Mobile Plant Experience Checklist
1
Process Owner or Function: HR Management Document ID: RR-HR-FM-022 Rev. No: 03 Effective Date: 01/07/2017 Name of Form- Mobile Plant Experience Checklist & Declaration Mobile Plant Experience Checklist 1. Please check or tick the appropriate box indicating your experience on each machine. 2. Where machines are not listed please use blank spaces to write them in. 3. Employee Name : Date Of Completion: Excavators 3-6 Mths 6-12 Mths 1-2 Yrs 2-3 Yrs 3-5 Yrs 5+ Yrs Graders 3-6 Mths 6-12 Mths 1-2 Yrs 2-3 Yrs 3-5 Yrs 5+ Yrs 5-30 Tonne 120/140 30-70 Tonne 12/14 G/H 70-100 Tonne 16 G/H PC1250 120/140M Hitachi 1200 12/14M Hitachi 1900 16M Hitachi 2500 24M Hitachi 3600 Hitachi 4500 Hitachi 5500 Hitachi 8000 Komatsu PC1250 Komatsu PC2000 Loaders 3-6 6-12 1-2 2-3 3-5 5+ Komatsu PC3000 CAT Komatsu PC4000 966/989 H Komatsu PC5500 988/990 H Komatsu PC7000 992/993 Komatsu PC8000 994F Dump Truck 3-6 6-12 1-2 2-3 3-5 5+ Komatsu 25/30t Artic WA250 35/40t Artic WA500 CAT 769/775 WA600 CAT 777 C/D/F WA900 CAT 785 C/D/F WA1200 CAT 789 P&H L-1150 Komatsu HD 785 P&H L-1350 Komat730E P&H L-1850 Komat830E P&H L-2350 Komat930E Komat980E Dozers 3-6 6-12 1-2 2-3 3-5 5+ Other 3-6 6-12 1-2 2-3 3-5 5+ D6/D7 Backhoe D8 R/T Bobcat D9 N/T CAT/VOLVO IT D10 N/T Artic W/Cart D11 N/T CAT 769/773 824 C Toyota Lv’s D375A Lighting Plant D475A Generators Forklifts Drills 3-6 6-12 1-2 2-3 3-5 5+ MD6200 MD6250 MD6310 MD6540C MD6640 P&H 250XPC P&H 285XPC P&H 320XPC P&H 77XR Please list any other relevant earthmoving plant Experience: I declare that I have worked and have experience on the above ticked mobile plant equipment; Signed Employee Date: Employer Witness Date: Doc No-RR-HR-FM-022 Uncontrolled when printed page 1 Form (serious legal consequences apply to false or misleading information and can lead to employment terminated)
Transcript of Mobile Plant Experience Checklist
Process Owner or Function:
HR Management
Document ID:
RR-HR-FM-022
Rev. No:
03
Effective Date:
01/07/2017
Name of Form- Mobile Plant Experience Checklist & Declaration
Mobile Plant Experience Checklist
1. Please check or tick the appropriate box indicating your experience on each machine.
2. Where machines are not listed please use blank spaces to write them in.
3. Employee Name: Date Of Completion:
Excavators 3-6
Mths
6-12
Mths
1-2
Yrs
2-3
Yrs
3-5
Yrs
5+
Yrs
Graders 3-6
Mths
6-12
Mths
1-2
Yrs
2-3
Yrs
3-5
Yrs
5+
Yrs 5-30 Tonne 120/140
30-70 Tonne 12/14 G/H
70-100 Tonne 16 G/H
PC1250 120/140M
Hitachi 1200 12/14M
Hitachi 1900 16M
Hitachi 2500 24M
Hitachi 3600
Hitachi 4500
Hitachi 5500
Hitachi 8000
Komatsu PC1250
Komatsu PC2000 Loaders 3-6 6-12 1-2 2-3 3-5 5+
Komatsu PC3000 CAT Komatsu PC4000 966/989 H Komatsu PC5500 988/990 H
Komatsu PC7000 992/993
Komatsu PC8000 994F
Dump Truck 3-6 6-12 1-2 2-3 3-5 5+ Komatsu
25/30t Artic WA250
35/40t Artic WA500
CAT 769/775 WA600
CAT 777 C/D/F WA900
CAT 785 C/D/F WA1200
CAT 789 P&H L-1150
Komatsu HD 785 P&H L-1350
Komat730E P&H L-1850
Komat830E P&H L-2350
Komat930E
Komat980E
Dozers 3-6 6-12 1-2 2-3 3-5 5+ Other 3-6 6-12 1-2 2-3 3-5 5+
D6/D7 Backhoe
D8 R/T Bobcat
D9 N/T CAT/VOLVO IT
D10 N/T Artic W/Cart
D11 N/T CAT 769/773
824 C Toyota Lv’s
D375A Lighting Plant
D475A Generators
Forklifts
Drills 3-6 6-12 1-2 2-3 3-5 5+ MD6200
MD6250
MD6310
MD6540C
MD6640
P&H 250XPC
P&H 285XPC
P&H 320XPC
P&H 77XR
Please list any other relevant earthmoving plant Experience:
I declare that I have worked and have experience on the above ticked mobile plant equipment;
Signed Employee
Date:
Employer Witness
Date:
Doc No-RR-HR-FM-022 Uncontrolled when printed page 1
Form
(serious legal consequences apply to false or misleading information and can lead to employment terminated)
