BACKHOE

Mobile Plant
Prestart Checklist

Verify Check

Address:
City/Suburb:
Phone:
Verify Check

SWL
Crane Chart

Plant Model:

Date:

CAB

Verify Check

Cleanliness
Seat
Operator Restraint
Instruments & Labelling
Levers / Controls
Pedals
ROPS AS2294
Windows / Wipers / Washers
Rear View Mirrors

Plant Owner:

December 4, 2000

WARNING DEVICES
Horn
Amber Flashing Beacon
Reversing Alarm

Verify Check

WARNING SIGNS (In Cabin)

SEAT BELTS MUST BE WORN

Verify Check

DANGER BEWARE OVERHEAD WIRES

& UNDERGROUND SERVICES
Verify Check

Verify Check

Serial No.:

Exhaust

Pivots
Connecting Rods
Safety Pins
(no excessive wear)

Signature:
Date:

Verify Check

Engine Guarding
Verify Check

Verify Check
Plant to conform to manufacturers specifications and HSE Regs.
Plant Operator is to provide daily checksheets to Plant Group on
a weekly basis
Where applicable, Personal Protective Equipment must be worn.
Plant Log Book Detailing service history in accordance with
Manufacturers specifications should be written legibly in
English.
Contractor must produce proof of competence of operator, e.g.,
Certificate of Competence, Licence, Detailed Log Book

HSE Use Only

NOTE: Sign only when all items have been checked

Plant Check By:

SWL

Quick Hitch
Safety Pins
(where applicable)
Verify Check

SWL

Hydraulics
Rams
Verify Check
Hoses
Connections
(check for excessive
wear, leaks and creep)

KEEP CLEAR

Verify Check

Connecting Rods
& Safety Pins

Travelling Hitch

Hydraulics
Verify Check

Verify Check

Tyres
Wheels
Brakes
Park Brake

(Signs on both sides of vehicle)

Position:
Date:

HSE-INSP-0002

Issue No.: 1

Statement of Operator Competence Required

Supplier Verification & Plant Details

Plant Make:

Form:

Verify Check

Stabilisers

Verify Check

Handrails
Steps

Verify Check

Rams
Hoses
Connections
(check for excessive wear,
leaks and creep)

Instructions:
Verify Box to be ticked by Owner / Supplier / Operator prior to arrival onsite.
Check Box to be ticked after visual inspection by HSE Department

This is to certify that the plant being supplied conforms to the relevant HSE Legislation, and the requirements as detailed above. HSE Department will assess this Pre-start Checklist to ensure the supplier has verified compliance to HSE Legislative requirements and, to
register the plant onto the site. The operator will be required to participate in ongoing training and perform work in accordance with the relevant Work Method Statement. Should the plant be found to not conform to the above, then it will be prevented from
commencing work on the site until the non-compliance is rectified. HSE Management will not reimburse the Owner / Supplier / Contractor for any down / lost time so caused from the non-conformance.
This form does not remove any liability for the plant supplier to conform with the relevant HSE Legislation.