Information
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Job # & Name
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Client/General Contractor
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Conducted on
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Prepared and inspected by
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Location
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Lift make, model, and number
EXTERIOR
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Wheels and Tires in good repair
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Add media
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Tag out of service and contact vendor for repair.
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Pothole protection system shows no visible sign of damage.
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Add media
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Tag out of service and contact vendor for repair.
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Platform extension operational and has no visible damage.
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Add media
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Tag out of service and contact vendor for repair.
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Access ladder attachment is straight and level with no dents.
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Add media
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Tag out of service and contact vendor for repair.
FLUIDS
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Hydraulic reservoir contains ample fluid.
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Add media
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Tag out of service and contact vendor for repair.
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Batteries contain ample fluid.
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Add media
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Tag out of service and contact vendor for repair.
INTERIOR
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Controls properly secured with no visible damage, placards legible.
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Add media
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Tag out of service and contact vendor for repair.
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Guard rail system has no visible damage.
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Add media
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Tag out of service and contact vendor for repair.
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Chain clasp locks securely?
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Add media
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Tag out of service and contact vendor for repair.
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Floor of lift is free of debris and other tripping hazards.
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Add media
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Tag out of service and contact vendor for repair.
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Operator manual is available.
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Add media
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Tag out of service and contact vendor for repair.
ELECTRICAL
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Outlet is in good repair.
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Add media
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Tag out of service and contact vendor for repair.
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Outlet has cover in good repair.
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Add media
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Tag OUTLET out of service (lift may still be used) and contact vendor for repair.
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Control wiring harness is intact and free of stray wiring.
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Add media
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Tag out of service and contact vendor for repair.
Sign Off
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Name
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Signature
