Information
PLEASE COMPLETE THIS SECTION IN BLOCK CAPITALS - DOUBLE TAP ON SHIFT KEY MAKES BLOCK CAPS
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JOB TITLE e.g. SITE NAME - LIFT 1 - JOB 9999
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SITE NAME
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ENGINEER
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Conducted on
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Location
LIFT DETAILS - Please enter details about the Lift including:
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ENTER DETAILS FOR LIFT - MAKE / MODEL / FLOORS / PERSONS / SERIAL NUMBER
CONDITION OF EQUIPMENT REPORT
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S = SATISFACTORY D = DEFECTS R = RECOMMENDATIONS. N/A = NOT APPLICABLE
PLANT ROOM
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LIFT MOTOR
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LIFT MOTOR BEARINGS
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LIFT MOTOR BRUSHES
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LIFT GENERATOR
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LIFT GENERATOR - BEARINGS
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LIFT GENERATOR - BRUSHES
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REDUCTION GEAR
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BEARINGS
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GEAR OIL
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SHEAVE
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PULLEYS
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BRAKE
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HYDRAULIC PUMP UNIT
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HYDRAULIC FLUID
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TACHO UNIT
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OVERSPEED GOVERNOR
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CONTROLLER
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LIFTING BEAM
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ACCESS TO PLANT ROOM
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ACCESS TO PULLEY ROOM
LIFT CAR
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CAR CONDITION
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CAR PUSH STATION
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ALARM SYSTEM (IF FITTED)
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INDICATORS
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LOAD PLATE
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LIGHTING
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SAFETY EDGE
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DOOR DETECTORS
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LIGHT RAY UNITS
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DOOR OPERATOR
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DOOR CONTACTS
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CAR DOORS AND FRAMES
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TRACK ROLLERS
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TRACK SLIDES
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AIR CORDS
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RAMP
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CAR TOP CONTROL
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CAR STOP SWITCH
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LEVELLING / SLOWING DEVICE
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ANTI-CREEP (HYDRAULIC ONLY)
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CAR WIRING
LIFT SHAFT
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TRAILING CABLES
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FLOOR LEVEL ACCURACY
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CAR GUIDE SHOES
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CAR SAFETY GEAR
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HOISTING ROPE CONDITION
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HOISTING ROPE TERMINATIONS
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SAFETY ROPE CONDITION
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SAFETY ROPE TERMINATIONS
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GOVERNOR ROPE CONDITION
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GOVERNOR ROPE TERMINATIONS
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COUNTER WEIGHT CONDITION
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COUNTER WEIGHT SHOES
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GUIDES AND FIXINGS
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SHAFT SWITCHES
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SHAFT WIRING
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SHAFT ENCLOSURE
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LANDING DOORS AND FRAMES
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LANDING TRACK ROLLERS / SLIDES
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LANDING AIR CORDS
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LANDING LOCKS
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LANDING PUSHES
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LANDING INDICATORS
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HYDRAULIC EQUIPMENT
COMPLIANCE TO BS7255
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COMPLIANCE TO BS7255 - PLEASE INDICATE AS FOLLOWS - YES. NO N/A (NOT APPLICABLE)
PLANT ROOM
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LIGHTING
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EMERGENCY LIGHTING
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GUARDING
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MOVING PARTS INDICATION
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SHOCK CHART
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DANGER NOTICE
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HAND WINDING NOTICE
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RUBBER MAT
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PLINTH LADDER
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HAND WINDING BUZZER
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WIRING DIAGRAMS
LIFT CAR
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CAR TOP CONTROL
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SAFETY GEAR
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SAFETY BARRIER
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EMERGENCY LIGHTING
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SAFETY OF CAR ROOF
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CAR TOE GUARD
LIFT SHAFT
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SHAFT SCREENS
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COUNTERWEIGHT SCREENS
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PIT LADDER
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SAFETY LIGHTING
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SOCKET OUTLET IN PIT
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SAFETY BARRIERS
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RUPTURE VALVE - HYDRAULIC
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PIT PROP - HYDRAULIC
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RELEASE KEYS
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ARE ANY WARNING SIGNS REQUIRED?
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SHAFT FASCIA PANELS
LG CERTIFICATES DISPLAYED
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ARE LG CERTIFICATES DISPLAYED?
ENGINEER COMMENTS
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PLEASE ADD COMMENTS
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PLEASE ADD OR TAKE ANY FURTHER PHOTOS IF NEEDED
ENGINEER SIGNATURE
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ENGINEER PRINT NAME AND SIGN
CLIENT SIGNATURE
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CLIENT PRINT NAME AND SIGN
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CLIENT POSITION