EQUIPMENT AUDIT REVIEW - LIFTS

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

EQUIPMENT DETAILS

• EQUIPMENT:

  Select CUSTOMER LIFT PASSENGER LIFT STAIRLIFT STAFF GOODS LIFT GOODS ONLY LIFT PLATFORM LIFT SCISSOR LIFT OTHER PLEASE STATE DOCK LEVELLER SCENIC LIFT CAR LIFT CONVEYOR

  • CUSTOMER LIFT
  • PASSENGER LIFT
  • STAIRLIFT
  • STAFF GOODS LIFT
  • GOODS ONLY LIFT
  • PLATFORM LIFT
  • SCISSOR LIFT
  • OTHER PLEASE STATE
  • DOCK LEVELLER
  • SCENIC LIFT
  • CAR LIFT
  • CONVEYOR

• EQUIPMENT NUMBER & GENERAL DETAILS

• DATE OF LAST INSURANCE INSPECTION

  Date

• DETAILS OF ANY INSURANCE ISSUES

• MAINTENANCE CONTRACTOR

  Select PICKERINGS LIFTS EXPRESS LIFTS LSD KONE ASCENDANT SCHINDLER OTHER PLEASE STATE

  • PICKERINGS LIFTS
  • EXPRESS LIFTS
  • LSD
  • KONE
  • ASCENDANT
  • SCHINDLER
  • OTHER PLEASE STATE

• DATE OF LAST SERVICE VISIT

  Date

• HAVE MAINTENANCE VISITS BEEN TO SCHEDULE

  Yes

  No

  N/A

• SUMMARY OF CALL OUTS ON LOG CARD

• IS LG CERTIFICATION ON SITE

  YES

  NO

  NOT APPLICABLE

• CONTRACT TYPE

  BASIC

  COMPREHENSIVE

  COMPREHENSIVE INCLUDING MISUSE

  OTHER PLEASE STATE

• REASON FOR AUDIT

MOTOR ROOM

• IS ACCESS SAFE

  Safe

  At Risk

  N/A

• PHOTO

  Media

• CONDITION OF MAIN GEAR/HYDRAULICS

  Safe

  At Risk

  N/A

• PHOTO

  Media

• CONTROLLER REVIEW

  Safe

  At Risk

  N/A

• PHOTO

  Media

• ANY OTHER COMMENTS

• PICTURE OF MOTOR ROOM

  Media

LIFT CAR

• OPERATION/CONDITION OF CAR DOORS/GATES

  Safe

  At Risk

  N/A

• PHOTO

  Media

• LIGHTING LEVEL/CONDITION IN CAR

  SATISFACTORY

  POOR

  REPLACE

  URGENT ACTION REQUIRED

• DO ALL BUTTONS AND INDICATORS WORK CORRECTLY

  Yes

  No

  N/A

• PHOTO

  Media

• OPERATION OF CAR ALARM

  Safe

  At Risk

  N/A

• CONDITION OF CAR FLOORING

  Safe

  At Risk

  N/A

• PHOTO OF FLOORING

  Media

• GENERAL COMMENTS

• PICTURE OF LIFT CAR

  Media

• DDA COMPLIANCE

  NO

  YES

  NOT APPLICABLE

LANDINGS

• CONDITION OF DOORS/GATES AT BASEMENT LEVEL

  Safe

  At Risk

  N/A

• CONDITION OF DOORS/GATES AT GROUND FLOOR

  Safe

  At Risk

  N/A

• CONDITION OF DOORS/GATES AT FIRST FLOOR

  Safe

  At Risk

  N/A

• CONDITION OF DOORS/GATES AT SECOND FLOOR

  Safe

  At Risk

  N/A

• CONDITION OF DOORS/GATES AT THIRD FLOOR

  Safe

  At Risk

  N/A

• CONDITION OF DOORS/GATES AT FOURTH FLOOR

  Safe

  At Risk

  N/A

• CONDITION OF DOORS/GATES AT ALL OTHER FLOORS

  Safe

  At Risk

  N/A

• DO ALL BUTTONS AND INDICATORS WORK CORRECTLY

  Yes

  No

  N/A

• PHOTO DOOR/GATE ISSUES

  Media

• LANDING INDICATORS

  Yes

  No

  N/A

• CONDITION OF LOCKS AND ASSOCIATED EQUIPMENT( RAMPS, CATCHES, SWITCHES)

