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EARTH MOVING, EQUIPMENT PRE-MOB INSPECTION REPORT

Applies to Wheel Loader, Backhoe

Equip No : Model : Brand :

Serial No : Km/Hourmeter : Service Date :

Inspected by : Date : Location : Owner :

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Documentation Operator and Equipment

1 Today's Pre-Trip Inspection Original Copy Available on Unit

Original Manufacturer Name Plate with Serial
2 Year of Manufacture:
Number
3 Original or a Copy of Operation Manual Book Matches Unit Type and Series
4 SOP - Standard Operating Procedure Based on OEM Operation Manual Book
5 Operator/Driver Government Driving Licence Expired :
6 Company Operator/Driver Permit Expired :
7 Company ID Number, Company Logo Correct Size, Minimum 15 Cm Height, Visible

Mandatory Safety Inspections and Devices

1 Back-Up Alarm Easy to Hear, 97 Decibles Minimum
2 Back-Up Light Adequate Illumination, Function Test
3 Horn Easily Operated From Inside Driver's Cabin, Easy to Hear
4 Windshield Wipers and Washer Wiper Blades Not Perished, Function Test
All Window Glass / Windshield Glass Totally Clear, No Film or Stickers Blocking Vision.
5
Units with OEM Window Tint Will Require Approval by Relevant CPI Authorities.
6 Door and Door Locks, Door Handles, Left - Right, Outside and Inner Test Function
7 Seat Belts for Driver, Operator Good Condition, Properly Mounted with OEM Hi Tensile Bolts
8 Backhoe Steering System Smooth and Controlled
9 Wheel loader Articulated Steering System Smooth and Controlled, No Worn Pins Bushings
10 Wheel loader Articulate Steering LOCK-OUT SAFETY BAR Easy Access, No Lost Pins
11 Service Brake System Properly Adjusted, No Leaks, Function Test
12 Parking Brake System Properly Adjusted, Function Test
13 Hydraulic Total System Safety Lock Out Witness a Function Test
14 Head Lights-Working Lights-Flood Lights Adequate Illumination, Function Test
15 Rear Combination Lights Adequate Illumination, Function Test
16 Amber Rotary Light Adequate Illumination, Function Test
17 Front Combination Lights Adequate Illumination, Function Test
18 Electrical Wiring Condition, Fuse Block All Splices Insulated, No Bare Wires
Internal Centrally Mounted Rear View Mirror(s)
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Not Loose, Clear Unobstructed Vision, Functions Properly
Side mounted Left and Right Mounted Rear View Mirrors
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Not Loose, Clear Unobstructed Vision, Functions Properly,
21 Safety Triangles Two Units In Good Condition, Reflective So As Visible at Night
Access Ladder Steps Handrails Securely Mounted, Ergonomic Design, Good Condition, Not
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Cracked, Not Bent, Not Dilapidated, No Sharp Edges, No Sharp Corners
Fire Extinguisher
23
Minimum 4kg, Current and Valid Inspection Tag, Properly Mounted and Accessible.
24 First Aid Kit Clean, Tidy, Completely Full
Safety Guards and Covers
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All In Place, Not Loose, None Missing, Not Modified, Remain within OEM Specs
ROPS Meets OSHA Structural Standards, Minimum Two (2) but Recommend Four (4) Full One-
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Piece Steel Beams Over the Operator, Mandatory Steel Roof, No Fiberglass Roof
Backhoe Front Axle Wheel Bearing Lubrication
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Oil-Hubs to Be Properly Filled and No Leaks, No Missing Covers / Caps on Grease Type Hubs
Tire and Wheel Condition No Broken-Missing Lug Nuts Front and Rear, Tread Depth Minimum
28 3mm or Check Manufacture Wear Indicator, No Recaps / Retreads / Vulcanized Permitted,
Correct Rotation, All-Terrain Tread Mud-Grip Pattern
29 Driver Monitoring System Refer to CPI Contract, Perform Function Test
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Body
1 Body Good Condition, Good Paint and General Appearance, No Excess Damage, No Rust
2 Backhoe Mud Flaps Properly Mounted, Not a Falling Hazard to Following Motorists
3 Front-Rear Bumper Bar All Rounded Corners, No Sharp Edges, Not Loose, Properly Mounted

Cabin and Interior

1 Cabin Interior Good Condition, Clean, No Rubbish, Good Housekeeping
Dashboard Indicators, Engine EMS (Electronic Monitoring System)
2 Gauges for Fuel, Hours, Kms, Odometer, Temperature, Brake Air Pressure, Hyd Pressure,
Alternator, Battery Voltmeter, Battery Charging System, etc, All Operating Properly
3 Steering Wheel, Steering Column Controls Levers and Switches Test Function
4 All Switches and Knobs on Dashboard Test Function
5 Cabin Air Conditioner or Fan Test Function
Seats, Cushions Securely Mounted, Ergonomically Good Condition, Not Torn Open
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or Dilapidated
7 Control Linkages and Levers Test Function

