Aerial Platform Inspection Checklist

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Main Info

• Unit Number

• Hour Meter

General info

• Are you trained and qualified to operate this equipment?

  Pass

  Fail

• Equipment walk around (exterior condition, obstructions)

  Pass

  Fail

Scissor Lift

• Storage compartments, doors latched

  Pass

  Fail

• Scissors, pins, keepers and pads

  Pass

  Fail

• Scissor lift cylinders

  Pass

  Fail

• Test tilt alarm censor

  Pass

  Fail

• Boarding ladder & gate

  Pass

  Fail

• Guardrail lock pins

  Pass

  Fail

• Warning stickers

  Pass

  Fail

• Platform extension lock pin

  Pass

  Fail

Work site inspection

• Absent of any structural damages

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Absent of grease and/or dirt

  Yes

  No

  N/A

• Absent of overhead wires or other obstructions<br>

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Comments / Repair & maintenance required reported to:

• undefined

Sign off

• Operator

  Sign