Form-096

Dozer Safety Checklist

Rev.: AC Date: 19 03 2018

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

④① ⑧
② ⑨③
⑤
⑥
⑦

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

Emergency Power is cut when button is pressed.

① stop button Button should be red and only
manipulated by hand

Operators Operators Safety Induction Form

② Induction should be signed by the operator. rear view
Emergency
form surveillance
stop button camera

Controller, Controller, clutch, brakes should

③ Brakes operate normally with seat belt

Rear view Rear view mirror should properly

④ mirror & installed and alarm should work
Alarm normally Controller Rear view mirror

Hydraulic There shouldn't be problems like

⑤ device & leakage, damage or worn-out on
cylinder hydraulic motor, cylinder, pipe

Track should not have any crack,

⑥ Track damage and deformation with proper
tension Hydraulic track, wheel
cylinder

Main Main structure, assemble part, active

⑦ structure part should not have any deformation
and damages

Function of headlight, Reverse Alarm

⑧ Lamp& ,Beconlights, taillight, fog lamp and mars
Alarms light should work properly Main structure lights

All screen curtains & view obstructions

should be removed operators cabin
⑨
Screens
Inspector's
opinion

Inspector Name: (signature) In

Site Engineer ec
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