Simple Equipment Checklist Report

Simple Equipment Checklist Report


Project/Task: Construction Site Preparation

  • Date: January 5, 2050

  • Location: [Your Company Address]

  • 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


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