6T0089 (45' BOOM) AERIAL WORK PLATFORM DAILY INSPECTION

• Site conducted

  Select

• 6T0089

• Conducted on

  Date

• Prepared by

• Location
  Address

• Asset status

  Available for use

  Out of service

• Were all machine controls disinfected prior to use? (If not, disinfect controls before proceeding)

  Yes

  No

INSTRUCTIONS:

• This report is to be completed prior to use. Use codes for each item listed below. All defective items shall be recorded below (comments) and reported to the Maintenance Department immediately

• After completing the form, forward original to the Safety Department

Visual Checks

• Record hour meter reading

• Engine oil level

  Compliant

  Non-Compliant

  N/A

• Any Leaks?

• Hydraulic oil level

  Compliant

  Non-Compliant

  N/A

• Any Leaks?

• IF FUEL IS BELOW HALF THEN FILL

• Fuel Level

  Above half

  Below half

• FILL TANK

  FILLED

• Operation and Safety Manual

  Compliant

  Non-Compliant

  N/A

• Warning & Instruction Decals

  Compliant

  Non-Compliant

  N/A

• Capacity & Control Decals

  Compliant

  Non-Compliant

  N/A

• All Covers & Shrouds in place

  Compliant

  Non-Compliant

  N/A

• Lift & Extension Cylinder Assemblies

  Compliant

  Non-Compliant

  N/A

• Pivot Pins & Retainers

  Compliant

  Non-Compliant

  N/A

• Boom(s) Condition

  Compliant

  Non-Compliant

  N/A

• Level Cylinder & Retainers

  Compliant

  Non-Compliant

  N/A

• Jib Boom Cylinder

  Compliant

  Non-Compliant

  N/A

• Electrical Wires

  Compliant

  Non-Compliant

  N/A

• Battery Condition & Brackets and Covers in place

  Compliant

  Non-Compliant

  N/A

• Tire Condition & Inflation & Lugs

  Compliant

  Non-Compliant

  N/A

• Gas & Hydraulic Tank Caps

  Compliant

  Non-Compliant

  N/A

• Turret Condition

  Compliant

  Non-Compliant

  N/A

• Platform Rails & Cages

  Compliant

  Non-Compliant

  N/A

• Toe Boards & Mesh Condition

  Compliant

  Non-Compliant

  N/A

• Control Box Assembly

  Compliant

  Non-Compliant

  N/A

• Platform Decking

  Compliant

  Non-Compliant

  N/A

• Platform Lanyard Connections

  Compliant

  Non-Compliant

  N/A

• Platform Mount Assembly

  Compliant

  Non-Compliant

  N/A

• Does door remote work correctly

• Door remote

  Yes

  No