Title Page
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Scissor Lift (Rough Terrain) Inspection
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Jobsite:
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Date of Inspection:
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Make and Model: (take photo of machine)
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Hour Meter:
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Project Superintendent(s):
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Operator Name:
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Prepared By:
Items for Inspection
FUNCTIONS AND CONTROLS
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Ensure Annual Inspection has been completed within the last 13 months.
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All joystick/toggle controls return to neutral/off position when release
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All machine functions are disabled when Emergency Stop Button is activated at ground and/or platform control stations.
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All function and speed limits/cut outs operate properly.
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Manual descent system and/or auxiliary power system operates properly.
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Brakes operate properly.
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All other machine controls, alarms, horn, displays, indicators, and functions operate properly at platform and ground control stations.
PLATFORM ASSEMBLY
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Platform installed and secure. Mounting hardware free of damage and secure. Gate or chain installed and latches properly.
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Platform guardrails and floor properly installed, secure and free of damage.
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Extension deck(s) properly installed and function (s) properly, locks at full extension and retraction.
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Lanyard anchorage points secures, free of damage and labeled.
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Fold-down rails installed properly No loose or missing parts.
SCISSOR ARMS
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Scissor arms free of damage, cracks and distortion.
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Safety prop (s) properly installed and function properly.
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Inspect all nuts, bolts, shafts, shields, locking devices, and bearings for proper installation, secure, no excessive wear, cracks or distortion.
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Cylinder pins, bearings and attaching hardware secure, free of damage and excessive wear.
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Arm pins, bearings and attaching hardware secure, free of damage and excessive wear.
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Arm pads and sliding blocks secure, free of damage and excessive wear.
CHASSIS
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Proper wheels/tires installed. Inspect for excessive damage, wear and corrosion.
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Steering components are properly installed and free of damage
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Leveling jacks or stabilizers operate properly.
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Hydraulic tray and battery/engine compartment covers open and latch properly.
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Pothole protection system deploys and retracts properly.
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Platform ladder properly installed, secure and free of damage
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Static strap is properly installed and secure
POWER SYSTEM
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Engine idle and throttle set at proper RPM
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Air & fuel filter clean.
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Proper coolant and engine oil level
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Proper fuel cap installed
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Engine fuel level
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Exhaust system operates properly, secure, and free of damage
HYDRAULIC/ELECTRICAL SYSTEM
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All cylinders/actuators free of damage with no evidence of leaks.
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All areas around hydraulic components have no evidence of leaks
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All hydraulic hoses, fittings and lines secure and free of damage. Check for chafing and leaks.
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All electrical connections tight, no corrosion or abrasions.
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Pump and motor secure, free of damage and leaks.
MANUALS AND DECALS
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Operation and Safety Manual, ANSI Manual of Responsibilities in storage box.
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All safety, capacity and instructional decals installed, secure and legible.
GENERAL
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Machine is free of unauthorized modifications or additions.
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Inspced general structural condtion including all welds.
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Drive and operate machine to test all machine functions.
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Is Annual Inspection due?
