AIWP Equipment Inspection

• Prepared by

• Conducted on

  Date
• Location
  Address

• Personnel

Job Name & Job Number

Equipment on Project

• Equipment

  Select Boom Lift Scissor Lift Fork Lift

  • Boom Lift
  • Scissor Lift
  • Fork Lift

• Scope(s) Equipment Being Used

  Select Fireproofing Spray Foam Waterproofing Insulation Fire Caulking

  • Fireproofing
  • Spray Foam
  • Waterproofing
  • Insulation
  • Fire Caulking

Delivery Inspection

• Was a PDI (Pre-Delivery Inspection) performed?

  Yes

  No

  N/A

• If not, why?

  Yes

  No

  N/A

• If so, was the PDI documented?

  Yes

  No

  N/A

• Add media

  Media

Daily Equipment Inspection

• Operator Manual

  Safe

  At Risk

  N/A

• Wheels, Tires

  Safe

  At Risk

  N/A

• Steering/Brakes

  Safe

  At Risk

  N/A

• Guardrails

  Safe

  At Risk

  N/A

• Fluid Levels

  Safe

  At Risk

  N/A

• Seatbelt or Anchors

  Safe

  At Risk

  N/A

• Outriggers

  Safe

  At Risk

  N/A

• Hoses, Belts

  Safe

  At Risk

  N/A

• Gauges, Controls

  Safe

  At Risk

  N/A

• Boom/Cylinders<br>

  Safe

  At Risk

  N/A

• Horn/Alarms

  Safe

  At Risk

  N/A

• Deck/Basket/Carriage<br>

  Safe

  At Risk

  N/A

• Batteries

  Safe

  At Risk

  N/A

• ROPS (Roll Over Protection Structure)

  Safe

  At Risk

  N/A

• Forks

  Safe

  At Risk

  N/A

• Pins, Bushings

  Safe

  At Risk

  N/A

• Boom, Scissor<br>

  Safe

  At Risk

  N/A

• Any Other Hazards

  Yes

  No

  N/A

• If So, List Hazards<br>

  Yes

  No

  N/A

• Add media

  Media

• Add signature

  Sign

Worksite Conditions

• Pedestrians

  Safe

  At Risk

  N/A

• Public Roads

  Safe

  At Risk

  N/A

• Other Contractor Equipment

  Safe

  At Risk

  N/A

• CAZ ( Controlled Access Zones)<br>

  Safe

  At Risk

  N/A

• Barricades<br>

  Safe

  At Risk

  N/A

• Overhead Obstructions<br>

  Safe

  At Risk

  N/A

• Power Lines

  Safe

  At Risk

  N/A

• Material Obstructions<br>

  Safe

  At Risk

  N/A

• Obstructed Vision

  Safe

  At Risk

  N/A

• Slippery Surfaces

  Safe

  At Risk

  N/A

• Slopes, Ramps, Hills

  Safe

  At Risk

  N/A

• Trenches<br>

  Safe

  At Risk

  N/A

• Ruts, Holes

  Safe

  At Risk

  N/A

• Wind, Rain

  Safe

  At Risk

  N/A

• Lighting<br>

  Safe

  At Risk

  N/A

• Narrow Passageways<br>

  Safe

  At Risk

  N/A

• Hazardous Atmosphere<br>

  Safe

  At Risk

  N/A

• Hazardous Materials<br>

  Safe

  At Risk

  N/A

• Any Other Hazards

  Safe

  At Risk

  N/A

• If So, List Hazards

  Safe

  At Risk

  N/A

• Add media

  Media

• Add signature

  Sign