Wheel Loader Bucket Inspection Date__________________________

Customer____________________________________________________________________________________________________________

Phone Number______________________________________________ Call Back Date ______________________________________________

Location___________________________________________________ Serial No.__________________________________________________

PSSR_______________________________________________________________________________________________________________

Bucket Type________________________________________________ Bucket No._________________________________________________

Bucket Width_______________________________________________ Machine Model_____________________________________________

Job No. _____________________________________________________________________________________________________________

Bucket Manufacturer __________________________________________________________________________________________________

Job Site Condition Job Application Adapters Adapter Position
High Moderate Low Quarry Sand Make 1 2 3 4 5 6 7 8
Material Mining Slag Model Worn
Impact Const Clay Size Missing
Abrasion Limestone Gravel Flush Mount Loose
Packing Granite Dirt 2 Strap Hardface
Moisture Iron Ore Other MAA Cracked
Other Shot Rock Bolt On Repaired
Other Other

Base Edge Assembly Condition Tip Position Tips

Good Repair Replace 1 2 3 4 5 6 7 8 Cat
Edge Worn Other
Bottom Missing Tip Series
Corners Loose Tip Type
Adapters Hardface
Tip Life
BEEPs Other

Indicate any cracks or problem areas

1 2 3 4 5 6 7 8

NOTES:___________________________________________________

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PEEP9264
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