ATT4_EQUIPMENT_PREUSE_CKLIST.docx

CONTRACTOR EQUIPMENT PRE-USE CHECKLIST

1. Owner

2. Contractor

3. Contract No.

4.Contract Date

1. Canopy, roll over-protection system.

2. Lights mounted and working while operating. (If Applicable).

3. Brakes hold at half travel.

4. No visible leaks or drips.

5. Belly plate and radiator guard securely mounted.

6. Tire, tracks or undercarriage in serviceable condition.

7. Blade or booms operate smoothly and hold at any point.

8. Drawbar: Serviceable, safe.

9. N/A

ACCESSORIES (CHECK BELOW IF IN OR ON VEHICLE)

FIRST AID: YES NO REFLECTORS YES NO

FIRE EXTINGUISHER YES NO SAFETY BELTS YES NO

BLOOD-BORNE PATHOGEN KIT YES NO BACK-UP ALARM YES NO

MIRRORS SERVICEABLE YES NO

DEMO: OPERATE THRU FULL RANGE YES NO

SIGNATURE: DATE:

The Contractor completes this checklist prior to the use of all Contractor / Vendor heavy equipment on Savannah River Site ensuring the equipment is serviced and maintained in accordance with each Manufacturer’s recommendations and OSHA requirements and will be operated, inspected, and maintained by a qualified, competent person for the duration of the Contract. If ANY component is determined to be unsatisfactory, the unsatisfactory equipment may not be used until the deficiency is corrected. The COR, Inspector, FSR, TSA, representative will observe the contractor completing this checklist and obtain a copy for USFS-SR contract files.

Attachment 4