Mining Equipment Inspection Form
Complete this form to document the inspection of mining equipment and ensure safety compliance.
Inspector Full Name
*
First Name
Last Name
Inspector Email Address
*
example@example.com
Inspector Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Equipment Type
*
Please Select
Excavator
Drill Rig
Loader
Haul Truck
Conveyor
Crusher
Other
Equipment Serial/ID Number
*
Equipment Location
*
Inspection Checklist
*
Rows
Pass
Fail
N/A
Brakes and Controls
1
2
3
Hydraulic Systems
4
5
6
Lights and Alarms
7
8
9
Tires/Tracks
10
11
12
Fluid Levels
13
14
15
Fire Extinguisher
16
17
18
Cabin Condition
19
20
21
Emergency Stop
22
23
24
Guards and Shields
25
26
27
Warning Labels
28
29
30
Are there any safety hazards identified?
*
Yes
No
If hazards were identified, please describe them and recommended actions:
Upload photos of equipment or identified issues (if any)
Upload a File
Drag and drop files here
Choose a file
Cancel
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Additional Comments or Observations
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: