Information

  • Site conducted

Audit details

  • Data collected by

  • Conducted on

  • Client Name

  • Asset Address

  • GPS Location
  • Please complete for Traction Lift

  • Traction lift

Asset description

  • Lift ID (Client)

  • Lift Type

  • Serial Number known?

  • Manufacturers serial number

  • Year installed known

  • Year installed

  • Has lift been modernised?

  • Floors serviced

  • Lift Speed (m/s)

  • Lift capacity known?

  • Lift capacity (Kg)

  • Lift manufacturer Known?

  • Original lift manufacturer

Log card

  • Log card shows evidence of structured PPM?

  • No. Of breakdowns in the last 12 months

  • No. Of PPM visits in last 12 months

  • Date of last PPM

  • Further comments?

Maintenance history

  • Machine

  • Machine room

  • Controller

  • Governors

  • LG 1 Complete?

  • Inside of car

  • Ride quality

  • Levelling/ Stopping

  • Door operation

  • Door protection

  • Car doors gates

  • Car top

  • Hoist way doors gate

  • Car/ ctwt guides

  • Counterweight

  • Hoist way

  • Underside of car

  • Pit

  • Further comments?

Machine room / Controller area

  • Machine room or controller area tidy and free from rubbish and debris?

  • Comment:

  • Are circuit diagrams mounted and tidy?

  • Comment:

  • Trough / Trunking and junction box covers fitted?

  • Comment:

  • Further comments?

Machine

  • Is the machine and motor in a satisfactory condition?

  • Comment:

  • Are machine and motor seals in tact?

  • Comment:

  • Are all lubrication levels adequate?

  • Comment:

  • Are brake linings adequate thickness and free of oil?

  • Comment:

  • Comment:

  • Is the brake lift in an acceptable condition?

  • Comment:

  • Are brake pins lubricated?

  • Comment:

  • Comment:

  • Are rope jump guards fitted correctly?

  • Comment:

  • Are Machine sound isolation pads in good condition?

  • Please select where applicable...

  • Suspension ropes free of dust & rouge and level in sheave?

  • Please select where applicable...

  • Comment:

  • Are machine guards fitted?

  • Comment:

  • Further comments?

Controller

  • Are controller(s) clean, dry and free from dust?

  • Comment:

  • Are all controller components correctly mounted/ labelled and in satisfactory condition?

  • Comment:

  • All controller wiring straight and secured ?

  • Please select where applicable...

  • Are printed circuit boards secure?

  • Please select where applicable...

  • Are contactor and relay contacts in good condition?

  • Further comments?

Governors

  • Is governor clean, lubricated and free from excessive grease?

  • Comment:

  • Governor rope free of dust and rouge?

  • Comment:

  • Comment:

  • Is governor sheave serviceable?

  • Comment:

  • Governor rope jaws, activator and operating weights free and will operate governor switch

  • Comment:

  • Is Wiring tidy in and around governor?

  • Comment:

  • Are governor guards fitted where available?

  • Comment:

  • Further comments?

Inside of car

  • Are car lights operational?

  • Comment:

  • Is the car light diffuser clean?

  • Comment:

  • Are the car operating panel buttons and position indicator operational?

  • Comment:

  • Is speech synthesiser operational?

  • Comment:

  • Are Car handrails and buffer rails secure?

  • Comment:

  • Is the car alarm/ auto dialler operational?

  • Comment:

  • Comment:

  • Is car interior clean and in a satisfactory condition? ( floor/ mirrors/ panels/ diffusers)

  • Comment:

  • Comment:

  • Further comments?

Ride quality

  • Is the car ride quality of an acceptable standard?

  • Comment:

  • Further comments?

Levelling / Stopping

  • Is the lift Levelling and/ or stopping operation satisfactory?

  • Comment:

  • Further comments?

Car top

  • Is car top clean and free of maintenance materials?

  • Comment:

  • Are car governor rope/ main rope or chain anchorage acceptable?

  • Comment:

  • Is top of car inspection control operating correctly?

  • Comment:

  • Are all covers and guards fitted correctly where available?

  • Comment:

  • Are junction box and equipment covers fitted?

  • Comment:

  • Is retiring cam device clean, lubricated & adjusted?

  • Comment:

  • Car top wiring protected and secured?

  • Comment:

  • Further comments?

Hoistway doors and gates

  • Hoistway door air cords serviceable.

  • Hoistway door closer device(s) operate correctly

  • Are hoistway door upthrusts rollers adjusted correctly?

  • Comment:

  • Are landing shutter gates satisfactory?

  • Comment:

  • Comment:

  • Are landing shutter vision panels satisfactory?

  • Comment:

  • Comment:

  • Are hoistway doors hangar roller adjusted correctly and serviceable?

  • Comment:

  • Comment:

  • Are door locks operational and maintained in good condition?

  • Comment:

  • Comment:

  • Are door top tracks free from wear?

  • Hoistway door plumb and gaps <6mm

  • Comment:

  • Hoistway door unlocking devices & escutcheons serviceable?

