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Mini Ex Daily Inspection Form

Uploaded by

Juan Martinez
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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0% found this document useful (0 votes)
568 views1 page

Mini Ex Daily Inspection Form

Uploaded by

Juan Martinez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Mini Excavator Daily Inspection Form

Date: ______________________________________

Operator Name: ______________________________________

Employee Number:
Unit Number : ______________________________________

Job #: ______________________________________

Hours on Machine: ______________________________________

1. Visual Inspection for Wear and Damage


Component Condition Comments
Bucket ☐ OK ☐ Needs Repair
Stick ☐ OK ☐ Needs Repair
Bucket Cylinder & Linkage ☐ OK ☐ Needs Repair
Boom Cylinders ☐ OK ☐ Needs Repair
Undercarriage ☐ OK ☐ Needs Repair
Car Body/Exterior Frame ☐ OK ☐ Needs Repair
Handholds and Steps ☐ OK ☐ Needs Repair
Seat Belt ☐ OK ☐ Needs Repair

2. Fluid and Oil Levels


Fluid/Oil Level Comments
Fuel ☐ Full ☐ Refill Needed
Engine Coolant ☐ Full ☐ Refill Needed
Hydraulic Oil ☐ Full ☐ Refill Needed

3. Air Filter Condition


Component Condition Comments
Air Filter ☐ Clean ☐ Needs Replacement

4. Leak Inspection
Component Leaks? Comments
Boom Cylinders ☐ Yes ☐ No
Hydraulic Oil Tank ☐ Yes ☐ No
Radiator ☐ Yes ☐ No
Fuel Tank ☐ Yes ☐ No
Bucket Cylinder ☐ Yes ☐ No
Underneath the Excavator ☐ Yes ☐ No

5. Safety Equipment
Component Condition Comments
Fire Extinguisher ☐ Charged ☐ Needs Service

6. Engine Compartment Inspection


Component Condition Comments
Belts and Hoses ☐ OK ☐ Needs Repair
Engine Compartment Cleanliness ☐ Clean ☐ Needs Cleaning
Swing Gear ☐ OK ☐ Needs Repair

7. Gauges, Controls, and Interior Components


Component Condition Comments
Seat Belts ☐ OK ☐ Needs Repair
Gauges & Indicators ☐ Working ☐ Needs Repair
Horn ☐ Working ☐ Needs Repair
Brakes ☐ Working ☐ Needs Repair
Steering Wheel ☐ Working ☐ Needs Repair

8. Light and Fuel-Water Separator Inspection


Component Condition Comments
Light Coverings & Bulbs ☐ OK ☐ Needs Replacement
Fuel-Water Separator ☐ OK ☐ Needs Maintenance

Operator Safety and Site Awareness Checklist


Job Site Conditions Reviewed? ☐ Yes ☐ No
Safety Gear Worn (Goggles, Boots, Hard Hat, Gloves)? ☐ Yes ☐ No
Machine Load Limit Not Exceeded? ☐ Yes ☐ No
Engine Running Smoothly (No Excessive Exhaust/Noise)? ☐ Yes ☐ No
Aware of Surroundings (Workers, Bystanders, Obstacles)? ☐ Yes ☐ No
Slope Navigation in Vertical Orientation? ☐ Yes ☐ No ☐ Not Applicable

Operator’s Signature: _____________________

Supervisor’s Signature (if applicable): _____________________

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