Back to Safety Forms Reload Form Starting Hours:Type of EquipmentDate(Required) MM slash DD slash YYYY Job #(Required)Select a Job001 - Green Depot002 - Sales003 - Hauling004 - Grinding005 - Timbro19-194 - Loyds Pit19-195 - Bodnar Pit19-196 - Devry20-207 - Harrison Lake View22-224 - Timbros Pioneer Lot22-230 - Bella Bella Ferry Rd23-232 - Wellington Ln Patricia Ave Uti23-233 - Kingsway Catalyst Vanmar23-235 - Seabird Island Cultural Centre23-237 - Kin Village Vanmar23-238 - Lower University Reservoirs 2 and 3 Squamish23-240 - Valemont Lift Station23-242 - Rockwell Dr Flood Recovery23-243 - Highway 1 Advanced Works Median Preload23-244 - Camrose Development Partnership23-245 - VHHS Lift Station and Sanitary Upgrade23-246 - Seabird Island Cultural Centre Civil Works24-247 - Runnel Dr Sanitary-Watermain24-248 - Xaxlip Emergency Water System Leak24-249 - Peardonville to MacCallum Median Soil24-250 - HHS Lift Station24-251 - HHS Lagoon Walkway24-252 - Neels Aldergrove Mushroom Barn24-253 - Devry Greenhouses24-254 - Lorenzetta Creek Flood Recovery24-255 - Flood Hope Road Mutli Use Pathway24-256 - Fraser River Bank Armouring25-257 - Preview Builders 9138 Mary St25-258 - Detention Pond Storm Sewer Road Work25-259 - MOTT Glasgow Horne Water KeyWe25-260 - Deroche Creek Recovery Works25-261 - 32 Ave Improvements 176 -184St25-262 - Strong Pit Management25-263 - Yale PitAdmin - AdminAjays - GeneralBIO - GeneralBIO-RDEK - RDEK Grinding - 2023BIO2 - BioCentral Green DepotDB - GeneralERS - Jobs - ERS - JobsERS General - Express Rock and SoilShop - ShopSJ - Small JobsTIES-ADMN - Ties AdminTIES-JB - JB Hall FlaggingEquipment Unit #(Required)Select EquipmentADT30T-01-Rock Truck VolvoADT30T-03-Rock Truck BellATBGRI-01-Grinder - Asphalt BobcatATBGRI-02-Grinder - Asphalt BobcatATBK35-02-Hydraulic Breaker Allied (350 size)ATBKBH-01-Hydraulic Breaker Stanley (Backhoe size)ATBKEX-02-Hydraulic Breaker Hammer (135 size)ATBKEX-03-Bucket 60" Tilt Bucket c/w Bolt on Cutting EdgeATBKEX-04-Bucket ONE Wrist 45 Degree L&RATBKEX-05-Bucket Garbro Concrete BucketATBKEX-07-Hydraulic Breaker Van Ed (3,477kgs) (200 size)ATBREX-01-Brush Cutter ProMacATBSWP-01-Sweeper BobcatATBSWP-02-Sweeper BobcatATBSWP-03-Sweeper CaseATBSWP-04-Sweeper CaseATBSWP-05-Sweeper CaseATBWEX-01-Barrier Grapple 10'-16' Kenco Attachment (9000lbs Capacity)ATBWEX-02-Barrier Grapple 10'-16' Kenco Attachment (9000lbs Capacity)ATCAGE-01-Trench Shield 8'x12' Steel Trench ShieldATDOGP-01-Topcon GPS Dozer System MCRATDOLB-02-Lowbed Jeep K-LineATDOLB-03-Lowbed Booster K-LineATDOLB-04-Lowbed Jeep Aspen TandemATDOSD-01-Converter Dolly SmithCoATEXGP-01 -X53I System TOPCONATEXGP-02-X53I System TOPCONATGRL0-01-GrabTec Wheel loader Grapple GrabTecATHPEX-01-Hopac Allied (Excavator)ATHPEX-02-Hopac Allied (Back Hoe)ATHPEX-03-Hopac Allied (Back Hoe)ATHPEX-04-Hopac Allied (Excavator)ATHPEX-05-Hopac Allied (Back Hoe)ATPUEX-01-Pulverizer Van Ed (3,477kgs) (200 size)ATRKEX-01-Brush Rake SecATRKEX-02-Brush Rake SecATRKEX-03-Brush Rake Accurate FabricatingATRKEX-04-Brush Rake InlandATWSEX-01-Wood Spliter - Stump Screw Lasco Cone SplitterBK0310-01-Backhoe John DeereBK0310-02-Backhoe John DeereBK0310-03-Backhoe John DeereBK0310-04-Backhoe 310SLBLOW45-01-Epress Blower EB EXPRESS BLOWERBLOW60-01-Express