Form: HSE-INSP-0001

Mobile Plant ARTICULATED DUMP TRUCK Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat Condition OK  Reversing Alarm
Operator Restraint Provided
Phone Number Instruments Operational & Labelled WARNING SIGNS (In Cabin)
Verify Check
Levers / Controls Operational
Plant Make Pedals in Good Condition SEAT BELTS
ROPS (Roll Over Protective Structure)
Plant Model Windows / Wipers / Washers
Verify Check

Rear View Mirrors Exhaust

Plate No.
Operator Instruction
Name (available on plant)

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.
Verify Check
 Contractor must produce proof of competence of operator, e.g.,
Certificate of Competence, Licence, Detailed Log Book Tyres
Wheels
Brakes
Hydraulics Verify Check
HSE Use Only Park Brake
Rams
Verify Check KEEP CLEAR
NOTE: Sign only when all items have been checked Handrails Hoses
Verify Check
Steps Connections
(Signs on both sides (check for excessive wear,
Plant Check By: of vehicle) and leaks)
Position:
Instructions:
Date: / / Verify Box to be ticked by Owner / Supplier / Operator prior to arrival on site.
Note : Register if to be used on Public Roads 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: HSE-INSP-0002

Mobile Plant BACKHOE Issue No.:

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat  Amber Flashing Beacon
Operator Restraint  Reversing Alarm
Phone Number Instruments & Labelling
Levers / Controls WARNING SIGNS (In Cabin)
Verify Check
Plant Make Pedals
ROPS (Roll Over Protective Structure) SEAT BELTS
Plant Model Windows / Wipers / Washers Verify Check
Verify Check
Rear View Mirrors DANGER – BEWARE OVERHEAD WIRES
Plate No. SWL & UNDERGROUND SERVICES
Crane Chart
Name
Verify Check Verify Check
Signature: Exhaust
Pivots
Verify Check
Connecting Rods
Date Engine Guarding
Safety Pins
(no excessive wear)
Verify Check
Verify Check
SWL
Quick Hitch
 Plant to conform to manufacturer’s specifications and HSE Regs. Safety Pins
 Plant Operator is to provide daily checksheets to HSE. SWL Verify Check
 Where applicable, Personal Protective Equipment must be worn. (where applicable) Connecting Rods
 Plant Log Book Detailing service history in accordance with
Manufacturer’s specifications should be written legibly in English. & Safety Pins
 Contractor must produce proof of competence of operator, e.g., Verify Check Hydraulics
Certificate of Competence, Licence, Detailed Log Book Rams
Hoses Verify Check
Connections Travelling Hitch
(check for excessive
HSE Use Only wear and leaks) Hydraulics Verify Check
Verify Check Verify Check Rams
NOTE: Sign only when all items have been checked Verify Check
KEEP CLEAR Tyres Hoses
Wheels Handrails Connections
Plant Check By: (Signs on both sides of vehicle)
Steps
Brakes (check for excessive wear,
Position: Verify Check Park Brake and leaks)
Instructions:
Date: / / Stabilisers 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: HSE-INSP-0003

Mobile Plant COMPACTOR Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat Condition OK  Reversing Alarm
Operator Restraint Provided
WARNING SIGNS (In Cabin)
Phone Number Instruments Operational & Labelled Verify Check
Levers / Controls Operational
Plant Make SEAT BELTS
Pedals in Good Condition
Verify Check
ROPS (Roll Over Protective Structure)
Plant Model Windows / Wipers / Washers DANGER – SAFE WORKING LIMITS
Rear View Mirrors ON BATTERS
Serial No.
Operator Instruction
Ratio 2 to 1
Name (available on plant) Eg only – As per Manufacturers Specifications

Signature: Verify Check

Exhaust
Date Verify Check Hydraulics
Verify Check
Rams
Engine Guarding Hoses
Connections
 Plant to conform to manufacturer’s specifications and HSE Plant Verify Check (check for excessive wear,
Regs.
 Plant Operator is to provide daily checksheets to HSE. Brakes and leaks)
 Where applicable, Personal Protective Equipment must be worn. Park Brake
 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 Office Use Only

