FIRST LIFT SERVICE

• JOB AUDIT TITLE INCLUDING JOB NUMBER

• CLIENT /SITE

• ENGINEER

• Conducted on

  Date
• Location
  Address

• Prepared by

LIFT DETAILS

• Lift Make / Lift Model and Serial Number

GENERAL

• Review Risk Assessment on Site

  YES

  NO

  N/A

  SEE NOTES

• Check all Oil and Grease Levels

  YES

  NO

  N/A

  SEE NOTES

• Clean Lift / Pit Equipment / Motor Room / Car Top

  YES

  NO

  N/A

  SEE NOTES

• Are any Warning Signs Required?

  YES

  NO

  N/A

  SEE NOTES

• Electrical Safety Devices - Operation OK

  YES

  NO

  N/A

  SEE NOTES

LANDINGS

• Landing Pushes and Indicators

  YES

  NO

  N/A

  SEE NOTES

• Check Release Key Operation

  YES

  NO

  N/A

  SEE NOTES

• Excessive Gaps ( > 6mm)

  YES

  NO

  N/A

  SEE NOTES

LIFT CAR

• Car Pushes and Indicators

  YES

  NO

  N/A

  SEE NOTES

• Autodial / Alarm

  YES

  NO

  N/A

  SEE NOTES

• Floor Levelling / Relevelling Operation

  YES

  NO

  N/A

  SEE NOTES

• Check Lift Car Lighting

  YES

  NO

  N/A

  SEE NOTES

• Lift Car Visual Check / Mirror / Load Plate / Hand Rail

  YES

  NO

  N/A

  SEE NOTES

• Car Door Operation

  YES

  NO

  N/A

  SEE NOTES

• Door Protection / Safety Edges / Light Ray Units

  YES

  NO

  N/A

  SEE NOTES

• Toe Guard - Blue

  YES

  NO

  N/A

  SEE NOTES

CAR TOP

• Landing Door Closers

  YES

  NO

  N/A

  SEE NOTES

• Door Contacts

  YES

  NO

  N/A

  SEE NOTES

• Door Rollers / Kicking Rollers

  YES

  NO

  N/A

  SEE NOTES

• Track Slides and Cills - Clean

  YES

  NO

  N/A

  SEE NOTES

• Air Cords

  YES

  NO

  N/A

  SEE NOTES

• Ramp / Skate

  YES

  NO

  N/A

  SEE NOTES

• Door Locks

  YES

  NO

  N/A

  SEE NOTES

• Guide Shoes / Car / Counterweights Visual Only

  YES

  NO

  N/A

  SEE NOTES

• Tape Head / Signal Switches / Shoes

  YES

  NO

  N/A

  SEE NOTES

• Car Top Control / Stop Switch Operation

  YES

  NO

  N/A

  SEE NOTES

• Car Top Light

  YES

  NO

  N/A

  SEE NOTES

• Final Limit Switch Operation

  YES

  NO

  N/A

  SEE NOTES

SHAFT

• Check Motor / Tacho / Encoder / MRL

  YES

  NO

  N/A

  SEE NOTES

• Rupture Valves Visual Check - Leaks

  YES

  NO

  N/A

  SEE NOTES

• Safety Gear Visual Check

  YES

  NO

  N/A

  SEE NOTES

• Ropes / Chains / Terminations Visual Check

  YES

  NO

  N/A

  SEE NOTES

• OSG Rope / Safety Rope / Terminations

  YES

  NO

  N/A

  SEE NOTES

• Ram Seals and Hoses Visual Check

  YES

  NO

  N/A

  SEE NOTES

• Trailing Cables Visual Check

  YES

  NO

  N/A

  SEE NOTES

• Guides and Fixings

  YES

  NO

  N/A

  SEE NOTES

• Shaft Lighting

  YES

  NO

  N/A

  SEE NOTES

• Lifting Beam

  YES

  NO

  N/A

  SEE NOTES

• Shaft Fascia Panels

  YES

  NO

  N/A

  SEE NOTES

PIT

• Check Buffers / ( e.g. Not Wooden Blocks)

