QSHE 193 - Dock leveller and Buffer Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

• Dock Leveller

Dock Leveller

• Is the dock leveller free of rubbish?

  Yes

  No

  N/A

• Does the dock leveller Lip function correctly and fully extend?

  Yes

  No

  N/A

• Does the dock leveller rise to full height?

  Yes

  No

  N/A

• Does the dock leveller emergency stop work?

  Yes

  No

  N/A

• Is the dock leveller free from visual damage?

  Yes

  No

  N/A

• Are the dock leveller skirts in good condition

  Yes

  No

  N/A

• Is the dock leveller control panel free of damage and operational?

  Yes

  No

  N/A

External Buffers

• Are the buffers in good condition?

  Yes

  No

  N/A

• Are the buffers secure to the wall and not loose?

  Yes

  No

  N/A