Title Page

  • Site Address
  • Lift Ref

  • Date

  • Engineer

Lift Car

  • Door open button

  • Stop switches

  • COP including buttons

  • Sills and car floor

  • Car lighting

  • Emergency lighting

  • Car alarm bell/siren

  • Autodialler

  • Safety edges/photocell

  • Car vision panels and glass car doors

  • Car enclosure

  • Ventilation

Top of Car and shaft

  • Top-of-car stop switch

  • Car top light and outlet

  • Car top control

  • Top-of-car clearance and refuge space

  • Normal terminal stopping device

  • Final and emergency terminal stopping devices

  • Car leveling and anti-creep devices

  • Floor, and emergency numbering

  • Windows/projections/setbacks/recesses

  • Hoistway clearances

  • Multiple hoistway

  • Traveling cables and junction boxes

  • Door and gate equipment

  • Car frame

  • Guide rails, fastening and equipment

  • Governor rope

  • Wire rope fastening and hitch plate

  • Suspension rope

  • Top counterweight clearance

  • Car, overhead, and divertor sheaves

  • Broken rope, chain, or tape switch

  • Crosshead data plate

  • Counterweight/counterweight buffer

  • Counterweight safeties

  • Compensating ropes and chains

  • Guide shoes

  • Safety gear

  • Overspeed governor

  • Motor/hydraulic tank

  • Shaft lighting

  • Shaft safety switches

Machine Room

  • Access to machine space

  • Headroom

  • Motoroom lighting

  • Machine space

  • Housekeeping

  • Ventilation

  • Fire extinguisher

  • Pipes, wiring, and ducts

  • Guarding of exposed equipment

  • Correct labels and signage

  • Disconnecting means and control

  • Controller wiring, fuses, earthing, etc.

  • Governor, overspeed switch, and seal

  • Overhead beam and fastenings

  • Drive machine brake

  • Traction drive machines

  • Gears, bearings and flexible couplings

  • Winding drum machine and slack cable device

  • Belt or chain-drive machine

  • Motor generator

  • Absorption of regenerated power

  • AC drives from a DC source

  • Traction sheaves

  • Divertors

  • Rope hitches

  • Maintenance records

Completion

  • Overall Recommendation

  • Name & Signature of Maintenance Personnel

Untitled Page

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.