Form:
ARTICULATED DUMP TRUCK
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify Check
CAB
Plant Supplier Phone Number Plant Make
Date: Verify Check
Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational
Plate No. Name
WARNING DEVICES • •
Verify Check
Horn Reversing Alarm
WARNING SIGNS (In Cabin) SEAT BELTS
Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model
HSE-INSP-0001
Verify Check
Exhaust
Signature: Date
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s 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
Verify Check
Tyres Wheels Brakes Park Brake
Hydraulics Verify Check
NOTE: Sign only when all items have been checked
KEEP CLEAR Handrails Steps
Plant Check By:
Verify Check
(Signs on both sides of vehicle)
Position: Date:
/
/
Note : Register if to be used on Public Roads
Verify Check
Rams Hoses Connections (check for excessive wear, and leaks)
Instructions: Verify Box to be ticked by Owner / Supplier / Operator prior to arrival on site. 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
Form:
BACKHOE
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify Check
Phone Number Plant Make Plant Model Verify Check
Plate No.
Date:
CAB
Verify Check
Cleanliness Seat Operator Restraint Instruments & Labelling Levers / Controls Pedals ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors
Plant Supplier
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
Verify Check
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
DANGER – BEWARE OVERHEAD WIRES & UNDERGROUND SERVICES
SWL Crane Chart
Name
HSE-INSP-0002
Verify Check
Verify Check
Signature:
Exhaust
Pivots Connecting Rods Safety Pins (no excessive wear)
Date
Verify Check
Engine Guarding Verify Check
Verify Check
Quick Hitch Safety Pins (where applicable)
Plant to conform to manufacturer’s specifications and HSE Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s 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:
Verify Check
SWL & Safety Pins
Hydraulics Rams Hoses Connections (check for excessive wear and leaks)
Verify Check
Travelling Hitch
Hydraulics Verify Check
Verify Check
KEEP CLEAR
Tyres Wheels Brakes Park Brake
Verify Check
/
/
Verify Check
Connecting Rods
(Signs on both sides of vehicle)
Position: Date:
SWL
Stabilisers
Verify Check
Handrails Steps
Verify Check
Rams Hoses Connections (check for excessive wear, and leaks)
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.
Form:
COMPACTOR
Mobile Plant Prestart Checklist
Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify
Issue No.: Date:
CAB
Verify Check
Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational
Phone Number Plant Make
Verify Check
Serial No. Name Signature:
WARNING SIGNS (In Cabin) SEAT BELTS
Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model
WARNING DEVICES • Horn • Reversing Alarm
Cleanliness
Plant Supplier
HSE-INSP-0003
Verify Check
DANGER – SAFE WORKING LIMITS ON BATTERS Ratio 2 to 1 Eg only – As per Manufacturers Specifications
Verify Check
Exhaust
Date
Verify Check Verify Check
Rams Hoses Connections (check for excessive wear, and leaks)
Engine Guarding Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Hydraulics
Verify Check
Brakes Park Brake
HSE Office Use Only NOTE: Sign only when all items have been checked
Plant Check By:
Crush Point Hazard Sign displayed both sides
Verify Check
Handrails Steps
Position: Date:
Verify Check
/
/
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 HS&E Legislation, and the requirements as detailed above. HSE Department will check this Pre-start Checklist to ensure the supplier has verified compliance to 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
Form:
BULL DOZER
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Date: Verify Check
Verify Check
Plant Supplier
Plant Make Plant Model Serial No. Name Verify Check
Signature:
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
CAB Cleanliness
Phone Number
HSE-INSP-0004
Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Verify Check
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
DANGER – BEWARE OVERHEAD WIRES & UNDERGROUND SERVICES Verify Check
Exhaust
Rams Hoses Connections (check for excessive wear, leaks and creep)
Date
Verify Check
Engine Guarding
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s 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
Verify Check Verify Check
Plant Check By: Position: Date:
/
/
Pivots Pins Connections Safety Pins
Tracks Tracks Complete Idlers Adjusted Drivers Free from Leaks
Handrails Steps