  • Comment:

  • Are hoistway door guides secure and in good condition?

  • Comment:

  • Comment:

  • Further comments?

Car and / or counterweight guides

  • Guide shoes or rollers clean and lubricated?

  • Comment:

  • Guide oil pot levels satisfactory?

  • Comment:

  • Guide shoes inserts or rollers serviceable

  • Comment:

  • Comment:

  • Guide roller/ shoe adjustment correct?

  • Comment:

  • Further comments?

Counterweight

  • Are counterweights clean?

  • Comment:

  • Are all counterweights properly secured?

  • Comment:

  • Counterweight 2:1 sheaves clean and lubricated?

  • Comment:

  • Is Guide shoe adjustment correct?

  • Comment:

  • Further comments?

Door protection

  • Detector wiring secured?

  • Comment:

  • Detectors operational?

  • Comment:

  • Covers and guards secure?

  • Comment:

Door operation

  • Door open operation satisfactory?

  • Door close operation satisfactory ?

  • Door re-open operation satisfactory?

Hoistway

  • Is Hoistway ( rails, brackets, beam etc.) clean to a satisfactory standard

  • Comment:

  • Are oil overspill pots empty?

  • Comment:

  • Are trunking covers fitted

  • Comment:

  • Are indicators operating correctly?

  • Comment:

  • Are Hall lanterns and gongs fully operational

  • Comment:

  • All buttons and jewels fully operational?

  • Comment:

  • All face plate screws correctly installed?

  • Comment:

  • Shaft lighting operational?

  • Comment:

  • Further comments?

Underside of car

  • Underneath and sides of car clean?

  • Comment:

  • Safety gear clean & lubricated

  • Comment:

  • Travelling cable and/ or comp. hitches aligned?

  • Comment:

  • All covers are in place?

  • Comment:

  • Further comments?

Pit and pit equipment

  • Is Pit and associated equipment clean and dry?

  • Comment:

  • Oil drip pans under rails where provided?

  • Comment:

  • Governor tension weight position correct

  • Comment:

  • Governor tension switch correctly positioned?

  • Comment:

  • Over run available with car at top floor

  • Further comments?

  • Please complete for hydraulic lift

  • Hydraulic Lift

Asset description

  • Lift Code ( Allianz number etc.)

  • Lift Type

  • Serial Number known?

  • Manufacturers serial number

  • Year installed known

  • Year installed

  • Has lift been modernised?

  • Floors serviced

  • Lift Speed (m/s)

  • Lift capacity known?

  • Lift capacity (Kg)

  • Lift manufacturer Known?

  • Original lift manufacturer

Log card

  • Log card shows evidence of structured PPM?

  • No. Of breakdowns in the last 12 months

  • No. Of PPM visits in last 12 months

  • Date of last PPM

  • Further comments?

Maintenance history

  • Machine / Tank

  • Hydraulic aggregate

  • Machine room

  • Controller

  • Governors

  • Hydraulic cylinders

  • Inside of car

  • Ride quality

  • Levelling/ Stopping

  • Door operation

  • Door protection

  • Car doors gates

  • LG 1 Complete?

  • Car top

  • Hoist way doors gate

  • Car/ ctwt guides

  • Hoist way

  • Underside of car

  • Pit

  • Further comments?

Machine room / Controller area

  • Machine room or controller area tidy and free from rubbish or debris

  • Comment:

  • Are circuit diagrams mounted and tidy?

  • Please select where applicable...

  • Trough / Trunking and junction box covers fitted?

  • Please select where applicable...

  • Further comments?

Machine

  • Is the machine and motor in a satisfactory condition?

  • Comment:

  • Are machine and motor seals in tact?

  • Comment:

  • Are all lubrication levels adequate?

  • Comment:

  • Are brake linings adequate thickness and free of oil?

  • Comment:

  • Comment:

  • Is the brake lift in an acceptable condition?

  • Comment:

  • Are brake pins lubricated?

  • Comment:

  • Comment:

  • Are rope jump guards fitted correctly?

  • Comment:

  • Are Machine sound isolation pads in good condition?

  • Please select where applicable...

  • Suspension ropes free of dust & rouge and level in sheave?

  • Please select where applicable...

  • Comment:

  • Are machine guards fitted?

  • Comment:

  • Further comments?

Controller

  • Are controller(s) clean, dry and free from dust?

  • Comment:

  • Are all controller components correctly mounted/ labelled and in satisfactory condition?

  • Comment:

  • All controller wiring straight and secured ?

  • Please select where applicable...

  • Are printed circuit boards secure?

  • Please select where applicable...

  • Are contactor and relay contacts in good condition?

  • Further comments?

Governors

  • Is governor clean, lubricated and free from excessive grease?

  • Comment:

  • Governor rope free of dust and rouge?

  • Comment:

  • Comment:

  • Is governor sheave serviceable?

  • Comment:

  • Governor rope jaws, activator and operating weights free and will operate governor switch

  • Comment:

  • Is Wiring tidy in and around governor?