Verify Check
NOTE: Sign only when all items have been checked
Crush Point Hazard
Sign displayed both Verify Check
Plant Check By: sides
Handrails
Position:
Steps
Instructions:
Date: / / 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: HSE-INSP-0004

Mobile Plant BULL DOZER Issue No.:

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check WARNING DEVICES

 Horn
Verify Check CAB
Plant Supplier  Amber Flashing Beacon
Cleanliness
 Reversing Alarm
Seat Condition OK
Phone Number
Operator Restraint Provided WARNING SIGNS (In Cabin)
Verify Check
Plant Make Instruments Operational & Labelled
Levers / Controls Operational SEAT BELTS
Plant Model Pedals in Good Condition Verify Check
ROPS (Roll Over Protective Structure) DANGER – BEWARE OVERHEAD WIRES
Serial No. Windows / Wipers / Washers & UNDERGROUND SERVICES
Rear View Mirrors
Name Operator Instruction Verify Check
Verify Check
(available on plant) Exhaust
Signature: Rams
Hoses
Date Connections
Verify Check
(check for excessive wear,
leaks and creep) 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
Handrails
Plant Check By: Pivots Tracks Verify Check
Steps
Pins Tracks Complete
Position:
Connections Idlers Adjusted Instructions:
Date: / / Safety Pins Drivers Free from Leaks 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: HSE-INSP-0005

Mobile Plant DRUM ROLLER Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat Condition OK  Reversing Alarm
Operator Restraint Provided
WARNING SIGNS (In Cabin)
Phone Number Instruments Operational & Labelled Verify Check
Levers / Controls Operational
SEAT BELTS
Plant Make Pedals in Good Condition
Verify Check
ROPS (Roll Over Protective Structure)
Plant Model DANGER – SAFE WORKING LIMITS ON BATTERS
Windows / Wipers / Washers
Rear View Mirrors
Serial No. Ratio 4 to 1
Operator Instruction Eg only – As per Manufacturers Specifications
Name (available on plant)
Verify Check
Signature: Locating lock for Verify Check
Low/Neutral/Lower Range
Pad lock provided Exhaust
Date
Warning sign – Hasp must be
locked in position before
operating Verify Check
 Plant to conform to manufacturer’s specifications and HSE Plant Engine Guarding
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 Verify Check
Manufacturer’s specifications should be written legibly in English.
 Contractor must produce proof of competence of operator, e.g., Tyres
Certificate of Competence, Licence, Detailed Log Book
Wheels
Brakes
Park Brake

HSE Use Only Verify Check

Verify Check Hydraulics Crush Point Hazard Verify Check

NOTE: Sign only when all items have been checked Sign displayed both
Hoses sides Handrails
Plant Check By: Connections Steps
(check for excessive wear
Position: and leaks)
Instructions:
Date: / / 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
 Form: HSE-INSP-0006

Mobile Plant ELEVATING WORK PLATFORM Issue No.:

Knuckle Boom
Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details kontrol UYARI/İKAZ DONANIMLARI Kontrol SEPET
 Korna Temizlik
Sub-con name  Tepe flaşör Operatör kısıtılması
 Hareket alarmı Etiketleme
Phone Number  Bom alarmı Kontrol paneli
 Fazla yük alarmı Pedal
Plant Make Kayıt defteri
Deadman
Plant Model Operation Instruction
Kontrol Hidrolik (available on plant)
Serial No. Rams Kont
Hortu
Name bağlantılar
SWL / Crane Chart
(yıpranma ya da kaçak) Kont
Signature: Kontrol
UYARI İŞARETLERİ Safety Harness & Lanyard
Mil Kontrol
Date EMNİYET KEME
Bağlantı
Kontrol
Rod kontrol
TEHLİKE – HAVAİ HATLARA KARŞI
Pin DİKKATLİ OLUNUZ
 Plant to conform to manufacturer’s specifications and HSE Plant (no excessive wear)
Regs. Kontrol Hidrolik kont
 Plant Operator is to provide daily checksheets to HSE.
 Where applicable, Personal Protective Equipment must be worn. Exhaust Rams
 Plant Log Book Detailing service history in accordance with (if applicable)
Manufacturer’s specifications should be written legibly in Hortumlar
English.
Kontrol . Bağlantılar
 Contractor must produce proof of competence of operator, e.g.,
Certificate of Competence, Licence, Detailed Log Book Kontrol ekranı (check for excessive wear,
Kontrol leaks and creep)
Motor kapağı

