Title Page
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Type of Aerial Lift
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Make
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Model
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Facility Location
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Vehicle Number
PHYSICAL DAMAGE AND DEFECTS
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Cracked welds
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Bent or broken structural members
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Fiberglass and insulating components damaged or contaminated (dirt, salt, etc…)
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Fuel leaks
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Hydraulic systems, visual for leaks
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Damaged controls and cables
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Loose wiring
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Tire condition
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Fuel, hydraulics and other fluid levels
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Fall protection anchor point
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Covers for shafts, gears and other moving parts
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Rotation bearing bolts tight
Operating Controls
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Return to off or neutral when released
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Protected against inadvertent operation
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Be clearly marked as to function
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Proper function of overriding, emergency, or lower controls
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Complete set-up for operation including outriggers
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Cycle complete range of motion from lower controls (except if operation creates a hazard)
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Proper operation of interlocks
LABELS , MARKINGS, MANUALS
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Operators manual, ANSI A92 Manual, and safety rules
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Rated capacity
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Electrical insulation
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Danger signs and labels
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Warning signs and labels
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Boom angle load chart
Site/Workplace Survey
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Ditches, drop offs, holes
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Bumps or debris
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Electrical power lines
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Ground and overhead obstructions
OTHER MANUFACTURERS RECOMMENDATIONS
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Inspected By
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INSPECTED BY:
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Name
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DATE:
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Retain this copy for 6 months unless the “Needs Repair” column is checked then retain this copy and the correction report for 5 years