PT GRACIA DIKATAMAS
CRANE TRUCK INSPECTION CHECK LIST
Product Identification : Company :
Model No : Contract No :
Engine No : Date of Inspection :
Frame No : Location of Inspc :
No. ITEM CHECKED / BAGIAN YANG DIPERIKSA Remarks
A DRIVER INFORMATION / Informasi Pengemudi
1 Name of Driver / Nama Supir
2 Driver Licence Number / No SIM Pengemudi
3 Class of Driving Licence / Jenis SIM
4 Expire Licence / Masa Berlaku SIM
B VEHICLE INFORMATION / Informasi Kendaraan
1 Licence Plate / Nomor Polisi
2 STNK Valid to / Masa Berlaku STNK
3 BUBKB / KIR Valid to ( Only for Pic-Up vehicle )
4 Type of Vehicle-Merk /Tipe Kendaraan - Merek
5 Year of Built / Tahun pembuatan
ITEM CHECKED Availability Condition
No. Remarks
BAGIAN YANG DIPERIKSA Yes No Good Fair Poor
Ada Tidak Bagus Kurang Jelek
C VEHICLE CONDITION / Kondisi Kendaraan
1 Km Driven / Kilometer tempuh
2 Glass / Kaca:
2.1 Windshield / Kaca depan
2.2 Rear Window / Kaca belakang
2.3 Side Window / Kaca samping
Windshield wiper / karet pembersih kaca depan
3 Mirror / Spion
3.1 Side / Samping
- Left / Kiri
- Right / Kanan
4 Light / Lampu
4.1 Head / Depan
4.2 Tail / Belakang
4.3 Parking / Parkir
4.4 Indicator - Sign / Signal
4.5 Break / Rem
4.6 Rotary Lamp / lampu putar
5 Door Condition / Kondisi pintu
6 Type of Tire / Tipe Ban
6.1 Mud Type / Type Mud
6.1.1 Front / Depan
6.1.2 Rear / Belakang
7 Valve Tire Cap / Penutup lubang angin ban
8 Gas / fuel tank door / lid - Gas / Penutup tanki bahan bakar
9 Fuel tank, any leak ? / Tangki bahan bakar, ada kebocoran?
10 Engine / Mesin
ITEM CHECKED Availability Condition
No. Remarks
BAGIAN YANG DIPERIKSA Yes No Good Fair Poor
Ada Tidak Bagus Kurang Jelek
11 Exhaust / Knalpot
12 Accu / Aki Electric System
13 Horn / Klakson
14 Safety belt / Sabuk pengaman
15 Speedometer / Speedometer
16 Break / Rem
17 Fuel indicator / Indikator bahan bakar
18 G.V.W : 23.000 Kg
19 Horse Power 220-250 HP/ 220-250 tenaga kuda
20 Double Rear Axle Configuration / Poros belakang Ganda
21 PTO Gear Box
22 Nut & Bolt Tire / Baut dan Mur Roda
23 V-Belt Engine / V - belt mesin
24 Hydraulic System / Sistem hidrolik
25 Transmission System / Sistim transmisi
26 Fire Extinguisher / Racun api
27 Manufacture’s Tool Kit / Perkakas
28 Vehicle Jack / Dongkrak
2 ea 3 Meter x5/8" heavy duty chain c/w 2 ea cleaves grab hook
29 on each chain / 2 buah, 3 M x 5/8" rantai pengikat beban berat
dengan 2 buah pengunci pengikat yg ada pengait
1 ea 8 Meter x1/2" heavy duty chain c/w 2 ea cleaves grab hook
30 on each chain / 1 buah, 8 M x 1/2" rantai pengikat beban berat
dengan 2 buah pengunci pengikat yg ada pengait
4 ea 1/2" heavy duty chain boomers ratchet type / 4 buah 1/2"
31
rantai pengunci yang kuat yng memiliki roda bergigi
32 2 ea 5/8" Crosby anchor shakle / 2 buah 5/8" shakle crosby
2 ea 3 m x 4" Wide nylon sling belt / 2 ea 3 m x lebar 4" sabuk
33
sling nylon
2 ea 3 m x 6" Wide nylon sling belt / 2 ea 3m x lebar 6" sabuk
34
sling nylon
35 Steel wire rope dalam keadaan baik?
36 Working Pressure : 250 Bar / tekanan kerja 250 bar
37 Slewing arch / dapat melipat atau melengkung
38 Slewing Movement / pergerakan akhir - jangkauan
39 Maximum lifting / Kemampuan angkat maksimum
40 Anti ti block berfungsi dengan baik ?
41 Safety divace (limit swict ) berfungsi dengan baik
42 Safety Triangle / Segitiga pengaman
43 First Aid / P3K
44 Operator & Helper PPE / PPE supir dan pembantunya
- Mechanical findings :
- Overall condition : GOOD FAIR POOR
- Conclusion : 1. Meet / Not meet contract spec.
2. Meet contract spec but on condition (specify) :
Inspected by,
