide Photo
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Pile Driver Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
①
⑨
③
⑥ ⑧
④ ⑤ ⑦
No. Item Inspection Method Result Guide Photo
Over winding
Before hook, hammer reach to highest point,
1 prevention
operation should stop with alarm sounds
device
Reverse
Reverse rotation prevention device and brakes
8 rotate
should work properly without any problems
prevention Counter weight Brake
Assembly part and active part of main structure
Main
9 structures
such as turntable and back stay should not have
any abnormalities
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Dump Truck Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
② ⑦
③
④
⑥ ⑤ ①
Hydraulic
There shouldn't be any leakage, damage and
4 device &
abrasion on hydraulic motor, cylinder and pipes
cylinder Alarm device Hydraulic device
8
Automatic cover
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Concrete Mixer Truck Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
①
②
③
⑤
Rear view
Rear view mirror should be properly attached
2 mirror &
and alarm device needs to work normally
alarm Controller Alarm device
Hydraulic There shouldn't be problems like leakage,
3 device & damage or worn-out on hydraulic motor, cylinder,
cyliner pipe
Other
Side footboard, wheel stopper should be
6 safety
installed well
devices Lamp Brake
1. STNK+PAJAK / Vehicle Registration
Certificate + Tax
Required 2. Kier dari DISHUB / kier from land
7 Document transportation services
3. SIM BII dari kepolisian lalulintas / Valid
Driving Licenses
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Trailer Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
Rear view
Rear view mirror should be properly attached
2 mirror &
and alarm device needs to work normally
alarm Controller Alarm device
Hydraulic There shouldn't be problems like leakage,
3 device & damage or worn-out on hydraulic motor, cylinder,
cyliner pipe
Other
Side footboard, wheel stopper should be
6 safety
installed well
devices Lamp Brake
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Concrete Pump Car Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
①
②
⑦ ⑥ ④
⑤
No. Item Inspection Method Result Guide Photo
Slewing
Fixing bolt of slewing device should have
6 device
abnormalities like loosened part
(Turntable) Wheel (Tire) Slewing device
Other safety
10 device
Side footboard should be installed well
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Tunnel High Platform Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑦ ④ ⑦
④
①
② ①
③ ②
⑤ ⑤
⑥ ①
⑧
⑨
⑨ ⑧
No. Item Inspection Method Result Guide Photo
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Motor Grader Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Loader Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑤
③
① ⑦ ④ ⑥ ⑧
10
Etc
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Road-Pavement Machine Safety Checklist
(Asphalt finisher / Concrete spreader)
Company Name: ID / Serial No.: Inspection Date:
② ①
⑤ ③
④ ⑥
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Asphalt Spreader Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
Rear view
Rear view mirror should be normally attached
2 mirror &
and alarm device needs to work properly
alarm Controller Alarm
Hydraulic There shouldn't be problems like leakage,
3 device & damage or worn-out on hydraulic motor,
cylinder cylinder, pipe
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Dozer Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
④① ⑧
② ⑤ ⑨③
⑥
⑦
Rear view
Rear view mirror should properly installed and
4 mirror &
alarm should work normally
Alarm controller Rear view Mirror
Hydraulic There shouldn't be problems like leakage,
5 device & damage or worn-out on hydraulic motor,
cylinder cylinder, pipe
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Drill Machine Safety Checklist
(Earth drill / Crawler drill / Jumbo drill / Earth auger)
Company Name: ID / Serial No.: Inspection Date:
③
①
⑥
④
⑤
②
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Condolidation Settlement Safety Checklist
(Sand drain / Paper drain / Pack drain)
Company Name: ID / Serial No.: Inspection Date:
①
①
⑦
④ ④
⑤ ③
④
②③ ⑤②
⑩⑨ ⑧ ⑧
⑥ ⑨ ⑥ ⑥
Overwinding
Hook and hammer stops with alarm sound
1 prevention
before they reach to the highest point
device
Reverse
Reverse rotation prevention device and brakes
2 rotation
should work well without any problem Over winding Reverse rotation
prevention
prevention device prevention device
Wire rope must have no wire cut and end
3 Wire rope
terminal should be in good condition
