Information
PLEASE COMPLETE THIS SECTION IN BLOCK CAPITALS - DOUBLE TAP ON SHIFT KEY MAKES BLOCK CAPS
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LIFT TITLE. e.g. SITE NAME - LIFT 1
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SITE NAME
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ENGINEER
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Conducted on
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Location
SITE NAME
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SITE NAME IN BLOCK CAPS
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PLEASE TAKE PHOTOS OF SITE BUILDING / SITE ENTRANCE / LIFT LOCATION
LIFT NAME e.g. PASSENGER LIFT 1 / GOODS LIFT 2
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PLEASE ENTER FULL NAME OF LIFT
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PLEASE TAKE PHOTOS OF THE OUTSIDE AND INSIDE OF THE LIFT
LIFT LOCATION / IDENTIFICATION FEATURES
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PLEASE ENTER FULL DETAILS TO IDENTIFY LIFT e.g. BLOCK / BUILDING / FLAT NUMBERS etc...
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PLEASE TAKE PHOTOS TO AID LIFT IDENTIFICATION e.g. FLAT NUMBER PLATES etc
LIFT TYPE
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PLEASE CHOOSE LIFT TYPE
- HYDRAULIC
- TRACTION
- PLATFORM
- SCISSOR
- STAIR LIFT
- HOIST
- OTHER
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Please add any details about the Lift Type as needed.
LIFT MAKE
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ENTER LIFT MANUFACTURER
LIFT MODEL
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ENTER LIFT MODEL
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PLEASE TAKE PHOTOS TO SHOW MAKE / MODEL etc
LIFT SERIAL NUMBER
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ENTER LIFT SERIAL NUMBER
NUMBER OF FLOORS
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ENTER NUMBER OF FLOORS
NUMBER OF PERSONS / LIFT WEIGHT CAPACITY
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ENTER NUMBER OF PERSONS / CARRYING WEIGHT
LIFT CONTROLLER TYPE AND NUMBER
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ENTER CONTROLLER TYPE / MODEL NUMBER etc
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PLEASE TAKE PHOTOS TO SHOW CONTROLLER
LIFT ORIGINAL INSTALLATION DATE
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ENTER LIFT ORIGINAL INSTALLATION DATE
LIFT OR CONTROLLER REFURB / REPLACEMENT DATE
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ENTER DATES OF LIFT REFURB OR CONTROLLER REPLACEMENT etc
LIFT RISK ASSESSMENT - NEW TYPE - ON SITE?
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PLEASE INDICATE IF THERE IS A NEW TYPE RISK ASSESSMENT ON SITE
DOOR CODES
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PLEASE ENTER ANY SITE DOOR CODES OR RELEVANT ACCESS DETAILS
AUTODIALLER PHONE NUMBER
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PLEASE ENTER THE LIFT AUTO DIALLER NUMBER
KEYS REQUIRED TO BE TAKEN / OR AVAILABLE ON SITE
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PLEASE GIVE FULL DETAILS ABOUT KEYS REQUIRED AND WHERE OBTAINED FROM...
ANY OTHER USEFUL INFORMATION
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PLEASE ENTER ANY OTHER USEFUL INFORMATION
ANY OTHER USEFUL PHOTOS
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PLEASE TAKE FURTHER PHOTOS TO SHOW SHAFT AND OTHER PANELS etc
