PT GRACIA DIKATAMAS

CRANE TRUCK INSPECTION CHECK LIST

Product Identification : Company :

Model No : Contract No :
Engine No : Date of Inspection :
Frame No : Location of Inspc :

No. ITEM CHECKED / BAGIAN YANG DIPERIKSA Remarks

A DRIVER INFORMATION / Informasi Pengemudi

1 Name of Driver / Nama Supir

2 Driver Licence Number / No SIM Pengemudi

3 Class of Driving Licence / Jenis SIM

4 Expire Licence / Masa Berlaku SIM

B VEHICLE INFORMATION / Informasi Kendaraan

1 Licence Plate / Nomor Polisi

2 STNK Valid to / Masa Berlaku STNK

3 BUBKB / KIR Valid to ( Only for Pic-Up vehicle )

4 Type of Vehicle-Merk /Tipe Kendaraan - Merek

5 Year of Built / Tahun pembuatan

ITEM CHECKED Availability Condition
No. Remarks
BAGIAN YANG DIPERIKSA Yes No Good Fair Poor
Ada Tidak Bagus Kurang Jelek
C VEHICLE CONDITION / Kondisi Kendaraan
1 Km Driven / Kilometer tempuh

2 Glass / Kaca:

2.1 Windshield / Kaca depan

2.2 Rear Window / Kaca belakang

2.3 Side Window / Kaca samping

Windshield wiper / karet pembersih kaca depan

3 Mirror / Spion

3.1 Side / Samping

- Left / Kiri

- Right / Kanan

4 Light / Lampu

4.1 Head / Depan

4.2 Tail / Belakang

4.3 Parking / Parkir

4.4 Indicator - Sign / Signal

4.5 Break / Rem

4.6 Rotary Lamp / lampu putar

5 Door Condition / Kondisi pintu

6 Type of Tire / Tipe Ban

6.1 Mud Type / Type Mud

6.1.1 Front / Depan

6.1.2 Rear / Belakang

7 Valve Tire Cap / Penutup lubang angin ban

8 Gas / fuel tank door / lid - Gas / Penutup tanki bahan bakar

9 Fuel tank, any leak ? / Tangki bahan bakar, ada kebocoran?

10 Engine / Mesin
 ITEM CHECKED Availability Condition
No. Remarks
BAGIAN YANG DIPERIKSA Yes No Good Fair Poor
Ada Tidak Bagus Kurang Jelek

11 Exhaust / Knalpot

12 Accu / Aki Electric System

13 Horn / Klakson

14 Safety belt / Sabuk pengaman

15 Speedometer / Speedometer
16 Break / Rem
17 Fuel indicator / Indikator bahan bakar
18 G.V.W : 23.000 Kg
19 Horse Power 220-250 HP/ 220-250 tenaga kuda

20 Double Rear Axle Configuration / Poros belakang Ganda

21 PTO Gear Box
22 Nut & Bolt Tire / Baut dan Mur Roda

23 V-Belt Engine / V - belt mesin

24 Hydraulic System / Sistem hidrolik

25 Transmission System / Sistim transmisi

26 Fire Extinguisher / Racun api

27 Manufacture’s Tool Kit / Perkakas

28 Vehicle Jack / Dongkrak

2 ea 3 Meter x5/8" heavy duty chain c/w 2 ea cleaves grab hook
29 on each chain / 2 buah, 3 M x 5/8" rantai pengikat beban berat
dengan 2 buah pengunci pengikat yg ada pengait

1 ea 8 Meter x1/2" heavy duty chain c/w 2 ea cleaves grab hook

30 on each chain / 1 buah, 8 M x 1/2" rantai pengikat beban berat
dengan 2 buah pengunci pengikat yg ada pengait

4 ea 1/2" heavy duty chain boomers ratchet type / 4 buah 1/2"

31
rantai pengunci yang kuat yng memiliki roda bergigi
32 2 ea 5/8" Crosby anchor shakle / 2 buah 5/8" shakle crosby
2 ea 3 m x 4" Wide nylon sling belt / 2 ea 3 m x lebar 4" sabuk
33
sling nylon
2 ea 3 m x 6" Wide nylon sling belt / 2 ea 3m x lebar 6" sabuk
34
sling nylon
35 Steel wire rope dalam keadaan baik?

36 Working Pressure : 250 Bar / tekanan kerja 250 bar

37 Slewing arch / dapat melipat atau melengkung

38 Slewing Movement / pergerakan akhir - jangkauan

39 Maximum lifting / Kemampuan angkat maksimum
40 Anti ti block berfungsi dengan baik ?
41 Safety divace (limit swict ) berfungsi dengan baik
42 Safety Triangle / Segitiga pengaman

43 First Aid / P3K

44 Operator & Helper PPE / PPE supir dan pembantunya

- Mechanical findings :

- Overall condition : GOOD FAIR POOR

- Conclusion : 1. Meet / Not meet contract spec.
2. Meet contract spec but on condition (specify) :

Inspected by,