Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Make/Model/Serial Number

Untitled Page

  • Is the Equipment the right MEWP for the task?

  • Is the operator trained and authorized for the MEWP?

  • Was the equipment inspection conducted and completed?

  • Was the work area inspected for potential hazards?

  • Are the operator and owner's manual on the piece of equipment?

  • Is the a fire extinguisher on the MEWP?

  • Is the employee using fall protection & maintaining 100% tie off?

  • Is the MEWP being used to hoist, lift, pull, material into place?

  • Is the basket free of trip hazards and clutter, trash debris?

  • Is the equipment on level ground or within manufacturer specifications of being level?

  • Are there any defects on the piece of equipment to report?

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.