Blower EXPRESS BLOWERCOM185-01-Compressor Ingersol RandCR0400-01-Jaw Crusher PowerscreenCRCONE-01-Cone Crusher Terex PegsonCVY034-01-Reload Conveyor CASCVY055-01-Stacker Conveyour SuperCVY055-02-Stacker Conveyour SuperCVYP70-01-Stacker Conveyour PowerscreenDO0155-01-Dozer KomatsuDO041P-02-Dozer KomatsuDO0700-02-Dozer (GPS) John DeereDO0700-03-Dozer (GPS) John DeereDTKFRD-02-Dumptruck FordDTKINT-01-Dumptruck InternationalDTKKEN-01-Dump Truck KenworthDTKKEN-02-Dump Truck KenworthDTKMAC-01-Dumptruck MackDTKVLV-02-Bin Truck VolvoETVCAM-01-ETV CAMPERETVCAM-02-ETV CAMPEREX0048-01-Excavator Mini KubotaEX0050-01-Excavator Mini HitachiEX0080-01 Excavator Linkbelt 80X3EXEX0121-01-Excavator Mini KubotaEX0135-01-Excavator John Deere (Hyd Quick change)EX0145-01 Excavator Case CX145D 2023EX0210-01-Excavator CaseEX0210-02-Excavator Hitachi (Hyd Quick change)EX0210-03-Excavator Link-Belt (Hyd Quick change)EX0210-04-Excavator (GPS) Link-BeltEX0210-05-Excavator Link-Belt (Hyd Quick change)EX0225-01-Excavator HitachiEX0235-01-Excavator Doosan (Hyd Quick change)EX0245-01-Excavator HitachiEX0245-02-Excavator Linkbelt (HYD. QUICK CHANGE)EX0245-03 Excavator (Thumb) WBM GPSEX0330-01-Excavator VolvoEX0336-01-Excavator CaterpillarEX0345-01-Excavator John DeereEX0350-02-Excavator Hitachi (Hyd Quick change)EX0350-03-Excavator (GPS) Link-Belt (Hyd Quick change)EX0350-04-Excavator Doosan (Hyd Quick change)EX0355-01-Excavator Link BeltEX0470-01-Excavator Link-BeltFEED42-01-Feeder BOX ClemroFORKLF-01-Forklift DaeWooFUSE06-01-2"-6" IPS Butt Fusion Machine Mcelroy RollingFUSE18-01-6"-18" IPS Butt Fusion Machine Mcelroy Rolling 618GEN060-01-Genset 60Kw For FEED-01 DSEGENMAG-01-Gen Set MagnumGR4000-01-Horizontal High Speed Grinder Diamond ZLIGHTW-01-Light Tower MagnumLIGHTW-02-Light Tower Magnum ProLIGHTW-03-Light Tower Terex PegsonLIGHTW-04-Light ToweLIGHTW-05-Light ToweLIGHTW-06-Light ToweLIGHTW-07-Light ToweLO0221-01-Loader CaseLO0221-02-Loader 221F CaseLO0380-01-Loader KomatsuLO0500-01-Loader KomatsuLO050E-01-Loader VolvoLO0938-01-Loader CaterpillarLO1021-01-Case Loader CaseMBOARD-01-Message board VER-MACMBOARD-02-Message board VER-MACMBOARD-03-Message board (orange)MBOARD-04-Message board (orange)MOLE25-01-Hammerhead Mole VermeerMOLE25-02-Hammerhead MoleMOLE50-01-Hammerhead MolePLTADP-03-Plate Packer Patron (1,200lb)PLTAMM-01-Plate Packer AmmannPLTAMM-02-Plate Packer AmmannPLTWEB-03-Plate Packer WeberPT1500-05-TT-Flagging TruckPT1500-07-GMC SilverPT1500-08-Chevrolet White Chevrolet WhitePT1500-10-GMC SilverPT1500-11-TT Chevrolet WhitePT1500-12-GMC WhitePT1500-14-TT Chevrolet WhitePT1500-15-Pit TruckPT1500-16-Arrow Board TruckPT1500-17-Chevrolet WhitePT1500-18-TT GMC WhitePT1500-19-GMCPT1500-20-GMC White Double CabPT1500-21-GMC Silver Crew CabPT1500-23-Chev Silverado Summit WhitePT1500-24-Silverado (White)PT1500-25-TT-Silverado (White)PT1500-26-TT-Silverado (White)PT1500-27-TT-Silverado (White)PT2500-10-Arrow Sign Truck Dodge RAM YellowPT2500-11-ETV - 01 Dodge RAM WhitePT2500-12-TT GMC White GMC WhitePT2500-14-TT Dodge RedPT2500-15-ETV - 02 Dodge WhitePT3500-01-TT GMC (BioCentral)PT3500-04-TT-GMC (1 tonne flat deck) WhitePT3500-05-TT-GMC Sierra (1 tonne flat deck) WhitePT3500-14-GMC WhitePT3500-15-TT-GMC Silver GMC