Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
Type of Equipment
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What type of lift will be used?
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Are the wheels in good shape?
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Is the operators manual on the machine?
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Does the main ground controls work properly?
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Does the man basket controls work properly?
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Does the deadman switch work?
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Do the brakes work?
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Do the warning lights, warning audio device and horn work properly?
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Are there any oil leaks ?
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Are there any cracks in the welds or steel?
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Are all the guards in place?
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Date of last Maintanance performed
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Photos of equipment
Equipment photo
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Photo
Fuel
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What is the fuel source?
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Do the batteries have signs of corrosion?
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Are the battery cables in good shape?
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Are the batteries leaking.
Photos of equipment
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Add media
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How is the fuel level?
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Are the fuel lines in good condition?
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Are the battery cables in good shape?
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Do the batteries have signs of corrosion?
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Are the batteries leaking.
Photos of equipment
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Add media
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How is the fuel level?
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Are the fuel lines in good condition?
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Do the batteries have signs of corrosion?
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Are the battery cables in good shape?
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Are the batteries leaking.
Photos of equipment
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Add media
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How is the fuel level?
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Are the fuel lines in good condition?
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Does the propane tank have corrosion?
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Has the propane tank expired?
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Do the batteries have signs of corrosion?
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Are the battery cables in good shape?
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Are the batteries leaking.
Photos of equipment
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Add media
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Are there other fuel souces?
- Elect.
- Gas
- Diesel
- Prop.
General
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Is there an operators manual present?
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Is a fire extinguisher present?
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What is the weight of the equipment?
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Is the platform clear of debris?
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Are all side rail pins in place?
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Does the lift work on auxiliary power?
Hydraulics
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Are the hydraulic fluid levels okay?
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Are any of the hydraulic cylinders leaking?
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Does the hydraulic pump show signs of deterioration or damage?
Fall Protection systems to be used
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Identify the fall protection systems to be used at the work site to protect the workers from fall hazards ( ie, travel restraint, fall arrest, safety net, control zone, etc.)
Fall Hazards
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Identify all existing and potential fall hazards associated with work site
Anchors to be used during the work
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Identify the anchors, both engineered and improvised that workers are to use
Procedures
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Identify the procedures to assemble, inspect, use, maintain and dismantle the fall protection systems identified above
Rescue plan
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Describe the procedures that will be followed if a worker falls and needs to be rescued
Worker sign off
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Worker acknowledgement of fall arrest plan and fall arrest equipment inspection.
Worker
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No physical damage to harness webbing? (cuts, burns, frying, chemical)
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Stitching in good condition?
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Buckles in Good condition and operating properly?
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Chest strap in good condition?
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Carabiner in good condition and operating properly?
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Lanyard, no damage to (cuts, fraying, burns, chemicals, non factory markings)
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Lanyard shock absorber in place and not damaged?
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Harness and lanyard stored properly when not in use?
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Photo of harness and lanyard
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Signature worker using the harness and lanyard.
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Certificate of Proficiency.
