Title Page

  • Site conducted

  • Building:

  • Lift Reference:

  • Date:

  • Conducted By:

Lift Details

  • Category of Lift (Goods/Passenger/Platform)

  • Manufacturer:

  • Model:

  • No. of Floors:

  • Load:

  • Scotec ID:

  • Drive Type:

  • Is a bund wall fitted?

  • Condition of Ram & Seals?

  • Year of Install:

Landing & Doors

  • Door Arrangement:

  • Manufacturer and model of door operator:

  • General condition and operation of doors:

  • Door Protection (Photocell, Safety Edges)?

  • Condition of landing push buttons?

Pit Area

  • Is it clean and free of debris?

  • Is there a stop switch within 1m reach of doors?

  • Is the pit ladder adequate and compliant?

  • Is there a maintenance barrier available?

  • Is there an electrically interlocked pit prop?

  • Is the shaft lighting adequate?

Car Top

  • Is it clean and free of debris?

  • Is there a stop switch within 1m reach of doors?

  • Is there a car top handrail? (if car>wall gap is >300mm)

  • Is the car top control station compliant?

  • Is there a car top emergency-backed light?

  • Is there a car top socket for use during maintenance?

  • Are guide oilers fitted?

Car Interior

  • Is there an adequate level of car lighting?

  • Is there car emergency lighting?

  • Does the car alarm sounder work?

  • Is the car alarm sounder battery-backed?

  • Autodialler type?

  • Condition of car push buttons?

Motor Room

  • Is there a rubber mat in front of the controller?

  • Is there electric shock signage / other signage?

  • Is there an adequate level of m/room lighting?

  • Is there m/room emergency lighting?

  • Is there adequate machinery guarding?

  • Is there a hand winding unit fitted with an indication buzzer?

  • Is the phone line live?

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.