  Safe

  At Risk

  N/A

• PHOTO

  Media

• GENERAL COMMENTS/ENTRANCE SIZE

• PICTURE OF ANY LANDING ISSUES

  Media

LIFT SHAFT

• ANY H&S ISSUES ASSOCIATED WITH PIT (LADDER, PIT SWITCH, SHALLOW PIT, ETC)

  Safe

  At Risk

  N/A

• CAR TOP CONTROL/CAR TOP ACCESS

  Safe

  At Risk

  N/A

• ANY HAZARDS IN SHAFT

  Safe

  At Risk

  N/A

• SHAFT LIGHTING

  TO STANDARD

  POOR

  UPGRADE

  REQUIRED AS NONE FITTED

• GENERAL COMMENTS

• PICTURE OF ANY SHAFT ISSUES

  Media

OPERATIONAL REVIEW

• HOW DOES LIFT OPERATE

  GOOD

  WORKS WITH MINOR ISSUES

  BREAKS DOWN REGULARLY

  POOR

  NOT ACCEPTABLE

• HAVE INSURANCE ITEMS BEEN ACTIONED IN TIMELY MANNER

  Yes

  No

  N/A

• ANY LEVELLING ISSUES

  Yes

  No

  N/A

• PATIENT CARE ISSUES

  Yes

  No

  N/A

• PHOTO

  Media

• RESPONSE TO CALL OUTS

  ALWAYS ON TIME

  GOOD

  AVERAGE

  POOR

  NOT ACCEPTABLE

• ANY HEALTH & SAFETY ISSUES THAT NEED ADDRESSING

  Yes

  No

  N/A

• PHOTO

  Media

• TIMESCALES FOR RESOLUTION OF HEATH & SAFETY ISSUES

  Select IMMEDIATE 1WEEK 1 MONTH 3MONTHS 6 MONTHS WITHIN 12 MONTHS WHEN LIFT IS REFURBISHED

  • IMMEDIATE
  • 1WEEK
  • 1 MONTH
  • 3MONTHS
  • 6 MONTHS
  • WITHIN 12 MONTHS
  • WHEN LIFT IS REFURBISHED

• IMPROVEMENTS/ACTIONS REQUIRED

• PHOTO

  Media

• TIMESCALES FOR RESOLUTION OF GENERAL ITEMS (LOW RISK)

  Select IMMEDIATE 1WEEK 1 MONTH 3MONTHS 6 MONTHS WITHIN 12 MONTHS WHEN LIFT IS REFURBISHED

  • IMMEDIATE
  • 1WEEK
  • 1 MONTH
  • 3MONTHS
  • 6 MONTHS
  • WITHIN 12 MONTHS
  • WHEN LIFT IS REFURBISHED

MAINTENANCE CONTRACTOR REVIEW

• Maintenance Quality - MACHINE ROOM (10=Max - 1=unacceptable)

  Select One Two Three Four Five Six Seven Eight Nine Ten

  • One
  • Two
  • Three
  • Four
  • Five
  • Six
  • Seven
  • Eight
  • Nine
  • Ten

• Maintenance Quality - LIFT CAR (10=Max - 1=unacceptable)

  Select One Two Three Four Five Six Seven Eight Nine Ten

  • One
  • Two
  • Three
  • Four
  • Five
  • Six
  • Seven
  • Eight
  • Nine
  • Ten

• Maintenance Quality - CAR & LANDING GATES/DOORS (10=Max - 1=unacceptable)

  Select One Two Three Four Five Six Seven Eight Nine Ten

  • One
  • Two
  • Three
  • Four
  • Five
  • Six
  • Seven
  • Eight
  • Nine
  • Ten

