Page 1 of 3

EARTH MOVING, EQUIPMENT PRE-MOB INSPECTION REPORT

Applies to Bulldozer, Track Loader, Trencher

Equip No : Type : Model : Brand :

Serial No : Km/Hourmeter : Service Date :

Inspected by : Date : Location : Owner :

d
oo
d
Description to be Checked Remarks

/A
oo

N
G

o
N
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 Track Unit Maneuvering and Steering Systems Smooth and Controlled
9 Travel Service Brake System Properly Adjusted, No Leaks, Function Test
10 Parking Brake System Properly Adjusted, Function Test
Crawler Track Links / Track Shoes
11
No Excessively Loose or Worn Pins or Segments, No Badly Worn Drive Teeth
Crawler Track Rollers, Upper Carrier Rollers
12
No Excess Misalignment, No Leaks, No Flat Spots, No Badly Worn or Loose Bushings
13 Crawler Idlers No Excess Misalignment, No Leaks, No Flat Spots, Loose Bushings
14 Crawler Track Sprockets No Excess Misalignment, No Excessively Worn Teeth
15 Crawler Track Drive Chain, Well Lubricated, No Broken or Stretched Links
16 Crawler Hydraulic Drive Motors No Leaks, No Loose Mounting Bolts
17 Belly Guards Good Condition Straight, Not Bent, No Cracks, No Uncertified Welding Repairs
18 Rear Drawbar All Rounded Corners, No Sharp Edges, Not Loose, Properly Mounted
19 Head Lights-Working Lights-Flood Lights Adequate Illumination, Function Test
20 Rear Combination Lights Adequate Illumination, Function Test
21 Amber Rotary Light Adequate Illumination, Function Test
22 Front Combination Lights Adequate Illumination, Function Test
23 Electrical Wiring Condition, Fuse Block All Splices Insulated, No Bare Wires
Internal Centrally Mounted Rear View Mirror(s)
24
Not Loose, Clear Unobstructed Vision, Functions Properly
Side mounted Left and Right Mounted Rear View Mirrors
25
Not Loose, Clear Unobstructed Vision, Functions Properly,
26 Safety Triangles Two Units In Good Condition, Reflective So As Visible at Night
Fire Extinguisher
27
Minimum 4kg, Current and Valid Inspection Tag, Properly Mounted and Accessible.
28 First Aid Kit Clean, Tidy, Completely Full
29 Dozer Winch If Equipped with Winch Must Have Rear Safety Guard Screen Behind Operator
Safety Guards and Covers
30
All In Place, Not Loose, None Missing, Not Modified, Remain within OEM Specs
 Page 2 of 3

EARTH MOVING, EQUIPMENT PRE-MOB INSPECTION REPORT

Applies to Bulldozer, Track Loader, Trencher

Equip No : Type : Model : Brand :

Serial No : Km/Hourmeter : Service Date :

Inspected by : Date : Location : Owner :

d
oo
d
Description to be Checked Remarks

/A
oo

N
G

o
N
ROPS Meets OSHA Structural Standards, Minimum Two (2) but Recommend Four (4) Full One-
31
Piece Steel Beams Over the Operator, Mandatory Steel Roof, No Fiberglass Roof
32 Final Drive Lubrication Properly Filled and No Leaks, No MISSING COVERS / CAPS

Body
1 Body Good Condition, Good Paint and General Appearance, No Excess Damage, No Rust

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 Track Unit Unit Steering System 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
6
or Dilapidated
7 Control Linkages and Levers Test Function
8 Cabin Tilt and Safey Lockout System Test Function

Main Frame
Main Frame
1
Good Condition, Straight, Not Bent, No Cracks, No Uncertified Welding Repairs

Blade, Bucket, Digging Chain

Blade Cutting Edges-End Bits, Digging Chain Teeth-Side Cutters
1
Not Worn Out, Tight, No Loose Bolts
Hydraulic Cylinders No Leaks or Excessively Worn Pins/Bushings, All Pins Properly
2
Secured with Split Cotter Pins and/or Bolted End Plates
Blade Linkages No Excessively Worn Pins/Bushings, All Pins Properly Secured with Split Cotter
3
Pins and/or Bolted End Plates
Trencher Digging Chain and Digging Chain Teeth
4
No Excessively Loose or Worn Out Links, Pins, or Cutters
Lock Pins, Pins and Bushings in Dozer Arm, Linkages for All Implements
5
All Pins Properly Secured with Split Cotter Pins and/or Bolted End Plates
Blade, Bucket, Digging Chain Frame Alternately Raise, Lower and Extend, Look for Any Fatigue
6
Cracks, Any improper Bending,Twisting
Dozer Winch, Hook and Winch Cable Condition
7
Mechanically Spliced Cable, Cable Not Deformed or Bent, No Excess Broken Wire Strands
8 Track 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 Pilot Valves and Hydraulic Cylinders No Leaks
 Page 3 of 3

EARTH MOVING, EQUIPMENT PRE-MOB INSPECTION REPORT

Applies to Bulldozer, Track Loader, Trencher

Equip No : Type : Model : Brand :

Serial No : Km/Hourmeter : Service Date :

Inspected by : Date : Location : Owner :

d
oo
d
Description to be Checked Remarks

/A
oo

N
G

o
N
6 Hydraulic Pumps and Motors No Leaks, No Excess Noise
7 All Hydraulic Controls and Hydraulic Control Valves No Leaks, Test Function

Engine(s) - Transmission(s)
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,
5
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 Bevel Gear Case No Leaks, All Mountings Tight, Nothing Loose
PTO and Transmisson, Drive Shafts, Propeller Shafts, U-Joints, Center Carrier Bearing
12
Properly Greased, No Leaks, All Mountings Tight, Nothing Loose

Servicing and Maintenance

1 Maintenance Schedule - PM and PdM Service Records Available

Others
1
2
3

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-004-RW-12 - Rev-1 - Oct-12