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
JOB DETAILS - Please enter job details including:
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LIFT MAKE / LIFT MODEL / LIFT SERIAL NUMBER
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Please provide these details and any other relevant information in this box.
NEW USEFUL INFORMATION - E.G. DOOR CODES / ACCESS OR CONTACT DETAILS / LIFT INFO etc.
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PLEASE ENTER ANY NEW USEFUL INFO WHICH WILL BE HELPFUL TO KNOW FOR FUTURE VISITS
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TAKE PHOTOS IF RELEVANT TO DO WITH ANY NEW USEFUL INFO TO DO WITH SITE OR LIFT
PLEASE CHOOSE OPTION FOR EACH ITEM BELOW
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PLEASE ADD NOTES IF - Urgent Attention / Should be Renewed / No
ITEMS TO INSPECT
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Autodial / Alarm
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Check Lift Car Lighting
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Check Lift Emergency Lighting
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Check All Oil / Grease Levels
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Detectors / Door Protection
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Door Operation
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Floor Levelling
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Review Risk Assessment On Site
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Car / Landing Pushes / Indicators
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Brake
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Controller
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Gear / Hyd Unit
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Governor
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Motor Room
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Motor / MG Set
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Sheaves
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Door Locks / Guide Shoes
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Door Operator
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Door / Gates
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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OSG Rope
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Hoistway Equipment
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Suspension Ropes
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Clean Lift / Pit Equipment / Motor Room
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Lift Car
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Ram Seals and Hoses
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Rupture Valves
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Safety Gear
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Scissor Lift Tables
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Sign and Date the Log Card
- NO
- NOT APPLICABLE
- SATISFACTORY
- SHOULD BE RENEWED
- URGENT ATTENTION
- WORN BUT SERVICEABLE
- YES
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Notes
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Recommendations
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Take Photos as required
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Engineers Signature
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This equipment has been serviced in accordance with the contract and has been left in a satisfactory, safe and serviceable condition.
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All equipment is in satisfactory condition excepting those items requiring attention as identified on this report.
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Customer Signature