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Form 000.653.

F0105
COMPACTOR Inspection Report - Motorized Construction Heavy Equipment
General
Company Name: Date:
Equipment No: Serial No:
Type of Equipment: Model No:
Make/Model: Year Manufactured:
Hours: Project/Contract No.
Location:
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
ISNIN SELASA RABU KHAMIS JUMAAT SABTU AHAD
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
Empty Weight Stencil
License Plate
Lights
Mirrors
Mud Flaps
Paint
Panels/Hood/Fenders, etc.
Reflectors
Tires/Wheel Front
Tires/Wheel Rear
Tracks and Pads
Undercarriage
Windshield
ENGINE COMPARTMENT
Air Filter Element
Air Intake System
Battery/Condition and Cables
Belts
Coolant - Level - Protection
Cracks
Electrical Components
Exhaust System
Fan and Shroud
Hoses, Lines
Hydraulic Oil Level & Condition
Leaks
Loose Bolts, Mounts
Oil Levels/Condition
UNDERSIDE
All Controls for Operator
Axles
Belly Pans
Brake Pads
Cracks
Decals and Labels

Copyright © 2017, Fluor Corporation. All Rights Reserved.


Form Date: 05Oct2017 Page 2 of 19 Health, Safety, and Environmental
Form 000.653.F0105
COMPACTOR Inspection Report - Motorized Construction Heavy Equipment
General
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
Drive Train
Exhaust System
Fluid Levels
Gauges and Alarms
Leaks
Lights
- Head
- Tail
- Turn Signals
Loose Bolts, Mounts
OPERATOR'S POSITION
Accessories
- Radio
- Air Conditioning
- Other
Backup Alarm
Clutch
Doors and Latches
Engine Condition
- Minor Repair
- Major Repair
- Smoking or Blow By
- Oil Pressure
- Transmission
- Pressure
- Speeds
- Forward and Reverse
Fire Extinguisher
Glass and Mirrors
Horn
Parking Brake
Steering Linkage
Switches
Transmission & Engine Mounts
Trunnion
Seat
Steering
Windshield Washers
Windshield Wipers
OTHER
Accessories
Operator’s Manual
Parts Book

Copyright © 2017, Fluor Corporation. All Rights Reserved.


Form Date: 05Oct2017 Page 3 of 19 Health, Safety, and Environmental
Form 000.653.F0105
COMPACTOR Inspection Report - Motorized Construction Heavy Equipment
General
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
PTO
Structural Welds/Condition

SIGNATURES:

Inspected By: Estimated Hours to Repair:

Approved By:

Note: This worksheet is to be completed for all equipment. Click on the separate worksheets (i.e. Backhoe, Excavator, Motor Grader, etc) for additional reports.

Copyright © 2017, Fluor Corporation. All Rights Reserved.


Form Date: 05Oct2017 Page 4 of 19 Health, Safety, and Environmental
Form 000.653.F0105
COMPACTOR Inspection Report - Motorized Construction Heavy Equipment
r
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

Controls
Cracks and Warpage
Hoses and Lines
Leaks
Operation
Pins and Bushings
Pressure Readings
Structural Condition

Note: This Inspection must also include the General Inspection as well to satisfy the inspection requirement.

Copyright © 2017, Fluor Corporation. All Rights Reserved.


Form Date: 05Oct2017 Page 11 of 19 Health, Safety, and Environmental

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