Title Page
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Site conducted
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Conducted on
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Prepared by
Lift Information
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Lift Type and Description
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Lift ID Number
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Manufacturers Serial Number
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Lift Location
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Signed
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Name
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Position
Details
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In order to verify that electrical safety devices are in efficient working order,
a functional test of each of these devices should be undertaken as part of
thorough examination by the Competent Person.
Where the functional test of a safety device cannot be carried out by the
Competent Person where access is difficult or a test may not be possible for
a given reason, then that person should call for a supplementary test to be
made of the specific device(s) at least annually. -
All components MUST be tested in situe, as if they were activated correctly.
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Examples: Over travel limits are tested by overtravelling the lift, return pulley switches are activated by lowering the weight, safety gear switches are tested by activating the safety gear etc.
A.2 Electrical Safety Devices
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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Component tested
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If a component has failed - Detail the method of test here
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Does the switch(s) operate satisfactorily?
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Is all wiring, including earth wiring, properly terminated and in good condition?
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Can it be determined that all parts are clean, secure and free of excessive wear with no signs of burning, or physical damage?
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If NO please explain
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Does the result of the supplementary test(s) indicate further remedial work is necessary?
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If YES, state your recommendation(s) for further action required