• Maintenance Quality - SHAFT (10=Max - 1=unacceptable)

  Select One Two Three Four Five Six Seven Eight Nine Ten

  • One
  • Two
  • Three
  • Four
  • Five
  • Six
  • Seven
  • Eight
  • Nine
  • Ten

• Maintenance Quality - PIT (10=Max - 1=unacceptable)

  Select One Two Three Four Five Six Seven Eight Nine Ten

  • One
  • Two
  • Three
  • Four
  • Five
  • Six
  • Seven
  • Eight
  • Nine
  • Ten

• PERFORMANCE OF CONTRACTOR (CLIENT OPINION - ADDITIONAL COMMENTS)

  EXCELLENT

  GOOD

  SATISFACTORY

  POOR

  ACTION REQUIRED

• Maintenance Quality - OVERALL SCORE (10=Max - 1=unacceptable)

  Select One Two Three Four Five Six Seven Eight Nine Ten

  • One
  • Two
  • Three
  • Four
  • Five
  • Six
  • Seven
  • Eight
  • Nine
  • Ten

EQUIPMENT OVERALL REVIEW BY SCORE

• AGE OF EQUIPMENT:

  Select Over 40 Years 35 - 39 Years 30 - 34 Years 25 - 29 Years 20 - 24 Years 15 - 19 Years 10 - 14 Years Under 10 Years

  • Over 40 Years
  • 35 - 39 Years
  • 30 - 34 Years
  • 25 - 29 Years
  • 20 - 24 Years
  • 15 - 19 Years
  • 10 - 14 Years
  • Under 10 Years

• call outs in last 24 MONTHS

  20 + (Very High)

  15 - 20 (High)

  10 - 14 (Medium)

  5 - 9 (Low)

  0 - 4 (Very Low)

• RELIABILITY OF UNIT AT TIME OF AUDIT:

  EXCELLENT

  GOOD

  SATISFACTORY

  POOR

  ACTION REQUIRED

• CONDITION OF UNIT AT TIME OF AUDIT:

  EXCELLENT

  GOOD

  SATISFACTORY

  POOR

  ACTION REQUIRED

• RECOMMENDATION FOR REFURBISHMENT (INCLUSION IN CAPITAL WORKS PROGRAMME)

  Select IMMEDIATELY 1 YEAR 2 YEARS 3YEARS 5 YEARS 7 YEARS 10 YEARS 10 YEARS PLUS

  • IMMEDIATELY
  • 1 YEAR
  • 2 YEARS
  • 3YEARS
  • 5 YEARS
  • 7 YEARS
  • 10 YEARS
  • 10 YEARS PLUS

• LIFE EXPECTANCY OF EQUIPMENT BEFORE REFURBISHMENT/REPLACEMENT

  NOT APPLICABLE

  1 YEAR

  3 YEARS

  5 YEARS

  10 YEARS PLUS

• HAS ANY MONEY BEEN SPENT ON EQUIPMENT IN LAST 12 MONTHS

  Select NONE COMPREHENSIVE CONTRACT UP TO £1,000 UP TO £5,000 UP TO £10,000 OVER £10,000

  • NONE
  • COMPREHENSIVE CONTRACT
  • UP TO £1,000
  • UP TO £5,000
  • UP TO £10,000
  • OVER £10,000

• GENERAL OVERALL REVIEW/FURTHER ACTIONS REQUIRED

• BUDGET COST FOR WORKS

  Select £1,000 £5,000 £10,000 £15,000 £20,000 £30,000 £40,000 £50,000 £60,000 £70,000,£100,000 £100,000 PLUS

  • £1,000
  • £5,000
  • £10,000
  • £15,000
  • £20,000
  • £30,000
  • £40,000
  • £50,000
  • £60,000
  • £70,000,£100,000
  • £100,000 PLUS

SIGNATURES

• CONTRACTOR

  Sign

• PMLC LTD

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