HSE Use Only Kontrol

Lasti
NOTE: Sign only when all items have been checked
Wheels
Brakes
Plant Check By:
Park Brake
Position:
Instructions:
Date: / / 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: HSE-INSP-0007

Mobile Plant ELEVATING WORK PLATFORM Issue No.:

Scissor Lift
Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check WARNING DEVICES Verify Check BASKET
 Horn Cleanliness
Plant Supplier Verify Check  Amber Flashing Beacon (when onsite) Instruments & Labelling
Levers / Controls  Reversing Alarm Levers / Controls Basket & Base
Phone Number  Head, Tail & Turn Indicators Pedals
Verify Check Log Book
Plant Make
Self Closing Gate Operation Instruction
(available on plant)
Plant Model
Verify Check
Serial No.
Safety Working Load
Name

Signature:
Verify Check
Date Pivots Verify Check
Connecting Rods WARNING & RESTRICTION SIGNS
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.
Verify Check Hydraulics
 Where applicable, Personal Protective Equipment must be worn. Verify Check Verify Check
 Plant Log Book Detailing service history in accordance with Rams
Manufacturer’s specifications should be written legibly in Safety Prop Guarding Of
Hoses
English. Under Scissor Scissor
 Contractor must produce proof of competence of operator, e.g., Connections
Certificate of Competence, Licence, Detailed Log Book (check for excessive Verify Check
Wear and leaks) Exhaust
(if applicable)
HSE Use Only Verify Check
Tyres
NOTE: Sign only when all items have been checked
Wheels
Brakes
Plant Check By:
Park Brake
Position:
Instructions:
Date: / / Verify Check
Verify Box to be ticked by Owner / Supplier / Operator prior to arrival onsite.
Engine Guarding 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: HSE-INSP-0008

Mobile Plant EXCAVATOR Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify Check WARNING DEVICES

 Horn
 Amber Flashing Beacon
Plant Supplier Verify Check
 Motion Alarm
Pivots
Phone Number WARNING SIGNS (In Cabin)
Connecting Rods Verify Check

Plant Make Safety Pins SEAT BELTS

(no excessive wear)
Verify Check
Plant Model Verify Check Hydraulics DANGER – BEWARE OVERHEAD WIRES
& UNDERGROUND SERVICES
Rams
Serial No. Hoses
Connections Verify Check CAB
Name Cleanliness
(check for excessive wear
and leaks) Seat Condition OK
Signature:
Operator Restraint Provided
Instruments Operational & Labelled
Date
Verify Check Levers / Controls Operational
SWL / Crane Chart Pedals in Good Condition
ROPS (Roll Over Protective Structure)
Windows / Wipers / Washers
 Plant to conform to manufacturer’s specifications and HSE Plant
Regs. Verify Check Rear View Mirrors
 Plant Operator is to provide daily checksheets to HSE. Operator Instruction
 Where applicable, Personal Protective Equipment must be worn.
Quick Hitch
 Plant Log Book Detailing service history in accordance with Safety Pins (available on plant)
Manufacturer’s specifications should be written legibly in
English.
(where applicable)
Verify Check
 Contractor must produce proof of competence of operator, e.g., (If Quick Hitch is fitted
Certificate of Competence, Licence, Detailed Log Book NO LIFTING POINTS Exhaust
Allowed on back of bucket Verify Check
Engine Guarding
HSE Use Only
Verify Check Hydraulics
Tracks Verify Check Verify Check
NOTE: Sign only when all items have been checked Rams
Tracks Complete Handrails
Hoses
Plant Check By: Idlers Adjusted Steps
Connections
(check for excessive wear, Drivers Free from Leaks
Position:
leaks and creep)
Instructions:
Date: / / 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: HSE-INSP-0009

