EXCAVATOR INSPECTION FORM YEAR: DATE OF INSPECTION: MAKE: MODEL: INSPECTOR: ‘SERIAL NUMBER: HOUR METER READING LOCATION TOTAL HOURS: INSTALLED EQUIPMENT AIC BOOM TYPE / SIZE R STICK SIZE / TYPE VARIABLE Gi ‘QUICK COUPLER THUME (TYPE) AUX HYDRAULICS SIDE SOOM BLADE FOPS SHEAR, T GRAPPLE PROCESSOR ‘TRAVEL PEDAL BREAKER COMPACTOR | CWT REMOVAL OTHER CONDITION _(E) EXCELLENT (V) VERYGOOD _(G)GOOD_(F) FAIR _(P) POOR OPERATORS COMPARTMENT. E|ve|G|F|P NOTES ROPS STRUCTURE INTEGRITY CAB CONDITION OVERALL SEAT CONDITION/ OPERATION SEAT BELT / ARMREST INSTRUMENT GUAGES INTERIOR LIGHTS BACK UP ALARM. GLASS / WINDOWS OPERATION DOORS (OPERATION/ HANDLES) WIPERS FLOOR MAT / HEADLINER HEATER / A/C FANS / VENTS CAB CONTROLS HORN/ STEREO (OPERATORS MANUAL (OVERALL ASSESSMENT: ADDITIONAL NOTES: Page 1of5EXCAVATOR INSPECTION FORM CONDITION —_(E) EXCELLENT (V)VERYGOOD (G)GOOD (F) FAIR _(P) POOR COSMETIC / EXTERIOR E [ve] G/F] Pe NOTES LADDERS / PLATFORMS STEPS / GRAB IRON ENGINE HOOD CONDITION COUNTERWEIGHT PAINT / DECALS FRONT / REAR LIGHTS UNDERNEATH SIDE PANELS INSPECTION/ ENGINE DOORS cas CAB DOOR SKIRT CAR BODY, (OVERALL ASSESSMENT: ADDITIONAL NOTES: CONDITION __(E) EXCELLENT _(V) VERY GOOD _(G)GOOD_(F) FAIR _(P) POOR POWERTRAIN E|ve|G|F|P NOTES ENGINE MAKE / MODEL EPATIER ENGINE SN SMOKE / BLOW BY ENGINE OIL LEVEL / CONDITION ENGINE OIL LEAKS RADIATOR CAP RADIATOR CONDITION COOLANT LEVEL/CONDITION BELTS/ HOSES TURBO EITHER DRIVE MOTORS TRAVEL CONTROLS OVERALL ASSESSMENT. ADDITIONAL NOTES: Page 2 ofSEXCAVATOR INSPECTION FORM CONDITION _(E) EXCELLENT (VJ VERYGOOD (G)GOOD (F) FAIR _(P) POOR ‘STRUCTURAL E|ve|Gl]F |p NOTES STRUCTURAL DAMAGE/ REPAIRS ROLLER FRAME/ CARBODY CRACKS BUCKET LINKAGE BUCKET PINS STICK TO BUCKET/QC PINS STICK TO BOOM PINS BOOMFOOT PINS BOOM LIFT CYLINDER PINS BUCKET CYLINDER PINS STICK CYLINDER PINS ROTEC BEARING (OVERALL ASSESSMENT: ADDITIONAL NOTES: CONDITION —_(E) EXCELLENT (V)VERYGOOD (G)GOOD (F) FAIR _(P) POOR BUCKET/ ATTACHMENTS E|ve[G] Fle NOTES BUCKET MAKE BUCKET TYPE BUCKET SIZE (OVERALL CONDITION ‘ADDITIONAL BUCKET MAKE ADDITIONAL BUCKET TYPE. ‘ADDITIONAL BUCKET SIZE QC MAKE QC TYPE QC OPERATION/CONDITION ATTACH MAKE ATTACH TYPE (IF APPLICABLE) ATTACHMENT CONDITION (OVERALL ASSESSMENT: ADDITIONAL NOTES: Page 3 0f5EXCAVATOR INSPECTION FORM CONDITION (E) EXCELLENT (V) VERYGOOD (G)GOOD (F) FAIR (P) POOR HYDRAULICS E [ve[6 |F [P NOTES OIL LEVEL HYDRAULIC OPERATION PUMP NOISE / LEAKS ‘AUX VALVES/ LINES TANK VALVES BUCKET/ STICK CYLINDERS LIFT CYLINDERS/ AUX CYLINDERS LINE/ HOSE CONDITION CAB CONTROLS SWING DRIVE SWING BRAKE SWING GEAR (OVERALL ASSESSMENT: ADDITIONAL NOTES: CONDITION __(E) EXCELLENT _(V) VERYGOOD (6) GOOD _(F) FAIR _(P) POOR UNDER CARRIAGE E [ve[G [F |P NOTES PAD SIZE PAD TYPE CONDITION IDLERS CONDITION (2) CHAIN CONDITION (L/R) CARRIER ROLLER CONDITION LEFT ROLLERS CONDITION RIGHT ROLLERS CONDITION ROLLER FRAME CONDITION PERCENTAGE REMAINING OVERALL ASSESSMENT: ADDITIONAL NOTES: Page dof 5EXCAVATOR INSPECTION FORM ‘ADDITIONAL NOTES: ACCEPTED INSPECTION TERMS: Dry= No oil loss at seals Seep = Oil slowly accumulating Wet = Fresh LEAK = Needs immediate repair / replacement ing on Seal Tight = Joint moves asnew Movement = Joint shows normal use Play = Joint will need eventual attention Loose = Joint needs immediate repair / replacement i Antena a poi rsrngin pea e: Page Sof5