SCISSOR LIFT INSPECTION (ROUGH TERRAIN)

• Scissor Lift (Rough Terrain) Inspection

• Jobsite Location
  Address

• Job Name:

  Select

• Manufacturer

  Select

• Model

• Date of Inspection:

  Date

• Current Hours / Horas Corriente

• Weather - Select all that apply

  Select

• Project Superintendent(s)

  Select

• Operator Name:

• Prepared by

FUNCTIONS AND CONTROLS

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

  Pass

  Fail

• All joystick/toggle controls return to neutral/off position when release

  Yes

  No

• All machine functions are disabled when Emergency Stop Button is activated at ground and/or platform control stations.

  Yes

  No

• All function and speed limits/cut outs operate properly.

  Yes

  No

• Manual descent system and/or auxiliary power system operates properly.

  Yes

  No

• Brakes operate properly.

  Yes

  No

• All other machine controls, alarms, horn, displays, indicators, and functions operate properly at platform and ground control stations.

  Yes

  No

PLATFORM ASSEMBLY

• Platform installed and secure. Mounting hardware free of damage and secure. Gate or chain installed and latches properly.

  Safe

  At Risk

• Platform guardrails and floor properly installed, secure and free of damage.

  Safe

  At Risk

• Extension deck(s) properly installed and function (s) properly, locks at full extension and retraction.

  Safe

  At Risk

• Lanyard anchorage points secures, free of damage and labeled.

  Safe

  At Risk

• Fold-down rails installed properly No loose or missing parts.

  Safe

  At Risk

SCISSOR ARMS

• Scissor arms free of damage, cracks and distortion.

  Yes

  No

• Safety prop (s) properly installed and function properly.

  Yes

  No

• Inspect all nuts, bolts, shafts, shields, locking devices, and bearings for proper installation, secure, no excessive wear, cracks or distortion.

  Yes

  No

• Cylinder pins, bearings and attaching hardware secure, free of damage and excessive wear.

  Yes

  No

• Arm pins, bearings and attaching hardware secure, free of damage and excessive wear.

  Yes

  No

• Arm pads and sliding blocks secure, free of damage and excessive wear.

  Yes

  No

CHASSIS

• Proper wheels/tires installed. Inspect for excessive damage, wear and corrosion.

  Pass

  Fail

• Steering components are properly installed and free of damage

  Yes

  No

• Leveling jacks or stabilizers operate properly.

  Yes

  No

• Hydraulic tray and battery/engine compartment covers open and latch properly.

  Yes

  No

• Pothole protection system deploys and retracts properly.

  Yes

  No

• Platform ladder properly installed, secure and free of damage

  Yes

  No

• Static strap is properly installed and secure

  Yes

  No

POWER SYSTEM

• Engine idle and throttle set at proper RPM

  Yes

  No

• Air & fuel filter clean.

  Yes

  No

• Proper coolant and engine oil level

  Yes

  No

• Proper fuel cap installed

  Yes

  No

• Engine fuel level

  Full

  3/4

  1/2

  1/4

  Empty

• Exhaust system operates properly, secure, and free of damage

  Yes

  No

HYDRAULIC/ELECTRICAL SYSTEM

• All cylinders/actuators free of damage with no evidence of leaks.

  Yes

  No

• All areas around hydraulic components have no evidence of leaks

  Yes

  No

• All hydraulic hoses, fittings and lines secure and free of damage. Check for chafing and leaks.

  Yes

  No

• All electrical connections tight, no corrosion or abrasions.

  Yes

  No

• Pump and motor secure, free of damage and leaks.

  Yes

  No

MANUALS AND DECALS

• Operation and Safety Manual, ANSI Manual of Responsibilities in storage box.

  Yes

  No

• All safety, capacity and instructional decals installed, secure and legible.

  Yes

  No

GENERAL

• Machine is free of unauthorized modifications or additions.

  Yes

  No

• Inspced general structural condtion including all welds.

  Yes

  No

• Drive and operate machine to test all machine functions.

  Yes

  No

• Record inspection date at "IMPORTANT" decal

• Is Annual Inspection due?

  Yes

  No