Free Simple Equipment Checklist Report Template
Simple Equipment Checklist Report
Project/Task: Construction Site Preparation
-
Date: January 5, 2050
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Location: [Your Company Address]
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Prepared by: [Your Name] (Site Supervisor)
1. Equipment Overview
|
Equipment Name |
Model/Serial Number |
Assigned To |
Condition |
Last Maintenance Date |
Notes |
|---|---|---|---|---|---|
|
Excavator |
CAT-330L / EX-2050 |
Mike Thompson |
Good |
12/1/49 |
Fully operational |
|
Concrete Mixer |
CMX-1200 / CM-1234 |
Sarah Lee |
Fair |
12/20/49 |
Minor oil leakage |
|
Bulldozer |
Komatsu D85EX / BD-7880 |
Chris Evans |
Good |
12/12/49 |
No issues reported |
|
Portable Generator |
GenPower GP-1500 / GP-896 |
Kim Nelson |
Good |
12/25/49 |
Ready for use |
2. Safety Inspection Checklist
|
Inspection Item |
Status (Yes/No) |
Comments |
|---|---|---|
|
Equipment is clean |
|
No issues found |
|
No visible damage |
|
Inspected thoroughly |
|
Safety guards in place |
|
Confirmed |
|
Properly calibrated |
|
Requires recalibration |
|
Functionality check |
|
All functions tested |
3. Compliance and Certifications
|
Certification/Inspection |
Required? (Yes/No) |
Last Checked |
Next Due |
Responsible Person |
|---|---|---|---|---|
|
Calibration Certification |
|
January 2, 2050 |
February 2, 2050 |
Karen Rogers |
|
Safety Inspection |
|
December 15, 2049 |
January 15, 2050 |
John Doe |
4. Maintenance Requirements
|
Equipment Name |
Maintenance Type |
Last Maintenance |
Next Maintenance |
Technician |
|---|---|---|---|---|
|
Excavator |
Routine |
December 1, 2049 |
March 1, 2050 |
Peter Clarke |
|
Concrete Mixer |
Repair |
November 20, 2049 |
January 20, 2050 |
Angela Harris |
|
Bulldozer |
Routine |
December 12, 2049 |
February 12, 2050 |
Samuel O'Neil |
|
Portable Generator |
Routine |
December 25, 2049 |
March 25, 2050 |
Diana Hughes |
5. Issues and Recommendations
|
Equipment Name |
Issue Identified |
Action Required |
Urgency |
Responsible Person |
Comments |
|---|---|---|---|---|---|
|
Concrete Mixer |
Oil leakage |
Replace oil seal |
High |
Sarah Lee |
Must be fixed before next use |
|
Bulldozer |
N/A |
N/A |
Low |
Chris Evans |
Regular inspection |
|
Portable Generator |
Calibration overdue |
Recalibration |
Medium |
Kim Nelson |
Schedule in next week |
6. Sign-Off
|
Name |
Role |
Date |
Signature |
|---|---|---|---|
|
[Your Name] |
Site Supervisor |
January 5, 2050 |
|
|
Peter Clarke |
Maintenance Technician |
January 5, 2050 |
|
|
Sarah Lee |
Equipment Operator |
January 5, 2050 |
|