  • Comment:

  • Are governor guards fitted where available?

  • Comment:

  • Further comments?

Inside of car

  • Are car lights operational?

  • Comment:

  • Is the car light diffuser clean?

  • Comment:

  • Are the car operating panel buttons and position indicator operational?

  • Comment:

  • Is speech synthesiser operational?

  • Comment:

  • Are Car handrails and buffer rails secure?

  • Comment:

  • Is the car alarm/ auto dialler operational?

  • Comment:

  • Comment:

  • Is car interior clean and in a satisfactory condition? ( floor/ mirrors/ panels/ diffusers)

  • Comment:

  • Comment:

  • Further comments?

Door protection

  • Detector wiring secured?

  • Comment:

  • Detectors operational?

  • Comment:

  • Covers and guards secure?

  • Comment:

Door operation

  • Door open operation satisfactory?

  • Door close operation satisfactory ?

  • Door re-open operation satisfactory?

Hydraulic aggregate

  • Valve block and tank clean

  • Comment:

  • Tank oil level satisfactory

  • Comment:

  • Pipe connections free from oil leakage

  • Comment:

  • Governor tension switch correctly positioned?

  • Comment:

Ride quality

  • Is the car ride quality of an acceptable standard?

  • Comment:

  • Further comments?

Levelling / Stopping

  • Is the lift Levelling and/ or stopping operation satisfactory?

  • Comment:

  • Further comments?

Car top

  • Is car top clean and free of maintenance materials?

  • Comment:

  • Are car governor rope/ main rope or chain anchorage acceptable?

  • Comment:

  • Is top of car inspection control operating correctly?

  • Comment:

  • Are all covers and guards fitted correctly where available?

  • Comment:

  • Are junction box and equipment covers fitted?

  • Comment:

  • Is retiring cam device clean, lubricated & adjusted?

  • Comment:

  • Further comments?

Car doors & Gates

  • Door travel allowing for full opening?

  • Comment:

  • Are all electrical terminals, switches and contacts secure?

  • Comment:

  • Does hanger roll free from wear?

  • Comment:

  • Car shutters in good order?

  • Comment:

  • Car shutter vision panels satisfactory?

  • Comment:

  • Comment:

  • Are car doors, gates and top tracks satisfactory?

  • Comment:

  • Are car door bottom guides satisfactory?

  • Comment:

  • Car doors plumb?

  • Comment:

  • Further comments?

Hoistway doors and gates

  • Hoistway door air cords serviceable.

  • Comment:

  • Comment:

  • Hoistway for closer device(s) operate correctly

  • Comment:

  • Are hoistway door upthrusts rollers adjusted correctly?

  • Comment:

  • Are landing shutter gates satisfactory?

  • Comment:

  • Comment:

  • Are landing shutter vision panels satisfactory?

  • Comment:

  • Comment:

  • Are hoistway doors hangar roller adjusted correctly and serviceable?

  • Comment:

  • Comment:

  • Are door locks operational and maintained in good condition?

  • Comment:

  • Comment:

  • Are door top tracks free from wear?

  • Hoistway door plumb and gaps <6mm

  • Comment:

  • Hoistway door unlocking devices & escutcheons serviceable?

  • Comment:

  • Are hoistway door guides secure and in good condition?

  • Comment:

  • Comment:

  • Further comments?

Car and / or counterweight guides

  • Guide shoes or rollers clean and lubricated?

  • Comment:

  • Guide oil pot levels satisfactory?

  • comment:

  • Guide shoes inserts or rollers serviceable

  • Comment:

  • Comment:

  • Guide roller/ shoe adjustment correct?

  • Comment:

  • Further comments?

Counterweight

  • Are counterweights clean?

  • Comment:

  • Are all counterweights properly secured?

  • Comment:

  • Counterweight 2:1 sheaves clean and lubricated?

  • Comment:

  • Is Guide shoe adjustment correct?

  • Comment:

  • Further comments?

Hoistway

  • Is Hoistway ( rails, brackets, beam etc.) clean to a satisfactory standard

  • Comment:

  • Are trunking covers fitted

  • Comment:

  • Cylinder seals free from leakage?

  • Comment:

  • Are indicators operating correctly?

  • Comment:

  • Are Hall lanterns and gongs fully operational

  • Comment:

  • All buttons and jewels fully operational?

  • Comment:

  • All face plate screws correctly installed?

  • Comment:

  • Shaft lighting operational?

  • Comment:

  • Further comments?

Underside of car

  • Underneath and sides of car clean?

  • Comment:

  • Safety gear clean & lubricated

  • Comment:

  • Travelling cable and/ or comp. hitches aligned?

  • Comment:

  • All covers are in place?

  • Comment:

  • Further comments?

Pit and pit equipment

  • Pipe connections free from oil leakage?

  • Comment:

  • Is Pit and associated equipment clean and dry?

  • Comment:

  • Oil drip pans under rails where provided?

  • Comment:

  • Governor tension weight position correct

  • Comment:

  • Over run available with car at top floor

  • Further comments?

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.