Verify Check
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 check 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
Form:
DRUM ROLLER
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify
Date:
CAB
Verify Check
Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational
Phone Number Plant Make
Verify Check
Serial No. Name
WARNING SIGNS (In Cabin) SEAT BELTS
Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model
WARNING DEVICES • Horn • Reversing Alarm
Cleanliness
Plant Supplier
HSE-INSP-0005
Verify Check
DANGER – SAFE WORKING LIMITS ON BATTERS Ratio 4 to 1 Eg only – As per Manufacturers Specifications
Verify Check
Signature:
Locating lock for Low/Neutral/Lower Range Pad lock provided
Date
Verify Check
Exhaust
Warning sign – Hasp must be locked in position before operating
Verify Check
Engine Guarding
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
Tyres Wheels Brakes Park Brake
HSE Use Only
Verify Check
NOTE: Sign only when all items have been checked
Plant Check By: Position: Date:
/
/
Verify Check
Hydraulics Hoses Connections (check for excessive wear and leaks)
Crush Point Hazard Sign displayed both sides
Verify Check
Handrails Steps
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 will assess this Pre-start Checklist to ensure the supplier has verified compliance to 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. HSEManagement 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
ELEVATING WORK PLATFORM
Mobile Plant Prestart Checklist
Knuckle Boom Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify Check
Phone Number
HSE-INSP-0006
Issue No.: Date:
WARNING DEVICES • • • •
Sub-con name
Form:
Verify Check
• Out of Level Alarm
Plant Make Plant Model Verify Check
Serial No.
Hydraulics Rams Hoses Connections (check for excessive Wear and leaks)
Name Signature:
Pivots Connecting Rods Safety Pins (no excessive wear)
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
SWL / Crane Chart Verify Check Verify Check
Verify Check
Date
BASKET Cleanliness Operator Restraint Instruments & Labelling Levers / Controls Pedals Log Book Deadman Switch Operation Instruction (available on plant)
Horn Amber Flashing Beacon Motion Alarms Raise & Lower Alarms
WARNING SIGNS
Safety Harness & Lanyard
Harness Available Verify Check
DANGER – BEWARE OVERHEAD WIRES &SERVICES
Hydraulics
Verify Check
Verify Check
Rams Hoses
Exhaust (if applicable) Verify Check
Levers / Controls
Verify Check
Connections (check for excessive wear, leaks and creep)
Engine Guarding
HSE Use Only
Verify Check
Tyres Wheels Brakes Park Brake
NOTE: Sign only when all items have been checked
Plant Check By: Position: Date:
/
/
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 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
Form:
ELEVATING WORK PLATFORM
Mobile Plant Prestart Checklist
Issue No.:
Scissor Lift Statement of Operator Competence – Required
Supplier Verification & Plant Details Plant Supplier
Verify Check
Levers / Controls
Phone Number
Date:
WARNING DEVICES • • • •
Verify Check
HSE-INSP-0007
Verify Check
Horn Amber Flashing Beacon (when onsite) Reversing Alarm Head, Tail & Turn Indicators
Cleanliness Instruments & Labelling Levers / Controls Basket & Base Pedals Log Book Operation Instruction (available on plant)
Verify Check
Plant Make
BASKET
Self Closing Gate
Plant Model
Verify Check
Serial No. Safety Working Load
Name Signature: Verify Check
Date
Verify Check
Pivots Connecting Rods Safety Pins (no excessive wear)
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
WARNING & RESTRICTION SIGNS
Hydraulics
Verify Check
Rams Hoses Connections (check for excessive Wear and leaks)
Safety Prop Under Scissor
Verify Check
Guarding Of Scissor
Verify Check
Exhaust (if applicable)
HSE Use Only
Verify Check
Tyres Wheels Brakes Park Brake
NOTE: Sign only when all items have been checked
Plant Check By: Position: Date:
/
/
Verify Check
Engine Guarding
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
Form:
EXCAVATOR
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence - Required
Date:
WARNING DEVICES
Verify Check
Supplier Verification & Plant Details Plant Supplier
• • •
Verify Check
Pivots Connecting Rods Safety Pins (no excessive wear)
Phone Number Plant Make Plant Model
HSE-INSP-0008
Verify Check
Verify Check
Name Signature: Date
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
DANGER – BEWARE OVERHEAD WIRES & UNDERGROUND SERVICES
Hydraulics Rams Hoses Connections (check for excessive wear and leaks)
Serial No.
