Title Page

  • Type of Aerial Lift

  • Make

  • Model

  • Facility Location

  • Vehicle Number

PHYSICAL DAMAGE AND DEFECTS

  • Cracked welds

  • Bent or broken structural members

  • Fiberglass and insulating components damaged or contaminated (dirt, salt, etc…)

  • Fuel leaks

  • Hydraulic systems, visual for leaks

  • Damaged controls and cables

  • Loose wiring

  • Tire condition

  • Fuel, hydraulics and other fluid levels

  • Fall protection anchor point

  • Covers for shafts, gears and other moving parts

  • Rotation bearing bolts tight

Operating Controls

  • Return to off or neutral when released

  • Protected against inadvertent operation

  • Be clearly marked as to function

  • Proper function of overriding, emergency, or lower controls

  • Complete set-up for operation including outriggers

  • Cycle complete range of motion from lower controls (except if operation creates a hazard)

  • Proper operation of interlocks

LABELS , MARKINGS, MANUALS

  • Operators manual, ANSI A92 Manual, and safety rules

  • Rated capacity

  • Electrical insulation

  • Danger signs and labels

  • Warning signs and labels

  • Boom angle load chart

Site/Workplace Survey

  • Ditches, drop offs, holes

  • Bumps or debris

  • Electrical power lines

  • Ground and overhead obstructions

OTHER MANUFACTURERS RECOMMENDATIONS

  • undefined

Inspected By

  • INSPECTED BY:

  • Name

  • DATE:

  • Retain this copy for 6 months unless the “Needs Repair” column is checked then retain this copy and the correction report for 5 years

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.