Information

  • Document No.

  • Conducted on

  • Job Name

  • Job Address
  • Location Number and Contact

  • Prepared by

Escalator Information

  • Escalator Name/Number

  • Escalator State Number

  • Type of Escalator

  • Escalator Manufacture

  • Approximate Number of Steps/Rise

Machine Room

  • Cleanliness

  • Controller Cleanliness

  • Relay Covers Installed

  • Brake Adjusted

  • Chains Lubricated

  • Missing Step Switch Operational

  • Automatic Oiler Full and Operational

  • Check Charts Current

  • Controller Fuses Correct Amps

Truss

  • Cleanliness

  • Step Treads/Demarcation Plates

  • Comb Plates

  • Skirt Gaps

  • Skirt and Deck Screws

  • Handrail Condition

  • Stop Switch Covers

  • Handrail Drive Chains

  • Key Switches Operational

  • Ride Quality

  • General Noise

Pit

  • Cleanliness

  • Stop Switch Operational

  • Tension Carriage Adjusted

  • Notes:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.