Horn Amber Flashing Beacon Motion Alarm
Verify Check
Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Verify Check
SWL / Crane Chart
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
CAB
Verify Check
Quick Hitch Safety Pins (where applicable) (If Quick Hitch is fitted NO LIFTING POINTS Allowed on back of bucket
Verify Check
Exhaust Verify Check
Engine Guarding
HSE Use Only Verify Check
NOTE: Sign only when all items have been checked
Plant Check By: Position: Date:
/
/
Hydraulics Rams Hoses Connections (check for excessive wear, leaks and creep)
Tracks
Verify Check
Verify Check
Handrails Steps
Tracks Complete Idlers Adjusted Drivers Free from Leaks
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 will assess this Pre-start Checklist to ensure the supplier has verified compliance to 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 RoK OH&S Legislation
Form:
GRADER
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify Check
Date:
CAB
Verify Check
Phone Number Plant Make
Verify Check
Plate No. Name
WARNING SIGNS (In Cabin) SEAT BELTS
ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition
Plant Supplier
HSE-INSP-0009
Verify Check
SAFE WORK LIMIT ON BATTERS Ratio 2 to 1 Ratio 2 to 1
e.g. only – As per Manufacturer’s Specifications
Signature:
Verify Check
Hydraulics Rams Hoses Connections (check for excessive wear and leaks)
Date
Verify Check
Exhaust Verify Check
Engine Guarding Plant to conform to manufacturer’s specifications and RoK Plant Regs. Plant Operator is to provide daily checksheets HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
Drive Guards
Verify Check
HSE Use Only NOTE: Sign only when all items have been checked
Steering Unions Rods Connections
Verify Check Verify Check
Plant Check By: Position: Date:
/
/ Note : Register if to be used on Public Roads
Verify Check
Pivots Pins Connections Safety Pins
Handrails Steps
Tyres Wheels Brakes Park Brake
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
Form:
FRONT END LOADER
Mobile Plant Prestart Checklist
HSE-INSP-0010
Issue No.:
Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify Check
Date:
CAB
Verify Check
Cleanliness
Plant Supplier
Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational
Phone Number Plant Make
Verify Check
Pedals in Good Condition ROPS Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model Serial No. Name
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
DANGER – BEWARE OVERHEAD WIRES Verify Check
Exhaust
Verify Check
Signature:
Verify Check
Pivots Connecting Rods Safety Pins (no excessive wear)
Date
Engine Guarding
Verify Check Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
Tyres Wheels Brakes Park Brake
Hydraulics Rams Hoses Connections (check for excessive Wear and leaks)
Verify Check
Handrails Steps
HSE Use Only NOTE: Sign only when all items have been checked
Plant Check By:
Verify Check
SWL if used as Crane Lift point
Crush Point Hazard Sign displayed both sides
Verify Check
Position: Date:
/
/
Note : Register if to be used on Public Roads
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 check 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
Form:
MOBILE CRANE
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence - Required
Supplier Verification & Plant Details
Verify Check
Phone Number Plant Make
Boom
Verify Check
Plant Model
Pivots Connecting Rods Safety Pins (no excessive wear)
Serial No.
