SCISSOR LIFT INSPECTION (ELECTRIC)

• Scissor Lift (Electric) Inspection

• Jobsite Location:
  Address

• Job Name:

  Select

• Scissor Lift Model # (take photo)

  Media

• Date of Inspection:

  Date

• Hour Meter

• Weather - Select all that apply

  Select

• Project Superintendent(s)

  Select

• Operator Name:

• Prepared by

Daily Checklist

• ENGINE PRE-START

• Has the operator been instructed in the safe operation of this type of lift?

  Yes

  No

• Ensure Annual Inspection has been completed within the last 13 months.

  Pass

  Fail

• Floorboard free of debris and garbage

  Yes

  No

• Operator’s manual complete, legible, and in storage box?

  Yes

  No

• Tires and rims in good condition?

  Pass

  Fail

• Condition of entry ladder

  Safe

  At Risk

• Presence of fire extinguishers

  Yes

  No

• Is the guardrail system in good condition all around the lift?

  Pass

  Fail

• Is the gate/chain functioning properly

  Yes

  No

• Are the wires to the control box covered and secure

  Pass

  Fail

• Battery Terminals

  Pass

  Fail

• Battery charging cord (all 3 pins)

  Pass

  Fail

• Decals

  Safe

  At Risk

• Pot hole guards functioning?

  Yes

  No

• Controls are clearly marked?

  Pass

  Fail

• Control levers, switches, Gauges and instruments operate properly, including options (horns, lights, etc.).

  Pass

  Fail

• Arm safety props operational

  Safe

  At Risk

• Drive Motors

  Safe

  At Risk

• Emergency stop switches at the ground & platform control stations operate properly, (Shuts off controls & engine)

  Yes

  No

• Platform goes Up & Down

  Yes

  No

• Manual descent/auxiliary power system operates properly.

  Yes

  No

• Arm pins, wear pads & attaching hardware secure & undamaged.

  Yes

  No

• Wheel turns smoothly?

  Yes

  No

• Extension platform slide is clean and locks in place?

  Yes

  No

• GFI outlet inside platform working? Cover in place?

  Safe

  At Risk

Confirmation

• Is the Scissor lift safe to use?

  Yes

  No