Information
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Extension Boom Platform Lift Pre Operation Inspection & Site Inspection
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Please fill out the following inspection prior to using the aerial lift. Operator must check off each item as having been checked "Pass" and is safe to use during daily inspection prior to operation. DO NOT OPERATE the lift if any item is found to be defective. Please contact your supervisor and let them know that the lift needs repaired.
Complete Work Site Evaluation for every new location if using multiple locations during your work shift.
Please e-mail this completed audit to Jeff Pearson (pearsoja@pwcs.edu) when you are complete with it.
Thanks and have a wonderful day! -
Lift MFG
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Model #:
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Serial #:
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Conducted on
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Starting Hour Meter Reading:
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Prepared by
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Add signature
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Badge #:
Lift Evaluation
Key Off Procedures
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Operator Manual & Decals are in place and legible
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Check Hydraulic cylinders/lifting mechanism/fluid level
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Check drive hubs & engine for oil leaks
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Check welds, pins, missing nuts or bolts, and other structural parts for cracks and defects
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Check outriggers, outrigger limiting switches, and locking pins
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Check drive hubs and engine for oil leaks
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Check platform entry mid-rail/gate, and platform housekeeping
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Examine Battery (physical condition) and fire extinguisher (when applicable)
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Check fuel level - can unit operate the length of the job?
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Tires/Rollers/Monitor air pressure if pneumatic
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Operator is responsible for inspecting all fall protection, and ensuring that all fall protection is being worn prior to using lift
Key On Procedures
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Check all ground controls for proper operation- Including emergency lowering switch
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Check all basket controls, foot switch, and horn for proper operation
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Battery discharge indicator & hour meter functioning
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Steering & drive function operating correctly
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Check limit switches, alarms, and flashing beacon (if equipped)
Site Assessment
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Use this to fill out site assessment before every location that is used during your shift
Location
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Add location
Site Evaluation
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Is work area structurally strong enough to handle the lift?
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Work area free of drop offs?
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Surface area where lift to be used level?
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Surface area where lift to be used free of obstructions?
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Are there ramps or other sloped surfaces that could impact lift stability?
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Checked for overhead obstructions or restricted places?
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Are you aware of the rated weight capacity of this lift?
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Will lift be used for electrical work, or near high voltage lines?
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Is wind or other weather a concern?
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Are winds below 28mph?
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List of any potentially hazardous site conditions that could affect the safe operation of this lift:
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Attach a photo of work area
Process/Use of Lift
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Has the proper lift been chosen for the type of work being conducted?
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Does the lift have the proper height and capacity for the job that will be done?
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Is the appropriate PPE being used?
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Is the basket free of trip hazards?
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Is there sufficient lighting for the workspace?
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Is the work area close to exits, hydrants, extinguishers, door ways, or other obstructions?
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List below any other potentially hazardous site conditions that could affect safe operation of this lift:
