MACHINERY, TOOLS AND EQUIPMENT SAFETY

OHS-PR-09-10-F07 (A) PNEUMATIC EQUIPMENT QUARTERLY

INSPECTION
Operating Area: Department:
Project Name:
Contractor Name: Project Type: Contract No.:

Notes: Do not “tick”. Write Ok or use the code of the specific deviation in the legend. If the Equipment is defective it must be tagged “Defective”and must be
reported to the person responsible for the repair of the equipment. If the equipment is beyond repair it must be destroyed and discarded. New
equipment to replace the discarded equipment must be obtained to discourage the use of make shift equipment.
LEGEND: OK – ALL IN GOOD CONDITION, ELM– EQUIPMENT LOST OF MISSING, REP – EQIPMENT BEING REPAIRED, C – COMMENTS
DEV 1 Equipment ID cannot be read DEV 7 Governor not in working order
DEV 2 Connections loose and in poor condition DEV 8 Max working pressure exceeded
DEV 3 Lugging in poor condition DEV 9 Tool not lubricated
DEV 4 Air strainer dirty DEV 10 Hoses damaged
DEV 5 Trigger faulty DEV 11 Guard
DEV 6 Regulator missing or damaged DEV 12 Other

ID NO LOCATION 1st QUARTER 2nd QUARTER 3rd QUARTER 4th QUARTER

Name of Inspector:
Date of Inspection
Signature

COMMENTS:
ID NO COMMENTS LOG

OHS Forms  Procedure Reference Revision Number Revision Date Approved By

PNEUMATIC EQUIPMENT QUARTERLY INSPECTION OHS-PR-09-10-F07 (A) 0 MAY 2021 OHSMS
 MACHINERY, TOOLS AND EQUIPMENT SAFETY
OHS-PR-09-10-F07 (A) PNEUMATIC EQUIPMENT QUARTERLY
INSPECTION
Operating Area: Department:
Project Name:
Contractor Name: Project Type: Contract No.:

OHS Forms  Procedure Reference Revision Number Revision Date Approved By

PNEUMATIC EQUIPMENT QUARTERLY INSPECTION OHS-PR-09-10-F07 (A) 0 MAY 2021 OHSMS