Safety Checklist

Equipment: Tipper
Make & Model:
Registration Number:
Asset Number (For Own Equipment):
Project Name:
Vendor Name (For Rental Equipment):
Month and Year of Manufacturing:
Note: Any of the following parameter is found "Not OK", RED Tag should be pasted on the machine till it is r
Instruction: Put "√" for "OK" condition and put "X" for "Not OK" condition.

Sr. No. Parameter Remarks

1 Age of the machine (Less than 5 Years)
2 Brake - Main
3 Brake - Parking
4 Front Horn
5 Automatic Reverse Horn
6 Fronts Head Lights (Right and Left)
7 Brake Lights (Right and Left)
8 Reverse Lights (Right and Left)
9 Indicator - Rear & Front (Right and Left)
10 Wind shield
11 Wipers
12 Front Tyres condition (Right and Left)
13 Rear Tyres condition (Right and Left)
14 Side view mirrors (Right and Left)
15 Fire extinguisher
16 First Aid Box
17 Wedge Block
Side Protection Guard.
18 (To protect any moving item / person from coming under the
tipper.)
Remarks (if any):

Operator / Driver
Name &
SHE In-Charge
Signature
Fleet & Resource In-Charge
n the machine till it is rectified.
 Check List for Tractors, Tippers & Trailers
Equipment Name/FA.No: Date of Audit:
Reg. No.: Eng. No.: Chassis No.:
Vendor Name: Location :
Sr.No Status of following parts to be checked Present Condition
1 Engine condition
2 Clutch / Transmission
3 Suspension (Condition of leaf springs)
4 Condition of Axles
5 Tyres Condition
6 Steering
7 King Pin
8 Brake system
9 Parking Brake Condition
10 Hub Greasing ( When previously done)
11 Electrical contact points/Fuse / Lights
12 Battery
13 Engine Hour meter
14 Front & Reverse Horn Condition
15 All the gauges in the cabin

16 Condition of cabin
17 Any Oil leakage
Condition of lubrication points
18 (Grease nipples in UJ cross etc.)
19 Condition of pins and bushes
20 condition of Body(Tipper/Trailer)

21 Condition of Tipping jack cylinder (in case of tippers)

22 Foot Rest (Physical Condition)
23 Fan belt
24 Radiator
25 Engine Oil Consumed
26 Total Engine Hours Run

27 Any Other remarks regarding the health of the crane

28 Daily Log book recodrings done
29 Operators Name
30 Number Plate as per M.V act.
 31 RTO Details

32 Equipment Suitable for Hiring (YES/NO)

Inspected By Authorised Sign - Project Project FED Incharge

EXPECTING DATE OF AUDIT REVIEW:

Sr.No Progress of the observation Action Taken
1
2
3
4
Responsed Persons: Reviewed By:
1. FE Incharge:
2. Name of the operator :