Form 000.653.

F0107
Inspection Report - General Line Equipment
TOC

Inspection Reports - General Line Equipment

Aerial Lifts
Aerial Work Platform Area
Air Compressor
Ditching Machine
Light Plant
Material Personnel Hoists - Day
Material Personnel Hoists - Monthly
Scissor Lift
Welding Machine

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 1 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
AerialLifts

Company Name: Date:

Equipment No: Serial No:
Type of Equipment: Model No:
Make: Location:
Hours: Project/Contract No:
The following items must be checked as applicable. If not applicable so indicate.
Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
GENERAL APPEARANCE
Hood and Panels
Paint
Tires - Condition
Undercarriage
ENGINE COMPARTMENT
Battery - Condition/Charge Level
Exhaust System
Fan/Radiator/Belts/Hoses
Fuel/Water/Oil/Lines
Governor/Idling Device
Oil Level and Condition
Oil Pressure
OPERATOR'S POSITION
Controls
Decals and Labels
Engine Condition
Gauges/Instruments
Starting/Charging System
Warning Lights
AERIAL PLATFORM
Auxiliary Power System
Backup Alarm
Basket and Door
Boom Condition
Control Labels
Emergency Lowering
Ground Controls
Hydraulic Components
- Fluid and Filter
- Hoses and Couplers

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 2 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
AerialLifts

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
Platform
- Anchorage Points
- Guardrails, Toeboards
Platform Controls
Power Track
Safety Circuits
Scissor Arms
Tilt Arm
Tires - Condition, Type
- Left Front
- Left Rear
- Right Front
- Right Rear
Wear Pads
OTHER
Fire Extinguisher
Operator’s Manual
PTO
Service Manual
Structural Welds/Condition

SIGNATURES:

Inspected By: Estimated Hours to Repair:

Approved By:

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 3 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
AerialWorkPlatformArea

Project Name: Date:

Equipment Make: Equipment Model:

Equipment Work Location:

1. Operator's license date: Operator Qualified for AWP to be utilized: Yes No

2. STA complete, noting use of AWP? Yes No

3. Pre-use inspection report complete? Yes No

Operators manual available? Yes No

4. Designated spotter/flagger in place? Yes No

Will more than 1 spotter/flagger be necessary? Yes No

5. Working in the vicinity of powerlines? Yes No

If "yes" describe:

Powerline work:

6. Ground conditions adequate to support equipment? Yes No

Mats needed to support equipment? Yes No

7. Weather conditions: (wind, etc.)

8. Barricade and tags around work area? Yes No

Tail swing radius free of crushing hazard(s)? Yes No

Print Names:

Equipment Operator:

Supervisor:

Signatures:

Equipment Operator:

Supervisor:

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 4 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
AirCompressor

Company Name: Date:

Equipment No: Serial No:
Type of Equipment: Model No:
Make: Location:
Hours: Project/Contract No:
The following items must be checked as applicable. If not applicable so indicate.
Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
GENERAL APPEARANCE
Hood and Panels
Paint
Tires - Condition
Undercarriage
ENGINE COMPARTMENT
Battery - Condition/Charge Level
Coolant - Level - Protect
Exhaust System
Fan/Radiator/Belts/Hoses
Fuel/Water/Oil/Lines
Governor/Idling Device
Oil Level and Condition
Oil Pressure
OPERATOR'S POSITION
Controls
Decals and Labels
Engine Condition
Gauges/Instruments
Starting/Charging System
Warning Lights
AIR COMPRESSOR
Air Valves and Receiver

Condition of air pressure receiver tank

(tank hydrostatic tested)

Condition of pressure relief valve for

pressure receiver tank (calibrated)
Cooling System
Leaks
Oil Level and Condition
Oil Separator
Operating Pressure
Protection System

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 5 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
AirCompressor

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 6 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
AirCompressor

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
OTHER
Fire Extinguisher
Operator’s Manual
Service Manual

SIGNATURES:

