MEWP RISK ASSESSMENT

• Document No.

• On site risk assessment for the use of?

• Conducted on

  Date

• Prepared by

• Location
  Address

MEWP Check List

• Are all guards in position?

  Yes

  No

  N/A

• Is the machine structurally sound?

  Yes

  No

  N/A

• Is the parking break on and working?

  Yes

  No

  N/A

• Are all the decals in place and legible?<br>(are all controls clearly marked?)

  Yes

  No

  N/A

• Are there any signs of leaks, Hydraulics, Fuel and Oil?

  Yes

  No

• Add media

  Media

• Are all hydraulic levels correct?

  Yes

  No

  N/A

• Are all hydraulic hoses in good condition?

  Yes

  No

  N/A

• Are the wheels in good condition?<br>(Tyre Pressure, wheel nuts, etc)

  Yes

  No

  N/A

• Is the basket clean and free from defects and obstructions?

  Yes

  No

  N/A

• Are Harness anchor points in the basket in good condition?

  Yes

  No

  N/A

• Is there sufficient fuel/battery power?

  Yes

  No

  N/A

• Disconnect electrical supply.

  Yes

  No

  N/A

• Start Machine.

  Yes

  No

  N/A

• Are ALL emergency stop buttons in working order?

  Yes

  No

  N/A

• Are all the gauges and warning lights/audible alarm warning devices working correctly?

  Yes

  No

  N/A

• Are all the stabilizer legs deploying correctly?

  Yes

  No

  N/A

• Do ALL 4 foot plates (individually) activate alarm when raised in work mode?

  Yes

  No

  N/A

• Are there any leaks from the rams/hydraulic pipes when operating the machine?

  Yes

  No

  N/A

• Add media

  Media

• Are all controls operating correctly

  Yes

  No

  N/A

• Are all the booms operating correctly?

  Yes

  No

  N/A

• Are the safety harnesses in good condition?

  Yes

  No

  N/A

• Is the emergency lowering system operating correctly?

  Yes

  No

  N/A

• Is the machine in safe working condition?

  Yes

  No

  N/A

• L.O.L.E.R Certificate in date?

• Machine type: Nifty Lift 170

• Owner of Machine: Longleat Enterprises, Grounds and Gardens Department.

• Serial Number: 1720830

Assessor/operator

• Assessor

  Select Dorian Stephens Paul Thompson Lewis Charles Matthew Whitcombe Mark C Other

  • Dorian Stephens
  • Paul Thompson
  • Lewis Charles
  • Matthew Whitcombe
  • Mark C
  • Other

• Other

• Operator

  Select Dorian Stephens Paul Thompson Lewis Charles Matthew Whitcombe Mark C Other

  • Dorian Stephens
  • Paul Thompson
  • Lewis Charles
  • Matthew Whitcombe
  • Mark C
  • Other

• Other

Site Assessment

• Ground Type

  Tarmac

  Concrete

  Brick

  Stone

  Grass

• Other & Any Action Required

• Terrain

  flat

  uneven

  gently sloping

  steeply sloping

  steep drop

• Action required

• Trip Hazzards

  Low

  Medium

  High

• Action required

• Services

  Select electric overhead overhead underground none

  • electric overhead
  • overhead
  • underground
  • none

• Action required

• Structures

  Select buildings boundaries none other

  • buildings
  • boundaries
  • none
  • other

• Action required

• Other site activities

  Select pedestrian vehicle none other

  • pedestrian
  • vehicle
  • none
  • other

• Public access

  Select vehicle pedestrian none

  • vehicle
  • pedestrian
  • none

• What are the weather conditions?

• Is the wind speed and direction at a safe level? Below 28mph

  Safe

  At Risk

  N/A

Emergency action plan

• Location name and grid reference if known

• Type of access

  hand surface

  light vehicle

  4x4

• Nearest road.
  A362 picket post roundabout

• Ambulance meeting point.
  Picket post - st842411
  Front house - st809430

• Helicopter landing site grid reference.
  Park hill - st837433
  Lodge - st808428

• Nearest landline telephone number.
  Both you - 01985 845 411/507
  Estate office - 01985 844 400

• Radio call signs

  Select golf 1 golf 2 golf 3 golf 4 golf 5 golf 6 golf 7 golf 8 golf 9 golf 10 golf 11 golf 12 golf 13 golf 14 golf 15 golf 16 golf 17 golf 17 golf 18 golf 19 golf 20 ranger 1 ranger 2 ranger 3 ranger 4 ranger 5 ranger 6 ranger 7

  • golf 1
  • golf 2
  • golf 3
  • golf 4
  • golf 5
  • golf 6
  • golf 7
  • golf 8
  • golf 9
  • golf 10
  • golf 11
  • golf 12
  • golf 13
  • golf 14
  • golf 15
  • golf 16
  • golf 17
  • golf 17
  • golf 18
  • golf 19
  • golf 20
  • ranger 1
  • ranger 2
  • ranger 3
  • ranger 4
  • ranger 5
  • ranger 6
  • ranger 7

• Mobile phone signal strength

  good

  average

  poor

• Date and time

  Date

• Please sign here

  Sign