Information

PLEASE COMPLETE THIS SECTION IN BLOCK CAPITALS - DOUBLE TAP ON SHIFT KEY MAKES BLOCK CAPS

  • JOB TITLE. e.g. SITE NAME - LIFT 1 - JOB 9999

  • SITE NAME

  • ENGINEER

  • Conducted on

  • Location

PLEASE ENTER DETAILS OF THE LIFT

  • E.G. Lift Make / Lift Model / Serial Number

NEW USEFUL INFORMATION - E.G. DOOR CODES / ACCESS OR CONTACT DETAILS / LIFT INFO etc.

  • PLEASE ENTER ANY NEW USEFUL INFO WHICH WILL BE HELPFUL TO KNOW FOR FUTURE VISITS

  • TAKE PHOTOS IF RELEVANT TO DO WITH ANY NEW USEFUL INFO TO DO WITH SITE OR LIFT

ACCESS TO THE MOTOR ROOM

  • Is there safe access to the Motor Room?

  • Risk Level

  • Access lighting to the Motor Room is adequate?

  • Risk Level

  • Is there clear unobstructed entry to the Motor Room?

  • Risk Level

  • Correct type of lock fitted to the Motor Room Door?

  • Risk Level

  • Motor Room Door locked?

  • Risk Level

  • Motor Room Door fitted with Danger Sign?

  • Risk Level

  • Motor Room light switch adjacent to entry point?

  • Risk Level

  • Is an oil barrier fitted in front or behind door?

  • Risk Level

  • Does Motor Room Door have a Tripping Hazard Sign?

  • Risk Level

INSIDE THE MOTOR ROOM

  • Does Motor Room have Emergency Lighting?

  • Risk Level

  • Has the Mains Isolator been fitted adjacent to the entry point?

  • Risk Level

  • Is the Isolator marked Lift Main Switch?

  • Risk Level

  • Is a lift parking sign been fitted to the Isolator?<br>

  • Risk Level

  • Can the Isolator be locked in the OFF position?

  • Risk Level

  • Is there an Electric Shock Card positioned in the main Isolator Box?

  • Risk Level

  • Is there a Landing Release Key available in the Motor Room?

  • Risk Level

  • If more than one Lift, are both Isolators identified?

  • Risk Level

  • Is there only Lift Equipment in the Motor Room?

  • Risk Level

  • Is the Lift Equipment guarded / separate?

  • Risk Level

  • Does the Lift Room have the correct type of ventilation?

  • Risk Level

  • Is the heating level correct?

  • Risk Level

  • Does Motor Room have trap doors and are they strong / guarded / sign fitted?

  • Risk Level

  • Is the lifting beam marked with the SWL?

  • Risk Level

  • Is there any raised section in the Motor Room & are they guarded?

  • Risk Level

  • Is a ladder fitted if they are 500mm or higher?

  • Risk Level

  • Is the motor room free of tripping / head hazards?

  • Risk Level

  • Does it have a non slip floor?

  • Risk Level

  • Is there a fire extinguisher (Black Type)?

  • Risk Level

MAIN LIFT CONTROLLER

  • Is there a Danger Sign 415 volts?

  • Risk Level

  • Is there a full width rubber Safety Mat in front of the Controller?

  • Risk Level

  • Is there a rubber mat fitted behind the controller if required?

  • Risk Level

  • If more than one lift are the controllers identified?

  • Risk Level

  • Fitted with warning signs if power still on when one is turned off?

  • Risk Level

  • Is there a clear distance of 900mm in front of the main Controller?

  • Risk Level

  • Is there a warning sign fitted to the controller isolator before opening?

  • Risk Level

  • Are there Controller wiring diagrams of correct type for this controller?

  • Risk Level

  • Have all objects been removed from the top of the Controller?

  • Risk Level

HYDRAULIC TANK / GEAR AREA

  • Is there a safe working clearance above the gear / tank area (300mm)?

  • Risk Level

  • Is there a hand winding wheel and is it of the spoke less type?

  • Risk Level

  • Painted Yellow?

  • Risk Level

  • Is a Brake Handle present?

  • Risk Level

  • Pump Handle and does it work correctly?

  • Risk Level

  • Hand Winding Instruction Sign & visible?

  • Risk Level

  • Is there a safe working area for Hand Winding?

  • Risk Level

  • Are guards fitted to the machine / governor unit?

  • Risk Level

  • Do the guards allow safe servicing?

  • Risk Level

  • Is there a Stop Switch fitted by the gear / motor / tank units?

  • Risk Level

TOP OF LIFT CAR

  • Is the Roof strong enough for man and tools?

  • Risk Level

  • Do the landing doors have the modern triangle release?

  • Risk Level

  • Has a stop switch been fitted max 1000mm from entrance of lift roof?

  • Risk Level

  • Has a car top control been fitted with guarded controls and a run button?

  • Risk Level

  • Have you tested the car top controls system turns off landing call?

  • Risk Level

  • Does the Lift Car have safety gear fitted - If not Do Not Ride

  • Risk Level

  • Are there any tripping hazards on roof?

  • Risk Level

  • Is there a Gap of 300mm or more around roof top therefore constituting a fall hazard?

  • Risk Level

  • Are there any finger trap areas / driving wheel / divertor wheels?

  • Risk Level

  • Is there a fixed light plus is it guarded?

  • Risk Level

  • Has a test up limit been fitted?

  • Risk Level

  • Does it stop the lift 1800mm from the first strike point?

  • Risk Level

  • Does the car top have low head room signs in place?

  • Risk Level

  • Is there a car top hand rail plus sign in place?

  • Risk Level

LIFT SHAFT

  • Is there a landing safety barrier available?

  • Risk Level

  • Is the lift shaft adequately illuminated?

  • Risk Level

  • Are all lock box covers fitted?

  • Risk Level

  • Are all landing doors fitted with closers?

  • Risk Level

  • Do all landing and car locks - electrically and mechanically work correctly?

  • Risk Level

  • Does the overhead lifting beam have a SWL Sign fitted?

  • Risk Level

  • Are all landing doors solid type (not lattice type) finger traps?

  • Risk Level

  • Are all landing and car toe guards fitted?

  • Risk Level

  • If two lifts in same shaft is screening guard been fitted?

  • Risk Level

  • Has top and bottom floor identification been visually marked?

  • Risk Level

LIFT PIT AREA

  • Has a lift pit stop switch been fitted that can be reached from the landing?

  • Risk Level

  • And lift pit safely?

  • Risk Level

  • Is it marked STOP?

  • Risk Level

  • Has a pit ladder been fitted plus hand grips?

  • Risk Level

  • Is there an interlocked pit prop available?

  • Risk Level

  • Has the pit prop been clearly labeled?

  • Risk Level

  • Is there a pit prop warning sign?

  • Risk Level

  • Is a pit warning sign required?

  • Risk Level

  • Has the hydraulic ram been fitted with a rupture valve?

  • Risk Level

  • Does this lift operate in an enviroment that requires special safety equipment or has hazards that may require two man working for safety?

  • Risk Level

Asbestos

  • Is there any asbestos present? - If Yes please record details.

  • Risk Level

RISK ASSESSMENT COMPLETE

  • Engineer Signature

  • Select date

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