Phase Item No. Item Name OK NOT OK N/A Deficiency
Phase Item No. Item Name OK NOT OK N/A Deficiency
Phase Item No. Item Name OK NOT OK N/A Deficiency
Date:
Crane Operator Badge # Supervisor Badge # Organization Code Telephone # Location
Carrier Hour Meter Start Hour Meter Finish Crane Hour Meter Start Hour Meter Finish
ITEM NOT
PHASE ITEM NAME OK N/A DEFICIENCY
No. OK
1.1 Inspection Sticker
1.2 Carrier Doors/Panels/Mirrors
1.3 Spark Arrestor
1.4 Under-Chassis Leak Check
1.5 Air Reservoir
1.6 Tire Condition - Pressure/Tread/Sidewalls
1.0 PRE-START WALK-AROUND CHECKS
Signature Signature