SilverPT3500-16-GMC BlackPT3500-18-Ford F350 WhitePT3500-20-TT-ERS-Dodge Ram whitePT5500-01-Ford Service TruckPT5500-02-Ford Service TruckRL001T-01-Compactor WackerRL005T-01-Compactor/Roller Bomag (Komatsu)RL010T-01-Compactor/Roller AmmannRL010T-02-Compactor/Roller CaterpillarRL012T-01-Compactor/Roller Bomag (Komatsu)RL012T-02-Hamm Roller 12 Ton H12iRL013T-01-Compactor/RollerROAPLA-01-Road Plate 1" Steel plate wilth lifting deviceROAPLA-02-Road Plate 1" Steel plate wilth lifting deviceROAWID-01-Road widener ROADWIDENERSCCH17-01-Screener PowerscreenSCSAND-01-Screener SandvikSCSTAR-01-Screener Van EykeSCWA14-01-Screener PowerscreenSK0250-01-Skidsteer Bobcat S250SK0250-02-Skidsteer Bobcat S250SK0332-01-Skidsteer Jhon Deer 332GSK0770-01-Skidsteer BobcatSK0770-02-Skidsteer BobcatSK0770-03-Skidsteer BobcatSK0770-04-Skidsteer BobcatSK0860-01-Skidsteer Bobcat S860SUBGMC-01-Suburban EMT, ETV GMCSVAUDI-01-A.MURILLO AUDISVMAZD-02-Silver SUV - MazdaSVSUBA-01-Ryan Scott Subaru AWDSVSUBA-02-Shehnaz Sidhu Subaru 4dr stnwagonSVYBAS-01-Network Rover Base TOPCONSVYROV-02-Network Rover TOPCONSVYROV-03-Network Rover TOPCONSVYROV-04-Network Rover TOPCONSVYROV-05-Network Rover TOPCONSVYTBL-01-Data Collector TOPCONSVYTBL-03-Data Collector TOPCONSVYTBL-04-Data Collector TOPCONSVYTOT-05-Robotic Total Station TOPCONTESLA3-01-Electric Tesla 3 TESLATKFD5T-03-5 ton Flat Deck International (DT 466)TL45FT-01-Equipment Trailer FellingTL9000-01-Water Tank Trailer UbuiltTLLB30-01-Trailer- 30Ton FellingTLLB65-01-Lowbed K-LineTLLD5T-01-CarTrailer Trail TechTLLD5T-02-CarTrailer Load TrailTLLD5T-03-CarTrailer Load TrailTLLD5T-04-CarTrailer TrailtechTLLD5T-05-Dump Trailer Big TexTLOF26-01-Office Trailer MnacTLPONY-01-Pony Trailer(DTKINT-01) Midland TandemTLPONY-02-Pony Trailer(DTKVLV-02) Brentwood TandemTLPONY-03-Pony Trailer (DTKKEN-01) Doepker- Tridem Pup TrailerTLPONY-04-Pony Trailer(DTKKEN-02) Langfab TandemTLRV27-01-RV Trailer TimberlodgeTLRV28-01-RV Trailer Forest River PumaTLRV30-02-RV Trailer Passport Travel trailerTLSDMP-01-Side Dump Trailer SmithCo WhiteTLSDMP-02-Side Dump Trailer SmithCo (Lead)TLSDMP-03-Side Dump Trailer SmithCo (Pup)TLSF53-01-Smooth flow trailer 53Ft TycropTLTEST-01-Cargo Trailer Soil TestingTLTRAN-01-Langfab Tub Trailer LangfabTLTSAB-01-Traffic Sign UBILTTRKBGY-01-Track Dumper KomatsuTTKKEN-01-Kenworth Tractor Truck KenworthTTKKEN-02-Kenworth Tractor Truck KenworthTTKMACK-01-Tractor Truck MackTTKMACK-02-Tractor Truck MackVN3500-01- RAMVN3500-02-GMCVN3500-03- GMCVTK600-01-Hydro Vac Truck Caterpiller HXX PRODIGYWT2000-01-Water Truck FreightlinerWT2000-02-Water Truck FreightlinerOther EquipmentExperience in the operation of the equipment(Required) Yes No Visual ChecklistGeneral Condition(Required) Checked N/A General Condition needs attention?(Required) No Yes Type of Repair required(Required)General Condition Checked - All Good!Scratches body, teeth or bucket(Required) Checked N/A Scratches needs attention?(Required) No Yes Type of Repair required(Required)Scratches Checked - All Good!Fire Extinguisher(Required) Checked N/A Fire Extinguisher needs attention?(Required) No Yes Type of Repair required(Required)Fire Extinguisher Checked - All Good!Tires/Tracks(Required) Checked N/A Tires/Tracks needs attention?