Page 1: Initial questions

  • Date of Service

  • Location
  • Lift Number

  • Engineer

Motor Room

  • Hydraulic Tank

  • Hydraulic Pipes

  • Suspension Ropes

  • Valve Block

  • Hand Pump

  • Motor Room Door Upstand

  • Control Panel

  • Circuit Breaker

  • Floor Selector

  • Overspeed Governor

  • Motor Room Emergency Lighting

  • Motor Room Area

Shaft

  • Ram

  • Trailing Cables

  • Guide Shoes

  • Lift Car Exterior

  • Car Top Control Station

  • Door Gear

  • Shaft Lighting

  • Relevelling Switches

  • Overtravels/ Buffers

  • Overtravel Switch

  • Wall Switches

  • Safety Switches

  • Pit Prop/ Lugs

  • Pit Stop Switch

  • Retiring Ramp

  • Safety Gear & Contact

Lift Car Interior

  • Doors/ Gate/ Shutter Contacts

  • Push Station

  • Alarm/ Telephone

  • Emergency Lighting

  • General

Landings

  • Doors/ Gates/ Shutters

  • Push Stations

  • Indicators

  • Pit Area

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.