Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Tests

  • Test Tag serial # - Machine

  • Test Tag serial # - Lead

  • Test Tag serial # - Other

  • Earth continuity value

  • Insulation Resistance Value

Safety

  • Any E-Stops isolate machine, latch and release

  • Cage door stops lifter ( maximum gap before shutting down 200mm )

  • All covers secured

  • Key switch installed

  • All guarding in sound condition

Machine

  • Unit number fixed on machine

  • All hinges and latches serviceable

  • Free movement of lifter and cradle lowers empty

  • No visible oil leaks

Electrical

  • Lead, switches and socket in serviceable condition

Operation

  • Unit works as intended

  • Test full up and down cycle

Jobs to do

  • Lubricate hinges and wheel

  • Apply compliance stickers

  • Rate condition of machine ( 0 = very poor condition, 10 = Brand new )

  • Other comments

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.