Information

  • Document No.

  • Project Name/Number

  • Conducted on

  • Prepared by

  • Location
  • Are workers using proper personal fall protection equipment?

  • Are workers remaining on the platform at all times?

  • Is the gate/chain closed when occupied?

  • Is the aerial/scissor lift on level ground per manufacturers recommendations?

  • Is the operator trained properly?

  • Are tools and materials secured from displacement from the lift?

  • Is the lifting capacity visible and appropriate for the task to be completed?

  • Are lanyards and/or retractable lifelines attached to proper anchorage points?

  • Was a pre-start inspection performed?

  • Are all cracks, dents, or damage in the welds or structural components of the aerial/scissor lift been repaired to manufacturers specifications?

  • Are all safety warning devices functioning properly?

  • Have all controls been tested for proper operation prior to any elevated use?

  • Is there proper clearance above, below and on all sides of the lift?

  • Are power lines located at a safe distance from the aerial/scissor lift?

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