Mobile Plant GRADER Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat Condition OK  Amber Flashing Beacon
Operator Restraint Provided  Reversing Alarm
Phone Number Instruments Operational & Labelled
Levers / Controls Operational WARNING SIGNS (In Cabin)
Verify Check
Plant Make Pedals in Good Condition
SEAT BELTS
ROPS (Roll Over Protective Structure)
Plant Model Verify Check
Windows / Wipers / Washers
Rear View Mirrors SAFE WORK LIMIT ON BATTERS
Plate No. Ratio 2 to 1 Ratio 2 to 1
Operator Instruction
Name (available on plant)
e.g. only – As per Manufacturer’s Specifications
Signature: Verify Check Hydraulics
Rams Verify Check
Date Hoses
Exhaust
Connections
(check for excessive wear
Verify Check
and leaks)
Engine Guarding
 Plant to conform to manufacturer’s specifications and RoK Plant
Regs.
 Plant Operator is to provide daily checksheets HSE. Verify Check
 Where applicable, Personal Protective Equipment must be worn.
 Plant Log Book Detailing service history in accordance with Drive Guards
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 Steering

HSE Use Only Unions
Verify Check

Rods Tyres
NOTE: Sign only when all items have been checked Verify Check Verify Check
Connections Wheels
Pivots Handrails Brakes
Plant Check By:
Pins Steps Park Brake
Position: Connections
Safety Pins Instructions:
Date: / / Verify Box to be ticked by Owner / Supplier / Operator prior to arrival onsite.
Note : Register if to be used on Public Roads 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: HSE-INSP-0010
FRONT END LOADER
Mobile Plant Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness
 Horn
Plant Supplier Seat Condition OK  Amber Flashing Beacon
Operator Restraint Provided
 Reversing Alarm
Phone Number Instruments Operational & Labelled
Levers / Controls Operational WARNING SIGNS (In Cabin)
Verify Check
Plant Make Pedals in Good Condition
ROPS SEAT BELTS
Plant Model Windows / Wipers / Washers Verify Check
Rear View Mirrors DANGER – BEWARE OVERHEAD WIRES
Serial No.
Operator Instruction Verify Check
Name (available on plant)
Exhaust
Verify Check
Signature: Verify Check
Pivots
Connecting Rods Engine Guarding
Date
Safety Pins
(no excessive wear)

Verify Check
 Plant to conform to manufacturer’s specifications and HSE Plant Tyres
Regs.
 Plant Operator is to provide daily checksheets to HSE. Verify Check Hydraulics Wheels
 Where applicable, Personal Protective Equipment must be worn. Brakes
 Plant Log Book Detailing service history in accordance with Rams
Manufacturer’s specifications should be written legibly in English. Hoses Park Brake
 Contractor must produce proof of competence of operator, e.g.,
Certificate of Competence, Licence, Detailed Log Book Connections
(check for excessive
Wear and leaks)
Verify Check
HSE Use Only Handrails
Steps
NOTE: Sign only when all items have been checked Verify Check Crush Point Hazard Verify Check
Sign displayed both
SWL if used as Crane sides
Plant Check By: Lift point
Position:
Date: / /
Instructions:

Note : Register if to be used on Public Roads 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: HSE-INSP-0011

