Equipment Revision Checklist Form

This document sets forth a checklist to be used when conducting a review of or purchasing new equipment. This checklist has fields for observations and remarks for the component parts of a piece of equipment or machinery. This form can be customized to fit the needs of a company auditing its equipment. This form is helpful to any company seeking to conduct a safety audit or assessment of existing equipment and facilities.

[Logo of Company] [Address of Company]

Equipment Checklist Form Revision No :

Revision Date:

User Name : Equipment:

Supplier: Plate #:

Location : Starting Date #:

S.
No. Equipment NameEquipment Code Observations Remarks
1 Bucket
2 Bucket cylinder & linkage
3 Boom , cylinders
4 Equipment Body
5 Steps, walkways
6 Lights
7 Machine overall
8 Wind shield, wiper & washers
9 Radiator leaks
10 Gear oil leaks
11 Engine oil leaks
12 Hydraulic oil leaks
13 Fuel tank leaks
14 Hoses leaks
15 Belts

Accepted Not Accepted

Mechanic Remarks

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Mechanic Remarks

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Document # [ ]

[Logo of Company]

Download equipment revision checklist

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