Form Inspeksi Bulanan - Dump Truck 05

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PT.

DEPRIWANGGA OM

MEDCO BANGKANAI

MONTHLY INSPECTION CHECK LIST


DUMP TRUCK
Date of Inspection 15/06/2024
Police Number DWOM-DT-05
Model Dump Truck Hino 500 JD 260

NO DESCRIPTION GOOD FAIR POOR N/A REMARKS


1 Driving License ✓

2 Brakes System ✓

3 Horn & Safety devices ✓

4 Wiper blades & control ✓

5 Lighting System ✓

6 Electrical cable connection, ✓


isolation
7 Jack up & tools ✓

8 Reverse alarm ✓

9 Cabin condition ✓

10 Battery connection and cover ✓

11 Engine & fuel system (leaks) ✓

12 Tires condition (front and ✓


rear)
13 First aid kit ✓

14 Fire Extinguisher ✓

15 Maintenance log book ✓

16 Log Book and driver check ✓


list
17 Vehicle Registration (STNK) ✓

18 Vehicle Registration (KIR) ✓

19 Emergency triangle / Safety ✓


cone
20 Spare tire ✓

21 Driver seat belts ✓

22 Warning lighting ✓
23 Meters, gauges & control ✓

24 Panel Indicator ✓

25 Inspection tag ✓

26 Operator daily checklist ✓

27 Mirors ✓

28 AC ✓

29 Exhaust system ✓

30 Cab, body, glass ✓

31 Connection, bolting ✓

32 Brake & sein lamp ✓

33 Rotary lamp ✓

34 Oil (condition, leaks) ✓

Engine ✓

Brake ✓

Cylinder ✓ TERDAPAT REMBESAN

35 Dump container ✓

36 Cylinder Dump ✓

37 Filter oli ✓

Filter fuel ✓

Filter Water Separator ✓

Tougroad ✓

Inspected by : Inspected by :
Name FAJAR Name

Position HSE Position

Sign Sign

Acknowledge by :
Name HADID

Position SPV

Sign

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