Mobile Plant MOBILE CRANE Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness
 Horn
Plant Supplier Seat Condition OK
 Amber Flashing Beacon
Operator Restraint Provided
Instruments Operational & Labelled  Reversing Alarm
Phone Number
Levers / Controls Operational
WARNING SIGNS (In Cabin)
Plant Make Pedals in Good Condition Verify Check
Verify Check Boom ROPS (Roll Over Protective Structure)
Plant Model Pivots Windows / Wipers / Washers SEAT BELTS
Connecting Rods Rear View Mirrors Verify Check
Serial No. Safety Pins Operator Instruction DANGER – BEWARE OVERHEAD WIRES,
(no excessive wear) (available on plant) PIPES and SERVICES
Name Log Book
SWL / Crane Chart
Signature:

Date Verify Check

Engine Guarding
Verify Check
Hambone & Wedge Verify Check
 Plant to conform to manufacturer’s specifications and Vic Plant Exhaust
Regs.
 Plant Operator is to provide daily checksheets to HSE.
 Where applicable, Personal Protective Equipment must be worn. Verify Check Hydraulics
 Plant Log Book Detailing service history in accordance with
Manufacturer’s specifications should be written legibly in English. Rams
 Contractor must produce proof of competence of operator, e.g., Hoses
Certificate of Competence, Licence, Detailed Log Book
Connections
(check for excessive
Wear and leaks)
Verify Check Verify Check
HSE Use Only Tyres Verify Check Slew Radius / Barricading
Wheels for around Outriggers
NOTE: Sign only when all items have been checked Handrails
Brakes
Steps Verify Check
Verify Check Park Brake
Plant Check By: Outriggers & Rams
Slings / Ropes / Chains (Tagged and in good working order) Operational
Position: Electrical Wiring (No visual signs of damage)
Instructions:
Steel or Timber Pads
Date: / / 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
 Form: HSE-INSP-0012

Mobile Plant MULTI-WHEEL ROLLER Issue No.:

Prestart Checklist Statement of Operator Competence - Required Date:

Supplier Verification & Plant Details

Verify Check WARNING DEVICES
Verify Check CAB
Plant Supplier  Horn
Cleanliness
Phone  Amber Flashing Beacon
Seat Condition OK
Number  Motion Alarm
Operator Restraint Provided
Instruments Operational & Labelled WARNING SIGNS (In Cabin)
Plant Make Levers / Controls Operational Verify Check

Plant Model Pedals in Good Condition SEAT BELTS

ROPS (Roll Over Protective Structure)
Serial No. Windows / Wipers / Washers
Verify Check
Rear View Mirrors
Exhaust
Name Operator Instruction
(available on plant)
Signature: Verify Check
Engine Guarding
Date

Verify Check
Handrails
 Plant to conform to manufacturer’s specifications and Vic Plant
Regs. Steps
 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
HSE Use Only Park Brake

NOTE: Sign only when all items have been checked

Plant Check By:

Position:
Instructions:
Date: / / 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: HSE-INSP-0013

Mobile Plant ROLLER Smooth or Pad Foot Issue No.: 1

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Owner: Seat Condition OK  Amber Flashing Beacon
Operator Restraint Provided  Reversing Alarm
Address: Instruments Operational & Labelled
Levers / Controls Operational
WARNING SIGNS (In Cabin)
Verify Check
City/Suburb: Pedals in Good Condition
SEAT BELTS
ROPS (Roll Over Protective Structure)
Phone: Windows / Wipers / Washers
Verify Check
DANGER – SAFE WORKING LIMITS ON BATTERS
Rear View Mirrors
Plant Make: Operator Instruction
(available on plant) Ratio 4/1
Plant Model: Eg only – As per Manufacturers Specifications
Verify Check
Serial No.: Exhaust Verify Check
Locating lock for
Signature: Low/Neutral/Lower Range
Verify Check
Pad lock provided
Engine Guarding
Warning sign – Hasp must be
Verify Check locked in position before
 Plant to conform to manufacturer’s specifications and Vic Plant operating
Regs.
Tyres
 Plant Operator is to provide daily checksheets to HSE Wheels
 Where applicable, Personal Protective Equipment must be worn. Brakes
 Plant Log Book Detailing service history in accordance with Verify Check
Manufacturer’s specifications should be written legibly in English. Park Brake
 Contractor must produce proof of competence of operator, e.g., Rubber Mounts (Drum)
Certificate of Competence, Licence, Detailed Log Book
Verify Check
Crush Point Hazard
Sign displayed both Verify Check
sides
HSE Use Only Verify Check Drum Cleaning Rakes

Handrails
NOTE: Sign only when all items have been checked Steps
Verify Hydraulics
Plant Check By: Rams
Position: Hoses
Connections Instructions:
Date: / / (check for excessive Verify Box to be ticked by Owner / Supplier / Operator prior to arrival onsite.
wear and leaks) 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
 SCRAPER – Twin Engine
Form: HSE-INSP-0014

Mobile Plant Issue No.:

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify CAB Verify Check WARNING DEVICES
Cleanliness
 Horn
Plant Supplier Seat Condition OK
 Reversing Alarm
Operator Restraint Provided
Phone Number Instruments Operational & Labelled
WARNING SIGNS (In Cabin)
Levers / Controls Operational Verify Check
Plant Make Pedals in Good Condition
SEAT BELTS
ROPS (Roll Over Protective Structure)
Plant Model Windows / Wipers / Washers
Verify Check
Rear View Mirrors
Serial No. Verify Check
Pivots
Verify Check
Operator Instruction Connecting Rods
(available on plant) Exhaust Exhaust
Name Safety Pins
(no excessive wear)
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 Hydraulics Verify

Verify Check
Rams Tyres
NOTE: Sign only when all items have been checked Handrails Hoses Wheels
Steps Connections Brakes
Plant Check By: (check for excessive Park Brake
Position: Wear and leaks)
Instructions:
Date: / / Verify Box to be ticked by Owner / Supplier / Operator prior to arrival onsite.
Note : Register if to be used on Public Roads 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: HSE-INSP-0015

Mobile Plant SCRAPER Issue No.:

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat Condition OK  Reversing Alarm
Operator Restraint Provided
Instruments Operational & Labelled WARNING SIGNS (In Cabin)
Phone Number Verify Check
Levers / Controls Operational
SEAT BELTS
Plant Make Pedals in Good Condition
ROPS (Roll Over Protective Structure)
Plant Model Hydraulics Verify Check
Windows / Wipers / Washers Rams
Rear View Mirrors Hoses
Serial No.
Operator Instruction Connections
Verify Check
(available on plant) (check for excessive
Name Pivots
Verify Check Wear and leaks)
Connecting Rods
Signature: Exhaust
Safety Pins
Date (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
HSE Use Only Steps Verify Check
Verify Check Hydraulics
Tyres
NOTE: Sign only when all items have been checked Wheels
Brakes Rams
Plant Check By: Park Brake Hoses
Position: Connections
Instructions:
Date: / / Verify Box to be ticked by Owner / Supplier / Operator prior to arrival onsite.
Note : Register if to be used on Public Roads 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: HSE-INSP-0016

Mobile Plant SKID STEER LOADER Issue No.:

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat  Amber Flashing Beacon
Operator Restraint  Reversing Alarm
Phone Number Instruments & Labelling
Levers / Controls WARNING SIGNS (In Cabin)
Plant Make Pedals Verify Check

Protective Mesh SEAT BELTS MUST BE WORN

Plant Model Rear View Mirrors
Verify Check
ROPS (Roll Over Protective Structure)
Serial No. DANGER – BEWARE OVERHEAD WIRES
Operator Instruction
& UNDERGROUND SERVICES
Name (available on plant) Verify Check
Exhaust
Signature: Verify Check Hydraulics

Rams Verify Check

Date Hoses Engine Guarding
Connections
(check for excessive wear
Verify Check and leaks)
 Plant to conform to manufacturer’s specifications and HSE Plant Pivots
Regs. Connecting Rods Hydraulics Verify Check
 Plant Operator is to provide daily checksheets HSE.
 Where applicable, Personal Protective Equipment must be worn. Safety Pins
 Plant Log Book Detailing service history in accordance with Rams
(no excessive wear)
Manufacturer’s specifications should be written legibly in English. Hoses
 Contractor must produce proof of competence of operator, e.g.,
Certificate of Competence, Licence, Detailed Log Book
Connections
(check for excessive wear,
leaks and creep)

HSE Use Only Verify Check

Tyres
NOTE: Sign only when all items have been checked
Verify Check Wheels
Brakes
Plant Check By: SWL / Crane Chart
Park Brake
Position:
Instructions:
Date: / / 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: HSE-INSP-0017

Mobile Plant TRACK LOADER Issue No.:

Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check CAB Verify Check WARNING DEVICES
Cleanliness  Horn
Plant Supplier Seat Condition OK  Amber Flashing Beacon
Operator Restraint Provided  Reversing Alarm
Phone Number Instruments Operational & Labelled
Levers / Controls Operational Verify Check
WARNING SIGNS (In Cabin)
Plant Make Pedals in Good Condition
SEAT BELTS
ROPS (Roll Over Protective Structure)
Plant Model Verify Check
Windows / Wipers / Washers
DANGER – BEWARE OVERHEAD WIRES
Rear View Mirrors & UNDERGROUND SERVICES
Serial No.
Operator Instruction
(available on plant)
Name Verify Check
Verify Check
Exhaust
Signature: Connecting Rods &
Safety Pins
Date

Verify Check Verify Check

SWL if used as Crane Engine Guarding
Lift Point
 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. Verify Check
 Plant Log Book Detailing service history in accordance with Pivots
Manufacturer’s specifications should be written legibly in English.
 Contractor must produce proof of competence of operator, e.g., Connecting Rods
Certificate of Competence, Licence, Detailed Log Book Safety Pins
Verify Check
(no excessive wear)
Brakes
Park Brake
Hydraulics
HSE Use Only Verify Check
Tracks Verify Check Verify Check
Rams Verify Check Tracks
NOTE: Sign only when all items have been checked Hoses Tracks Complete Handrails
Tracks Complete
Connections Idlers Adjusted Steps
Plant Check By: Idlers Adjusted
(check for excessive Drivers Free from Leaks
Drivers Free from Leaks
Position: Wear and leaks)
Instructions:
Date: / / 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: HSE-INSP-0018

Mobile Plant TRUCK and TRAILER Issue No.:

Articulated Vehicle
Prestart Checklist Statement of Operator Competence – Required Date:

Supplier Verification & Plant Details Verify Check WARNING DEVICES WARNING SIGNS (In Cabin) Verify Check CABIN
Verify Check
 Horn Cleanliness
Plant Supplier  Amber Flashing Beacon (when onsite) SEAT BELTS Seat
 Reversing Alarm Seat Belts
Phone Number  Head, Tail & Turn Indicators Instruments & Labelling
Levers / Controls
Plant Make Pedals
Verify Check Air / Hydraulics Verify Check Windows / Wipers / Washers
Plant Model
Rams Exhaust Rear View Mirror
Serial No. Hoses Current Registration Sticker
Connections
Name (check for excessive wear and leaks)
Hoist Control from Cabin
Signature: 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., Verify Check
Certificate of Competence, Licence, Detailed Log Book
Tyres
Wheels
Brakes
Park Brake
HSE Use Only
Towing Hitch Verify Check
NOTE: Sign only when all items have been checked
Connecting Rods
Plant Check By: Verify Check Safety Pins
Verify Check Steering Tyres
Handrails (no excessive wear
No Cuts or Splits
Position: visible
Good Tread Condition Steps
Instructions:
Date: / / Not Recaps 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