• Client / Site

  • Conducted on

  • Prepared by

  • Location

Main Info

  • Unit Number

  • Hour Meter

General info

  • Are you trained and qualified to operate this equipment?

  • Equipment walk around (exterior condition, obstructions)

  • Fall arrest anchor point

  • Engine oil

  • Engine coolant

  • Belts tension / condition

  • Gauges & instruments

  • Hydraulic oil

  • Battery and cables

  • Tire pressure / condition

  • Wheels, nuts & tires

  • Steering arms & cylinder

  • Limit switch

  • Fuel tank

  • Test all ground controls

  • Emergency lower sticker

  • Fire extinguisher

  • Emergency buttons

  • Horn

  • Platform

  • Handrails & kickplate

  • Platform controls

  • Steering control

  • Warning lights & alarm

  • Parking brake

  • Operations manual

Scissor Lift

  • Storage compartments, doors latched

  • Scissors, pins, keepers and pads

  • Scissor lift cylinders

  • Test tilt alarm censor

  • Boarding ladder & gate

  • Guardrail lock pins

  • Warning stickers

  • Platform extension lock pin

Work site inspection

  • Absent of any structural damages

  • Absent of holes, drop offs, or soft spot in your work path

  • Absent of any debris that will hinder your work<br>

  • Absent of grease and/or dirt

  • Absent of overhead wires or other obstructions<br>

  • Absent of electrical, telephone, or cable boxes on the ground<br><br>

  • Is the environment suitable for planned work? (wind, rain, mud, ice, lightning)<br>

  • Is the work surface able to support the lift<br>

Comments / Repair & maintenance required reported to:

Sign off

  • Operator

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