Main Frame, Main Chassis, Backhoe Side Shift Frame

Main Chassis Good Frame Condition, Straight, Not Bent, No Cracks, No Uncertified
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Welding Repairs
Backhoe Side Shift System Frame Good Condition Straight, Not Bent, No Cracks, Hydraulic
2
Lock System Function Test, No Uncertified Welding Repairs
Wheel Loader Articulate Center Bearing
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No Excessively Loose or Worn Pins or Bushings, Adequate Lubrication
Axle Mounts, Axle Pivot System, Front / Rear
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Straight Not Bent, No Loose Pins / Bushings, Adequate Lubrication
Backhoe Swing Bearing (Swivel) Condition
5
Properly Lubricated, Not Loose, No Loose Mounting Bolts, Adequate Lubrication
Backhoe Steering Box, Steering Linkages, No Loose Ball Joints, Lubricated Properly, No Loose
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Pins, Not Worn Out, No Loose Mounting Bolts
Wheel Loader Articulated Steering System
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No Loose Ball Joints, Lubricated Properly, No Loose Mountings, No Leaks, Test Function

Bucket - Boom - Stick - Digging Arm

Bucket Cutting Edges-End Bits, Bucket-Teeth-Side Cutters
1
Not Worn Out, Tight, No Loose Bolts
Hydraulic Lift Cylinders No Leaks or Excessively Worn Pins/Bushings, All Pins Properly
2
Secured with Split Cotter Pins and/or Bolted End Plates
Bucket Linkages No Excessively Worn Pins/Bushings, All Pins Properly Secured with Split
3
Cotter Pins and/or Bolted End Plates, Adequate Lubrication
Backhoe Boom and Outrigger Linkages No Excessively Worn Pins/Bushings, All Pins Properly
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Secured with Split Cotter Pins and/or Bolted End Plates, Adequate Lubrication
Lock Pins, Pins and Bushings in Stick, Boom, Arm, Linkages for All Implements
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All Pins Properly Secured with Split Cotter Pins and/or Bolted End Plates
Backhoe Digging Stick Alternately Raise, Lower and Extend All Boom Sections, Look for Any
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Fatigue Cracks, Any improper Bending,Twisting, Kinking, Adequate Lubrication
7 Front End Loader Bucket "Self-Leveling" System is Functioning

Hydraulics, General Hydraulics, Fluids, Fuel, Hoses

1 All Fuel Hoses and Lines Properly Secured, No leaks
2 All Hydraulic Hoses and Hydraulic Lines Properly Secured, No Leaks
3 Hydraulic Tanks Mounts, Leaks, and Filler Cap Properly Secured, No Leaks
4 Fuel Tank Mounts, Leaks, and Filler Cap No Leaks, No loose Mounts
5 Air Tank(s) No Leaks, No loose Mounts
6 Pilot Valves and Hydraulic Cylinders No Leaks
7 Hydraulic Pumps and Motors No Leaks, No Excess Noise
8 All Hydraulic Controls and Hydraulic Control Valves No Leaks, Test Function

Engine(s) - Transmission(s)
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1 Main Engine Clean Appearance, No Defective Mounts, No Leaks, Observe Performance
2 Engine Dipstick Easy to read, Oil Level Adequate
Battery, Battery Covers, Battery Mounting, Battery Terminals Optional Battery Disconnect
3 Switch, Test Function, No Loose or Corroded Cables-Terminals, Battery Hold-Downs in Place,
Clean Battery Box, No Loose Mounts
4 Starter Motor Test Function, Adequate Cranking Strength, No Bad Noises or Overheating
Alternator Observe Charging Function, No Bad Noises or Overheating, No Loose Mounts,
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No Loose Belts
6 Cooling System Inspect Radiator and Hoses, No Leaks, No Perished Hoses
7 V-Belts or Serpentine Belts Not Loose, Not Squealing, Not Cracked
8 Exhaust System Check Pipes and Muffler, No leaks, Not Loose
9 Transmission No Leaks, Observe a Function Test
10 Clutch No Smoke or Slipping, Observe a Function Test
11 Differentials Front and Rear No Leaks, All Mountings Tight, Nothing Loose
PTO and Transmisson, Drive Shafts, Propeller Shafts, U-Joints, Center Carrier Bearing
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Properly Greased, No Leaks, All Mountings Tight, Nothing Loose

Servicing and Maintenance

1 Maintenance Schedule - PM and PdM Service Records Available

Others
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Comments
Good = Good condition, able to be operated in
all CPI areas
No Good = Broken, Malfunction, Repair or
Replace

N/A = Not Applicable

The undersigned hereby accept and agree
Inspected by: Acknowledged by RW and CPI :
that this equipment is "OK" and safe for
operation. Menerima dan Menyetujui bahwa
Alat ini sudah "OK" dan aman untuk
dioperasikan.
SIGNATURE, Date

RW-CEM RW-HES
Contractor's Name
C-010-RW-12 - Rev-1 - Oct-12