Inspected By: Estimated Hours to Repair:

Approved By:

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 7 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
DitchingMachine

Company Name: Date:

Equipment No: Serial No:
Type of Equipment: Model No:
Make: Location:
Hours: Project/Contract No:
The following items must be checked as applicable. If not applicable so indicate.
Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
GENERAL APPEARANCE
Hood and Panels
Paint
Tires - Condition
Undercarriage
ENGINE COMPARTMENT
Battery - Condition/Charge Level
Coolant - Level - Protect
Exhaust System
Fan/Radiator/Belts/Hoses
Fuel/Water/Oil/Lines
Governor/Idling Device
Oil Level and Condition
Oil Pressure
OPERATOR'S POSITION
Controls
Decals and Labels
Engine Condition
Gauges/Instruments
Starting/Charging System
Warning Lights
DITCHING MACHINE
Blade
Hydraulic Fluid Level
Hydraulic Pressure
Trenching Chain

Copyright © 2017 Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 8 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
DitchingMachine

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
OTHER
Fire Extinguisher
Operator’s Manual
Service Manual

SIGNATURES:

Inspected By: Estimated Hours to Repair:

Approved By:

Copyright © 2017 Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 9 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
LightPlant

Company Name: REDA Hazard Control Date: 16-Jan-21

Equipment No: RD-16 Serial No: MG-020056E
Type of Equipment: Welding Machine Model No:
Make: Miller Location: HB-MCBP
Hours: Project/Contract No: A8JE-00-K013
The following items must be checked as applicable. If not applicable so indicate.
Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date
1/16/2021 1/17/2021 1/18/2021 1/19/2021 1/20/2021 1/21/2021 1/22/2021
Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
GENERAL APPEARANCE
Hood and Panels
Paint
Tires - Condition
Undercarriage
ENGINE COMPARTMENT
Battery - Condition/Charge Level
Cooland - Level - Protect
Exhaust System
Fan/Radiator/Belts/Hoses
Fuel/Water/Oil/Lines
Oil Level and Condition
Oil Pressure
OPERATOR'S POSITION
Controls
Decals and Labels
Engine Condition
Gauges/Instruments
Starting/Charging System
OTHER
Fire Extinguisher
Light Fixtures/Bulbs
Light Supports
Operator’s Manual
Service Manual
Winch/Cable

SIGNATURES:

Inspected By: Jainuddin Ali Estimated Hours to Repair:

Approved By: Muhammad Umar

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 10 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
MaterialPersonnelHoists-Day

KEY: I = INSPECTION PC = PERFORMANCE CHECK

ITEM KEY DAY 1 DAY 2 DAY 3 DAY 4 DAY 5 DAY 6 DAY 7
Base & Landing Enclosures I
Bicycle Wheel I
Car Gate Latches PC
Car Interlock Switches PC
Cathead Sheaves I
Condition of Control Cable I
Condition of Supply Cable I
Control Panel I
Counterweight Cable Clamps I
Counterweight Rollers I
Damage/Settling of any Support Structure of Base
I
Slab
Drive Motor Coupling Bolts & Nuts I
Gate Interlock Switches PC
Gearbox Oil level I
General Housekeeping of Platform & Landings I
Limit Switches PC
Mast (Bent or Damaged Sections) I
Operation of Emergency Brake PC
Operation of Motor Brake PC
Required Signs & Postings I
Unusual Noises PC
Wall Tie Assemblies I
Wear on Guide Rollers, Pinion Gears, & Rack I
Daily Hours of Operation
COMMENTS/CORRECTIVE ACTIONS:

HOIST MODEL: SERIAL NO.:

OPERATOR: DATE(s) CHECKED:

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 11 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
MtrlPersonnelHoists-Monthly