(Required) No Yes Type of Repair required(Required)Tires/Tracks Checked - All Good!Safety devices in place(Required) Checked N/A Safety devices in place needs attention?(Required) No Yes Type of Repair required(Required)Safety Devices Checked - All Good!Hydraulic Wedge(Required) Checked N/A Hydraulic Wedge needs attention?(Required) No Yes Type of Repair required(Required)Safety Devices Checked - All Good!MaintenanceEngine oil level(Required) Checked N/A Engine oil level needs attention?(Required) No Yes Type of Repair required(Required)Engine Oil Checked - All Good!Hydraulic oil level(Required) Checked N/A Hydraulic oil level needs attention?(Required) No Yes Type of Repair required(Required)Hydraulic Oil Checked - All Good!Air filter (weekly)(Required) Checked N/A Air filter needs attention?(Required) No Yes Type of Repair required(Required)Air Filter Checked - All Good!Coolant level(Required) Checked N/A Coolant level needs attention?(Required) No Yes Type of Repair required(Required)Coolant level Checked - All Good!Hose(Required) Checked N/A Hose needs attention?(Required) No Yes Type of Repair required(Required)Hose Checked - All Good!Leaks(Required) Checked N/A Leaks needs attention?(Required) No Yes Type of Repair required(Required)Leaks Checked - All Good!Greasing(Required) Checked N/A Greasing needs attention?(Required) No Yes Type of Repair required(Required)Greasing Checked - All Good!Followed Regeneration Procedure(Required)If requested by the equipment Checked N/A Regen needs attention?(Required) No Yes Type of Repair required(Required)Function TestSeat belt(Required) Checked N/A Seat belt needs attention?(Required) No Yes Type of Repair required(Required)Seat belt Checked - All Good!Lights(Required) Checked N/A Lights needs attention?(Required) No Yes Type of Repair required(Required)Lights Checked - All Good!Gauges(Required) Checked N/A Gauges needs attention?(Required) No Yes Type of Repair required(Required)Gauges Checked - All Good!Back up alarm(Required) Checked N/A Back up alarm needs attention?(Required) No Yes Type of Repair required(Required)Back up Alarm Checked - All Good!Horn(Required) Checked N/A Horn needs attention?(Required) No Yes Type of Repair required(Required)Horn Checked - All Good!Controls(Required) Checked N/A Controls needs attention?(Required) No Yes Type of Repair required(Required)Controls Checked - All Good!PhotosPlease add 5 pictures of the equipment: Front, Rear, Left, Right and Interior(Cabin) Please use Lanscape mode to take the pictures Front ViewAccepted file types: jpg, png, jpeg, heic, Max. file size: 5 MB. Left Side ViewAccepted file types: jpg, png, jpeg, heic, Max. file size: 5 MB. Rear ViewAccepted file types: jpg, png, jpeg, heic, Max. file size: 5 MB. Right Side ViewAccepted file types: jpg, png, jpeg, heic, Max. file size: 5 MB. Interior ViewAccepted file types: jpg, png, jpeg, heic, Max. file size: 5 MB. CommentsComments OperatorSubmitted by(Required)Date(Required) MM slash DD slash YYYY This field is hidden when viewing the formUser_Email Signature(Required)NOTICE: Please note that once you hit the submit button it could take up to 10 sec to process your pictures and convert it to PDF so, please do not leave or close this page until to get the confirmation.