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FM-QHSE-40 Ceklist Inspeksi Kendaraan

This document is a regular inspection report for a light vehicle. It contains 9 sections to inspect various parts of the vehicle including the engine, body, brake system, drive line, chassis, electrical system, accessories, and other sections. Each section lists the specific parts to inspect and rates their condition as good, fair, or poor. The inspection date, vehicle information, odometer reading, and inspector's comments are also included. Upon completion, the inspection report is signed by the inspector and acknowledged by the company director.

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165 views1 page

FM-QHSE-40 Ceklist Inspeksi Kendaraan

This document is a regular inspection report for a light vehicle. It contains 9 sections to inspect various parts of the vehicle including the engine, body, brake system, drive line, chassis, electrical system, accessories, and other sections. Each section lists the specific parts to inspect and rates their condition as good, fair, or poor. The inspection date, vehicle information, odometer reading, and inspector's comments are also included. Upon completion, the inspection report is signed by the inspector and acknowledged by the company director.

Uploaded by

ashindo tama
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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LIGHT VEHICLE REGULAR INSPECTION

INSPEKSI BERKALA KENDARAAN RINGAN

Date of Inspection / Tanggal : Kilometer Driven


:
Company Name / Perusahaan : / Total Jarak Tempuh
Type of Vehicle / Tipe :
Brand / Merek :
Police number / No. Polisi :

Condition
No Description Remarks
Good Fair Poor
I Engine / Mesin 1. Engines Assembly / Kondisi Mesin
II Body / Badan 1. Fender LH / Spatbor Kiri
2. Fender RH / Spatbor Kanan
3. Engines Hood / Penutup Mesin
4. Door & Glass LH / Pintu dan Kaca Kiri
5. Door & Glass RH / Pintu dan Kaca Kanan
6. Front & Rear Bumper / Bemper Depan & Belakang
7. Windshield System / Sistem Pelindung Kaca
8. Radiator Grill / Garis Partisi Radiator
9. Rear Body Assembly / Body Belakang
10. Windshield / Pelindung Kaca
11. Wipers / Pengelap Kaca
III Brake System / Sistem Rem 1. Front Brake LH & RH / Rem Depan Kanan & Kiri
2. Rear Brake LH & RH / Rem Belakang Kanan & Kiri
3. Parking Brake / Rem Tangan
IV Drive Line / Sistem Roda 1. Clutch System / Sistem Kopling
2. Transmission Assy / Sistem Transmisi
3. Transfer Case Assy / Sistem pergantian gear
4. Front Differential / Pengaturan roda depan
5. Rear Differential / Pengaturan roda belakang
6. Front Propeller Shaft Assy / Putaran gardan depan
7. Rear Propeller Shaft Assy / Putaran gardan belakang
8. Front Axle Shaft (LH & RH) / Pangkal roda depan
9. Rear Axle Shaft (LH & RH) / Pangkal roda belakang
10. 5 Tires / 5 Ban atau Roda
11. Tie-Rod Ends / Terod
12. Stabilizer Bar / Batang Penyeimbang antar roda
V Chassis / Rangka 1. Frame / Rangka
2. Spring / Pegas
3. Parking Brake / Rem Tangan
4. Shock Absorber / Peredam Getaran
VI Electrical System / Sistem 1. Charging System / Sistem Pengisian Aki
elektrik
2. Starting System / Sistem Stater
3. Lighting System / Sistem Lampu
4. Battery / AKI
5. Metering System / Sistem Matering
6. Horn / Klakson
7. Air Condition / AC
VII Accessories / Aksesoris 1. Safety Belt / Sabuk Keselamatan
2. Fire Extinguisher / APAR (Alat Pemadam)
3. Safety Triangle / Segi Tiga Pengaman
4. First Aid Kit / Kotak P3K
5. Whip flag / Bendera
6. Back-up alarm / alarm mundur
7. Rotary/strobe light / lampu Rotary
8. Jack c/w Handle and Tools / alat – alat / kunci - kunci
VIII Others / Lain - lain 1.
2.
3.
IX Comment / Komentar

Reported by, Acknowledged by,


Dilaporkan oleh, Diketahui oleh,

Romli M. Ali Mahfud


HSE Officer Direktur

FM-QHSE-40/Rev.00

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