Date:
CAB
Verify Check
Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant) Log Book SWL / Crane Chart
Plant Supplier
Name Signature:
HSE-INSP-0011
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
WARNING SIGNS (In Cabin) Verify Check
SEAT BELTS Verify Check
DANGER – BEWARE OVERHEAD WIRES, PIPES and SERVICES
Date
Verify Check
Engine Guarding Verify Check
Hambone & Wedge Plant to conform to manufacturer’s specifications and Vic Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
Hydraulics Rams Hoses Connections (check for excessive Wear and leaks) Verify Check
HSE Use Only NOTE: Sign only when all items have been checked
Plant Check By:
Verify Check
Position: Date:
Verify Check
Exhaust
/
/
Verify Check
Tyres Wheels Brakes Park Brake Slings / Ropes / Chains (Tagged and in good working order) Electrical Wiring (No visual signs of damage) Steel or Timber Pads
Slew Radius / Barricading for around Outriggers
Verify Check
Handrails Steps
Verify Check
Outriggers & Rams Operational 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 check this Pre-start Checklist to ensure the supplier has verified compliance to 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 Legalisation
MULTI-WHEEL ROLLER
Mobile Plant Prestart Checklist
Statement of Operator Competence - Required
Form:
HSE-INSP-0012
Issue No.: Date:
Supplier Verification & Plant Details Verify Check
Plant Supplier Phone Number
Verify Check
CAB Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Make Plant Model Serial No. Name
WARNING DEVICES • Horn • Amber Flashing Beacon • Motion Alarm
Verify Check
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
Exhaust
Signature:
Verify Check
Engine Guarding
Date Verify Check
Handrails Steps
Plant to conform to manufacturer’s specifications and Vic Plant Regs. Plant Operator is to provide daily checksheets to HSE Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
Tyres Wheels Park Brake
HSE Use Only NOTE: Sign only when all items have been checked
Plant Check By: Position: Date:
/
/
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
ROLLER Smooth or Pad Foot
Mobile Plant Prestart Checklist
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify Check
CAB
Address: City/Suburb: Phone: Plant Make: Plant Model:
WARNING DEVICES
Verify Check
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
DANGER – SAFE WORKING LIMITS ON BATTERS
Ratio 4/1 Eg only – As per Manufacturers Specifications
Exhaust
Signature:
Verify Check
Locating lock for Low/Neutral/Lower Range Pad lock provided
Verify Check
Engine Guarding
Warning sign – Hasp must be locked in position before operating
Verify Check Plant to conform to manufacturer’s specifications and Vic Plant Regs. Plant Operator is to provide daily checksheets to HSE Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Tyres Wheels Brakes Park Brake
NOTE: Sign only when all items have been checked
Verify Check
Rubber Mounts (Drum) Verify Check
Crush Point Hazard Sign displayed both sides
HSE Use Only
Verify Check
Drum Cleaning Rakes
Verify Check
Handrails Steps
Verify
Plant Check By: Position: Date:
Date:
• Horn • Amber Flashing Beacon • Reversing Alarm
Verify Check
Serial No.:
HSE-INSP-0013
Issue No.: 1
Verify Check
Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Owner:
Form:
/
/
Hydraulics Rams Hoses Connections (check for excessive wear and leaks)
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
Form:
SCRAPER – Twin Engine
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify
CAB
Date:
Verify Check
Cleanliness
Plant Supplier
Plant Make
WARNING SIGNS (In Cabin) Verify Check
Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model Serial No. Name
WARNING DEVICES • Horn • Reversing Alarm
Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational
Phone Number
HSE-INSP-0014
SEAT BELTS Verify Check
Pivots Connecting Rods Safety Pins (no excessive wear)
Verify Check
Exhaust
Signature:
Verify Check
Exhaust
Date
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s 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: Position: Date:
Verify Check
Verify Check
/
Handrails Steps
Hydraulics
Verify Tyres Wheels Brakes Park Brake
Rams Hoses Connections (check for excessive Wear and leaks)
/ Note : Register if to be used on Public Roads
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
Form:
SCRAPER
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify Check
Date:
CAB
Phone Number Plant Make Plant Model Serial No. Name
• Horn • Reversing Alarm Verify Check
WARNING SIGNS (In Cabin) SEAT BELTS
Hydraulics Verify Check Rams Hoses Connections (check for excessive Wear and leaks)
Verify Check
Signature:
WARNING DEVICES
Verify Check
Cleanliness Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Supplier
HSE-INSP-0015
Exhaust
Date
Verify Check
Pivots Connecting Rods Safety Pins (no excessive wear)