  YES

  NO

  N/A

  SEE NOTES

• Pit Prop Hydraulic

  YES

  NO

  N/A

  SEE NOTES

• Counter Weight Screens

  YES

  NO

  N/A

  SEE NOTES

• Pit Ladder

  YES

  NO

  N/A

  SEE NOTES

• Socket Outlet in Pit

  YES

  NO

  N/A

  SEE NOTES

MOTOR ROOM

• MRL ONLY - Check Brake Release and Battery

  YES

  NO

  N/A

  SEE NOTES

• Controller Visual Check

  YES

  NO

  N/A

  SEE NOTES

• Controller - Are Correct Fuses fitted?

  YES

  NO

  N/A

  SEE NOTES

• Controller Drawing are on site

  YES

  NO

  N/A

  SEE NOTES

• Check Isolator Switch - Position and Lockable

  YES

  NO

  N/A

  SEE NOTES

• Check Lift Emergency Lighting

  YES

  NO

  N/A

  SEE NOTES

• Governor

  YES

  NO

  N/A

  SEE NOTES

• Brake Visual Check

  YES

  NO

  N/A

  SEE NOTES

• Gear / Hydraulic Unit / Hydraulic Fluid

  YES

  NO

  N/A

  SEE NOTES

• Motor / Tachometer / Encoder

  YES

  NO

  N/A

  SEE NOTES

• Sheaves / Divertors Visual Check + Lubrication

  YES

  NO

  N/A

  SEE NOTES

• Electrical Wiring Visual Check

  YES

  NO

  N/A

  SEE NOTES

• Pressure Relief Valve

  YES

  NO

  N/A

  SEE NOTES

• Hand Pump

  YES

  NO

  N/A

  SEE NOTES

• Motor run time limiter overload trips

  YES

  NO

  N/A

  SEE NOTES

• Lifting Beam

  YES

  NO

  N/A

  SEE NOTES

MOTOR ROOM SAFETY

• Lighting

  YES

  NO

  N/A

  SEE NOTES

• Emergency Lighting

  YES

  NO

  N/A

  SEE NOTES

• Guarding

  YES

  NO

  N/A

  SEE NOTES

• Moving Parts Indication ( e.g. Yellow Paint)

  YES

  NO

  N/A

  SEE NOTES

• Signs and Hazards

  YES

  NO

  N/A

  SEE NOTES

• Shock Chart

  YES

  NO

  N/A

  SEE NOTES

• Danger Notice

  YES

  NO

  N/A

  SEE NOTES

• Hand Winding Notice

  YES

  NO

  N/A

  SEE NOTES

• Rubber Mat + Working Space

  YES

  NO

  N/A

  SEE NOTES

• Plinth Ladder

  YES

  NO

  N/A

  SEE NOTES

• Hand Wiring Buzzer / Indication

  YES

  NO

  N/A

  SEE NOTES

• Safety Barrier

  YES

  NO

  N/A

  SEE NOTES

• SAFED Certificates available?

  YES

  NO

  N/A

  SEE NOTES

• SAFED Certificates required?

  YES

  NO

  N/A

  SEE NOTES

PULLEYS and PULLEY ROOM

• Access to Pulley Room OK

  YES

  NO

  N/A

  SEE NOTES

LOG CARD

• Sign and Date Log Card

  YES

  NO

  N/A

  SEE NOTES

NOTES and RECOMMENDATIONS

• NOTES

• RECCOMMENDATIONS

• PLEASE TAKE ANY ADDITIONAL PHOTOS IF REQUIRED

  Media

ENGINEERS SIGNATURE

• Engineer - Please Print Name and Sign

  Sign

CUSTOMERS SIGNATURE

• This equipment has been serviced in accordance with the contract and has been left in a satisfactory, safe and serviceable condition.

• Customers - Please Print Name and Sign

  Sign