Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Lift Information
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Lift Type and Description
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Lift ID Number
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Manufacturers Serial Number
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Lift Location
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Signed
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Name
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Position
A.2 Electrical Safety Devices
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Description and location of safety device(s) being inspection/tested and method test
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Does the switch(s) operate satisfactorily?
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Is all wiring, including earth wiring, properly terminated and in good condition?
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Can it be determined that all parts are clean, secure and free of excessive wear with no signs of burning, or physical damage?
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If NO please explain
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Does the result of the supplementary test(s) indicate further remedial work is necessary?
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If YES, state your recommendation(s) for further action required
A.4 Landing Door Interlocks
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Do the electrical interlocks operate satisfactorily?
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Does the mechanical locking operate satisfactorily?
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Is all wiring, including earth wiring, properly terminated and in good condition?
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Are all parts clean, secure and free of excessive wear with no signs of burning or physical damage?
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If NO, explain
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Does the result of the supplementary test(s) indicate further remedial work is necessary?
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If YES, state your recommendation(s) for further action required
