Title Page
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Prepared by
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Company Name:
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Site conducted
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Location
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Conducted on
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Make & Model
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Hour Meter Reading
Additional Participants
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Name:
Visual Inspection
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Operator/AEM/ANSI Manuals?
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Weather Resistant Compartment?
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WorkPlatform/Guardrails/Anchor?
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Wires/Cables/Terminals
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Accessory Plugs/Cables
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GFI Box/Power to the Platform
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Rotator/Rotator Bolts
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Ext. Axles/Stabilizers/Outriggers
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Hydraulic Cylinders/Rods
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Pins/Banjo Bolts
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Hydraulic Hoses/Lines/Fittings
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Primary/Main Boom
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Secondary/Tower Boom
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Jib Booms/Lift Arms
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Power Track/Extension Track
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Data/Capacity Plate/Decals/Placards
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Inspection Decals/NDT Inspection
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Wheels/Tires/Tracks/Torque Hub
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Engine Compartment
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Belts/Hoses/Fan Blade
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Battery-Batteries Clean/Dry/Secure
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Engine Oil
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Coolant
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Hydraulic Oil
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Air Filter/Air Filter Indicator
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Fuel Gas/Diesel/Propane/DEF
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Jib Boom Swing Lock
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HA Upright (JLG)
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Safety Prop (Scissor Lifts)
Function Test
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Unit Starts/Runs Properly
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DEF % to next required Regen
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Instruments/System Warning Indicators
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Audible/Visual Warning Devices
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Lights/Strobe/Beacons
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Emergency Stop Button
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Toggles/Switches – Return to Neutral
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Joystick/Levers – Return to Neutral
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Function Enable/Footswitch/Dead Man
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Primary/Main Boom – Smooth Oper.
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Secondary/Tower Boom – Smooth Oper.
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Track Extensions/Retraction – Smooth
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Jib Boom/Lift Arms – Smooth Oper.
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Platform Rotate/Level – Smooth Oper.
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Drive/Steering/Braking
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Slewing/Turret Rotate
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Drive Enable
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Safety Interlocks/Limit Switches
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Ext. Axles/Stabilizers/Outriggers
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Calibration of Envelope System
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Skyguard/Tripwire Safety Device
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Emergency/Auxiliary Controls
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Other:
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Specify
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Status?
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Other:
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Specify
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Status?
