VISUAL INSPECTION CONDITION REPORT
Review Date May 16
Page
1
of
7
Equipment Number
Customer
Dispatch/Receipt
Date Out / /
Date In / /
Store Location
Expected Return Date
Item
Number
Number
of items
Item name
Checked
OUT
Checked
IN
Comments
1.
1
Base
2.
1
Support Post
3.
1
Hopper
4.
2
J-Bin Attachments
5.
1
Utility Box
6.
1
Hose
7.
1
Clamp & Pulley System
8.
2
Circular Clamps
9.
1
Documentation (17 pages)
7 pages – Operating and
Safety Instructions
10 pages – Installation
Manual
This equipment has received an in-service inspection and was found to have no obvious defects.
CHECKED OUT BY
CHECKED IN BY
Name:
Name:
Signature:
Signature:
Comments:
ELCO
ROCK
®
FILLING FRAME & J-BINS
2.5m
3
Sand Containers
