TRUCK CHECKLIST INSPECTION
Project :................... Date :.........................
Inspection Data Equipment Data Police No :
Date : Merk / Type : Equip Certificate (STNK) :
Location : Capacity : Operator Name :
Inspector : Year build/ Manufacture : Operator License :
User : Load Certificate (KIR) : Exp Date :
No Description Condition
Remarks
A Operation Room Good Bad
1 Operator Cabin
2 Steering
3 Seat
4 Seat Belt/ Seat Passenger
5 Cabin Miror
6 Wind Shield and Wiper
7 Horn
8 Instrument Light Panel
9 Cabin Lamp
10 Signal Lights (Front, Rear, R/L Side)
11 Speedo Meters
12 Odometer
13 Brake
14 Hand Brake
15 Door
16 Door Lock
17 Window
18 Head lamp
19 View mirrors (side)
B Safety Device
1 Triangle Red Cones
2 First Aid kit (P3K)
3 Fire Extinguisher
4 Turn back Light
5 Rotary Light
C Enggine & Operation Part
1 Engine Condition
2 Oil Engine
3 Engine Oil Leacks
4 Radiator water
5 Radiator Condition
6 Battery Condition
7 Water Level Battery
8 Cable Battery Connection
9 Belt Condition
10 Fan Condition & Belt
11 Transmission Oil
13 Hydraulic Hose Leak/Connection
14 Hydraulic Oil
15 Jack Hydraulic
16 Brake Fluid
17 Tire Condition
18 Wheel Nuts
19 Dump Condition & Pin Lock
Notes/ Recommendation Result of Inspection:
Di cek oleh / Check by: Di Setujui oleh / Approved by: Diketahui oleh / Acknowledge by:
Nama / Tanggal Nama / Tanggal Nama / Tanggal