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book Verify Check
Handrails Steps
HSE Use Only NOTE: Sign only when all items have been checked
Plant Check By:
Verify Check
Verify Check
Tyres Wheels Brakes Park Brake
Rams Hoses Connections
Position: Date:
/
/ Note : Register if to be used on Public Roads
Hydraulics
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 check 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. Company 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
Form:
SKID STEER LOADER
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify Check
Date:
CAB
Verify Check
Cleanliness Seat Operator Restraint Instruments & Labelling Levers / Controls
Plant Supplier Phone Number Plant Make
WARNING SIGNS (In Cabin) Verify Check
SEAT BELTS MUST BE WORN Verify Check
ROPS (Roll Over Protective Structure) Operator Instruction (available on plant)
Serial No. Name Verify Check
Signature: Date
Verify Check Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
Pedals Protective Mesh Rear View Mirrors
Plant Model
HSE-INSP-0016
DANGER – BEWARE OVERHEAD WIRES & UNDERGROUND SERVICES Verify Check
Exhaust
Hydraulics Rams Hoses Connections (check for excessive wear and leaks)
Verify Check
Engine Guarding
Pivots Connecting Rods Safety Pins (no excessive wear)
Hydraulics
Verify Check
Rams Hoses Connections (check for excessive wear, leaks and creep)
HSE Use Only
Verify Check
Tyres Wheels Brakes Park Brake
NOTE: Sign only when all items have been checked Verify Check
Plant Check By:
SWL / Crane Chart
Position: Date:
/
/
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. Company 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
Form:
TRACK LOADER
Mobile Plant Prestart Checklist
Issue No.:
Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify Check
Date:
CAB
Verify Check
Cleanliness
Plant Supplier
Plant Make
Verify Check
Pedals in Good Condition ROPS (Roll Over Protective Structure) Windows / Wipers / Washers Rear View Mirrors Operator Instruction (available on plant)
Plant Model Serial No. Name
WARNING DEVICES • Horn • Amber Flashing Beacon • Reversing Alarm
Seat Condition OK Operator Restraint Provided Instruments Operational & Labelled Levers / Controls Operational
Phone Number
HSE-INSP-0017
WARNING SIGNS (In Cabin) SEAT BELTS
Verify Check
DANGER – BEWARE OVERHEAD WIRES & UNDERGROUND SERVICES
Verify Check Verify Check
Signature:
Exhaust
Connecting Rods & Safety Pins
Date Verify Check
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE. Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Engine Guarding
Verify Check
Pivots Connecting Rods Safety Pins (no excessive wear)
Verify Check
Brakes Park Brake
HSE Use Only
Verify Check
NOTE: Sign only when all items have been checked
Plant Check By: Position: Date:
Verify Check
SWL if used as Crane Lift Point
/
/
Hydraulics Rams Hoses Connections (check for excessive Wear and leaks)
Verify Check
Tracks Tracks Complete Idlers Adjusted Drivers Free from Leaks
Tracks
Verify Check
Verify Check
Tracks Complete Idlers Adjusted Drivers Free from Leaks
Handrails Steps
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 will check 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
Form:
TRUCK and TRAILER
Mobile Plant Prestart Checklist
Issue No.:
Articulated Vehicle Statement of Operator Competence – Required
Supplier Verification & Plant Details
Verify Check
Plant Supplier Phone Number
Date:
WARNING SIGNS (In Cabin)
WARNING DEVICES • • • •
HSE-INSP-0018
Verify Check Verify Check
Horn Amber Flashing Beacon (when onsite) Reversing Alarm Head, Tail & Turn Indicators
Cleanliness Seat Seat Belts Instruments & Labelling Levers / Controls Pedals Windows / Wipers / Washers Rear View Mirror Current Registration Sticker
SEAT BELTS
Plant Make Verify Check
Plant Model
Air / Hydraulics Rams
Verify Check
Exhaust
Hoses Connections (check for excessive wear and leaks) Hoist Control from Cabin
Serial No. Name Signature:
CABIN
Tail Gate Control from Cabin
KEEP CLEAR AIR OPERATED TAILGATE
Date
Verify Check
Plant to conform to manufacturer’s specifications and HSE Plant Regs. Plant Operator is to provide daily checksheets to HSE . Where applicable, Personal Protective Equipment must be worn. Plant Log Book Detailing service history in accordance with Manufacturer’s specifications should be written legibly in English. Contractor must produce proof of competence of operator, e.g., Certificate of Competence, Licence, Detailed Log Book
Verify Check
Tyres Wheels Brakes Park Brake
HSE Use Only Towing Hitch NOTE: Sign only when all items have been checked
Plant Check By:
Verify Check
No Cuts or Splits
Position: Date:
/
/
Verify Check
Steering Tyres Good Tread Condition Not Recaps
Handrails Steps
Verify Check
Connecting Rods Safety Pins (no excessive wear visible 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