KEY: I = INSPECTION PC = PERFORMANCE CHECK L = LUBRICATE

MONTH MONTH MONTH MONTH MONTH MONTH
ITEM KEY
Base & Landing Enclosures I
Bicycle Wheel I
Car & Counterweight Buffers I
Car Gate Latches PC
Car Interlock Switches PC
Cathead Sheaves I/L
Condition of Control Cable I
Condition of Supply Cable I
Control Panel I
Counterweight Cable Clamps I
Counterweight Rollers I
Damage/Settling of any Support Structure of Base
I
Slab
Drive Motor Coupling Bolts & Nuts I
Drive Motor Pinion I
Gate Interlock Switches PC
Gear Rack I/L
Gearbox Oil level I
General Housekeeping of Platform & Landings I
Governor & Drive Pinion I
Limit Switches PC
Mast (Bent or Damaged Sections) I
Operation of Emergency Brake PC
Operation of Motor Brake PC
Required Signs & Postings I
Unusual Noises PC
Wall Tie Assemblies I
Wear on Guide Rollers, Pinion Gears, & Rack I
Wear on Tower Legs I
Daily Hours of Operation
COMMENTS/CORRECTIVE ACTIONS:

HOIST MODEL: SERIAL NO.:

OPERATOR: DATE(s) CHECKED:

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 12 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
ScissorLift

Company Name: Date:

Equipment No: Serial No:
Type of Equipment: Model No:
Make: Location:
Hours: Project/Contract No:
The following items must be checked as applicable. If not applicable so indicate.
Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
GENERAL APPEARANCE
Hood and Panels
Paint
Tires - Condition
Undercarriage
ENGINE COMPARTMENT
Battery - Condition/Charge Level
Exhaust System
Fan/Radiator/Belts/Hoses
Fuel/Water/Oil/Lines
Governor/Idling Device
Oil Level and Condition
Oil Pressure
OPERATOR'S POSITION
Controls
Decals and Labels
Engine Condition
Gauges/Instruments
Starting/Charging System
Warning Lights
PLATFORM
Auxiliary Power System
Backup Alarm
Basket and Door
Control Labels
Emergency Lowering
Ground Controls
Hydraulic Components
- Fluid and Filter
- Hoses and Couplers

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 13 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
ScissorLift

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
Platform
- Anchorage Points
- Guardrails, Toeboards
Platform Controls
Power Track
Safety Circuits
Scissor Arms
Tires - Condition, Type
- Left Front
- Left Rear
- Right Front
- Right Rear
Wear Pads
OTHER
Fire Extinguisher
Operator’s Manual
Service Manual

SIGNATURES:

Inspected By: Estimated Hours to Repair:

Approved By:

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 14 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
WeldingMachine

Company Name: REDA Date:

Equipment No: Serial No:
Type of Equipment: Welding Machine Model No:
Make: Miller Location: HB - MCBP
Hours: Project/Contract No: A8JE-00-K013
The following items must be checked as applicable. If not applicable so indicate.
Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
GENERAL APPEARANCE
Hood and Panels
Paint
Tires - Condition
Undercarriage
ENGINE COMPARTMENT
Battery - Condition/Charge Level
Exhaust System
Fan/Radiator/Belts/Hoses
Fuel/Water/Oil/Lines
Governor/Idling Device
Oil Level and Condition
Oil Pressure
OPERATOR'S POSITION
Controls
Decals and Labels
Engine Condition
Gauges/Instruments
Starting/Charging System
Warning Lights
WELDING MACHINE
Cooling Fan
Lead Studs/Receptacles
Out-Put Power Open
Voltage
Welder Generator
Wiring

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 15 of 16 Health, Safety, and Environmental
 Form 000.653.F0107
Inspection Report - General Line Equipment
WeldingMachine

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
OTHER
Fire Extinguisher
Operator’s Manual
Service Manual

SIGNATURES:

Inspected By: Shahul Hameed Estimated Hours to Repair:

Approved By: Muhammad Umar

Copyright © 2017, Fluor Corporation. All Rights Reserved.

Form Date: 31Jul2017
Page 16 of 16 Health, Safety, and Environmental