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HYDROSTATIC TEST PUMP PRE-MOB INSPECTION REPORT

Applies to HydrostaticTest Pump

Equip. No. : Type : Model : Brand :

Serial No. : Hourmeter : Service Date :

Inspected by : Date : Location : Owner :

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Description to be Checked Remarks

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Equipment Documentation
1 Today's Pre-Trip Inspection
2 Original Manufacturer Name Plate
3 Original or a Copy of Operation Manual Book
4 SOP - Standard Operating Procedure
5 Company ID Number, Company Logo
o
N
Original Copy Available on Unit
Year of Manufacture
Matches Unit Type and Series
Based on OEM Operation Manual Book
Correct Size, Minimum 10 Cm Height, Visible

Mandatory Safety Inspections and Devices

1 Automatic Overpressure Safety Release Valve Test Function

2 Quick Change Hose Couplers Connector and Clamps must be SAFETY WIRED

3 Pressure Manifold Discharge Check Valve Test Function

4 Trailer Towing Ring -Towing Connecting Devices Not Bent, No Fatigue Cracks
Trailer Wheels and Tires, Wheel Condition, No Broken-Missing Lug Nuts, Tread Depth Minimum
5
3mm
Trailer Suspension System, Springs, Brakes
6 No Loose Axle Mount Bolts, No Worn Out Spring Bushings and Pins All U-Bolts Tight, No Cracks,
Parking Brake Functional
Safety Covers and Guards All Covers in Place, Not Loose, None Missing, Not Modified, Remain
7
within OEM Specs

8 Safety Stand Leg Not Bent, Not Unsafe or in Danger of Collapsing

Engine and Main Pumping Unit

1 Engine Clean Appearance, No Leaks, No Defective Mounts, Observe Performance

2 Engine Dipstick Easy to read, Oil Level Adequate

Battery, Battery Covers, Battery Mounting, Battery Terminals
3
Optional Battery Disconnect Switch, Test Function, No Loose or Corroded Cables-Terminals, Battery
4 Starter Motor Test Function, Adequate Cranking Strength, No Bad Noises or Overheating
Alternator
5
Observe Charging Function, No Bad Noises or Overheating, No Loose Mounts, No Loose Belts
6 Cooling System, Radiator, Hoses No Leaks, No Perished Hoses

7 V-Belts or Serpentine Belts Not Loose, Not Squealing, Not Cracked

8 Exhaust System, Pipe, Muffler No leaks, Not Loose

9 Hose and Pipes Properly Secured, No Leaks

Frame and Body

1 Body Condition Good Paint and General Appearance, No Excess Damage, No Rust

2 Engine Cover Hinges Inspect Latches for Safety Holding Brackets, Can NOT Pinch Fingers

Servicing and Maintenance

1 Maintenance Schedule - PM and PdM Service Records Available

Others
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2
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Description to be Checked Remarks

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Comments
Good = Good condition, able to be operated
in all CPI areas
No Good = Broken, Malfunction, Repair or
Replace

N/A = Not Applicable

Inspected by: Acknowledged by RW and CPI The undersigned hereby accept and
agree that this equipment is "OK" and
safe for operation. Menerima dan
Menyetujui bahwa Alat ini sudah "OK"
dan aman untuk dioperasikan.

SIGNATURE, Date

RW-CEM RW-HES
Contractor's Name