Title Page

  • Model Number

  • Serial Number

  • Conducted on

  • Inspected by

  • Location

Operating and Emergency Controls

  • Steering and components are operating properly

  • Check booms and cylinder for proper working order

  • Check if operating and emergency controls are free of: excessive dirt, grease or foreign matter

Safety Devices

  • Run light operates properly

Personal Protective Devices

  • Hard hat, safety glasses, steel toe boots, harness, and lanyard are worn (if required)

  • Platform floor is in good order

  • Housekeeping is observed in platform floor

  • Pothole protection is in proper working condition

  • Fire extinguishers are in place and inspected regularly

Tires and Wheels

  • Tires are free of excessive wear, cuts, and proper inflation

  • Wheels are free of cracks and damage (bent rims, etc.)

  • Lug nuts installed and secured

Air, Hydraulic and Fuel System Leaks

  • Check for leaks, hose chafing and cracking, kinking or binding.

  • Check for proper service levels

Loose or Missing Parts

  • Check for loose or missing parts at the boom, assemblies and platform

Battery, Cable and Wiring Harness

  • Check for proper installation

  • Check if in good working condition

  • Free of excessive dirt, grease or foreign matter

  • Free of loose wire connectors, damaged electrical cables, chafing, kinking or binding of electrical cables or wires

Placards, Warning, Control Marking and Operating Manual

  • Capacity label is legible

  • All warning and equipment control markings for proper operation is legible and attached

  • Operating and Responsibilities Manuals are installed on the lift and are legible

  • Manuals are stored in a weatherproof container and the container is easily identifiable

Guardrail System

  • Check for cracked welds, cracked metal, distorted components, broken structures, sign of metal fatigue

  • Lanyard attachment points are in good condition

  • Lanyard attachment points are near the bottom of the basket in the corners

Equipment Task Function Operation

  • Lower controls operate properly

  • Platform controls operate properly

Hazards

  • No signs of hazards such as: drop off, holes, bumps, debris, overhead obstructions, high voltage areas or over headlines, high winds or bad weather, inadequate ground support, inadequate ventilation, hazardous atmosphere, other

Completion

  • Additional Comments

  • Inspection Completed By

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.