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Roller Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Forklift(Highlander) Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑨ ⑦
③
① ⑧ ②
⑥
⑤ ④
No. Item Inspection Method Result Guide Photo
Rear view
Rear view camera should be on at all times
1 surveillance
without any problem on monitor
camera
Rear mirror & Rear view mirror should properly attached and
3 alarm device alarm device need to work normally
Hydraulic
There shouldn't be any damage, worn-out and
4 device and
leakage on hydraulic motor, cylinder, pipe
cylinder Alarm device Hydraulic device
Track, Wheel Wheel (tire) should not have any cracks and
5 (Tire) has good connection condition
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
High Platform(Scissor) Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑨
⑦
①
⑩ ⑧
⑤
② ③
⑥
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
High Platform(Boom)Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑦ ⑥
①/②
⑧ ⑤
④
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
High Platform Car Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑤
⑥
②
① ③ ⑨⑧
④
⑦
⑩
Slewing
Fixing bolt should not be loosen and platform
6 device and
needs to have fall prevention device
platform Wire rope Slewing device
Main structure like welded part should not
7 Exterior have deformation, crack and hydraulic device
doesn't have problems
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Removal Van Lift Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
①
⑩
② ⑨
⑤
⑧ ⑦ ⑥
⑥
⑩
⑧③ ④
Slewing
Fixing bolt of slewing device should not have
6 device
abnormalities like loosened part
(Turn table) Wire rope Slewing device
Main structure like welded part shouldn't have
7 Exterior cracks or deformation and hydraulic device
should not have problems
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Tower Crane Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑨②⑩ ①
⑦ ⑧ ①
③ ⑥ ④
⑥⑤ ②
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Hydro Crane Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑦
⑨ ④
①
② ⑧
⑥
③ ⑤
No. Item Inspection Method Result Guide Photo
Hydraulic
Hydraulic motor, cylinder, pipe should not be
8 system and
worn, damaged and leak
cylinder Fixing pin Hydraulic cylinder
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Crawler Crane Safety Checklist
(Clamshell / Drag line)
Company Name: ID / Serial No.: Inspection Date:
⑤ ② ⑦
④
⑧ ⑥ ⑩
①
⑨
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Cargo Crane(Boom Truck) Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑨ ① ⑧
③
⑦
⑩ ②
④ ⑤
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Gondola Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
Fall
When main wire rope is cut, assisting wire
4 prevention
rope should work properly
device Emergency stop Fall prevention
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Passenger Car Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑨ ⑥
⑤
②
⑦ ⑧ ④
①
③
⑧
⑧
No. Item Inspection Method Result Guide Photo
Three phase
When upper and bottom limit switch is broken,
2 blocking
power should be shut down Overload limit Three phase
device
device blocking device
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Overhead Gantry Crane Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
⑧ ①
⑧ ⑧
②
⑥ ⑤
⑤④ ① ④
②
⑦
③ ⑦ ④ ⑨ ⑥
⑨
No. Item Inspection Method Result Guide Photo
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Winch-Hoist Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
①
⑥
①⑥ ⑦
② ⑤
⑧
④ ③
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Air Compressor Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
10
Oil tank Whip arrestor
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Vessel Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Electrical Panel Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
4 Earthing / Insulation
5 Earthing / Insulation
6 Distribution Diagram
8 Circuit Reading
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Lifting Gear Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
1 Broken Wires
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Fall-Arresting Equipment Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
2 All Stitching
6 Lanyard
7 Lifelines
8 Hook-Safety latch
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Fire Extinguisher Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
2 Correct Pressure
3 Accessibility
4 Hose / Nozzle
5 General Condition
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)
Safety Checklist
Company Name: ID / Serial No.: Inspection Date:
10
Inspector’s
Comments
Const. Safety
Inspector: (Sign.) Manager (Sign.) Manager (Sign.)