PWCS Scissor Lift Pre-Use Inspection

• Scissor Platform Lift Pre Operation Inspection & Site Inspection

• 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

• Model #:

• Serial #:

• Conducted on

  Date

• Starting Hour Meter Reading:

• Prepared by

• Add signature

  Sign

• Badge #:

Key Off Procedures

• Operator Manual & Decals are in place and legible

  Pass

  Fail

  Not Applicable

• Check Hydraulic cylinders/lifting mechanism/fluid level

  Pass

  Fail

  Not Applicable

• Check welds, pins, missing nuts or bolts, and other structural parts for cracks and defects

  Pass

  Fail

  Not Applicable

• Check outriggers, outrigger limiting switches, and locking pins

  Pass

  Fail

  Not Applicable

• Check platform entry mid-rail/gate, and platform housekeeping

  Pass

  Fail

  Not Applicable

• Examine Battery (physical condition) and fire extinguisher (when applicable)

  Pass

  Fail

  Not Applicable

• Check battery charge level - can unit operate the length of the job?

  Pass

  Fail

  Not Applicable

• Tires/Rollers/Monitor air pressure if pneumatic

  Pass

  Fail

  Not Applicable

Key On Procedures

• Check all ground controls for proper operation- Including emergency lowering switch

  Pass

  Fail

  Not Applicable

• Check all basket controls, foot switch, and horn for proper operation

  Pass

  Fail

  Not Applicable

• Battery discharge indicator & hour meter functioning

  Pass

  Fail

  Not Applicable

• Steering & drive function operating correctly

  Pass

  Fail

  Not Applicable

• Check limit switches, alarms, and flashing beacon (if equipped)

  Pass

  Fail

  Not Applicable

• Use this to fill out site assessment before every location that is used during your shift

Location
• Add location
  Address

Site Evaluation

• Is work area structurally strong enough to handle the lift?

  Yes

  No

  N/A

• Work area free of drop offs?

  Yes

  No

  N/A

• Surface area where lift to be used level?

  Yes

  No

  N/A

• Surface area where lift to be used free of obstructions?

  Yes

  No

  N/A

• Are there ramps or other sloped surfaces that could impact lift stability?

  Yes

  No

• Checked for overhead obstructions or restricted places?

  Yes

  No

  N/A

• Are you aware of the rated weight capacity of this lift?

  Yes

  No

  N/A

• Will lift be used for electrical work, or near high voltage lines?

  Yes

  No

• Is wind or other weather a concern?

  Yes

  No

• Are winds below 28mph?

  Yes

  No

  N/A

• List of any potentially hazardous site conditions that could affect the safe operation of this lift:

• Attach a photo of work area

  Media

Process/Use of Lift

• Has the proper lift been chosen for the type of work being conducted?

  Yes

  No

  N/A

• Does the lift have the proper height and capacity for the job that will be done?

  Yes

  No

  N/A

• Is the appropriate PPE being used?

  Yes

  No

  N/A

• Is the basket free of trip hazards?

  Yes

  No

  N/A

• Is there sufficient lighting for the workspace?

  Yes

  No

  N/A

• Is the work area close to exits, hydrants, extinguishers, door ways, or other obstructions?

  Yes

  No

• List below any other potentially hazardous site conditions that could affect safe operation of this lift: