Title Page

  • Sub-contractor Name:

  • Site conducted

  • Conducted on

  • Prepared by

  • IPAF Card:

  • Location
  • MEWP Model:

  • MEWP Serial Number:

  • Documentation

  • Current thorough examination certificate (within last six months)

  • Photo of thorough examination sticker

  • Manufacturer's operator manual present?

  • Is there a rescue plan in place? (This must be read and signed by MEWP Operator and MEWP Spotter).

  • Wheels/ Tyres

  • Confirm Wheel security (nuts, retainers: loose, not damaged or missing)

  • Confirm tyre pressure (pneumatic, foam filled or solid)

  • Confirm there are no Cuts, splits, exposed braiding, damaged rims

  • Engine/ Power Source

  • Correct fluid levels (engine oil, coolant)

  • Confirm no fluid leakage on ground and around engine

  • Battery in good condition (electrolyte, security and charging plug condition)

  • Hydraulics

  • Correct hydraulic fluid levels?

  • Confirm there are no leaks (hoses, pipe connections, rams, cylinders)

  • Hoses and Cables

  • Confirm adequate security and condition of cuts, chaffing andbulges

  • Confirm Power track cable trays are free from damage and debris

  • Outriggers/ Stabilisers used on MEWP?

  • Confirm good general condition, pins/retainers and footplate

  • Spreader plates (present, condition, secure for travel)

  • All Interlocks are functioning and engaged

  • Chassis, boom and scissor pack

  • Confirm good condition, no damage, misalignment or corrosion

  • Confirm no cracks in welds

  • Confirm security and no signs of wear to Pins, retainers and chains

  • Confirm Canopies, guards and engine covers are in good condition

  • Platform or Cage

  • Steps for access/egress are secure, undamaged and clear

  • Entrance gate, guard rails and retaining pins in good condition

  • Harness anchor points present and in good condition

  • Platform Clear of rubbish, debris and obstructions

  • Decals and signage present and legible

  • Functional Checks Confirm the following

  • Using Ground (G) and Platform(P) controls

  • Security device (power isolator, keypad, smart card) working

  • Function enable (ignition key, foot switch, hold to run device) working correctly

  • Emergency stops and emergency lowering system working correctly?

  • All switches, function controls (move freely, do not stick)

  • Lifting functions (raise, lower, slew, tele-out, tele-in) working correctly?

  • Travel functions (forward, reverse, steer, brakes) work correctly?

  • Elevated drive speed (reduced or prevented) working correctly?

  • Lights, beacons, warning devices working correctly?

  • Alarms (tilt, descent and travel) working correct

  • Limit switches (e.g. descent, load, outreach, rotation) working correctly?

  • Pothole protection device (fully deploys and retracts) working correctly?

  • Oscillating axle locks, extending axles working correctly?

  • Accessories, power to platform, extending decks working correctly?

  • Jacks-legs, stabilizers, outriggers and levelling devices working correctly?

  • ALL FAULTS AND DEFECTA TO BE REPORTED IMMEDIATELY TO YOUR SUPERVISOR

  • Confirm the above check shave been carried out daily below

  • Confirm daily inspection - Monday

  • Sign off as safe to use by IPFAF Operative

  • Photos of MEWP to confirm checks

  • STATE DEFECTS:

  • Confirm daily inspection - Tuesday

  • Sign off as safe to use by IPFAF Operative

  • Photos of MEWP to confirm checks

  • STATE DEFECTS:

  • Confirm daily inspection - Wednesday

  • Sign off as safe to use by IPFAF Operative

  • Photos of MEWP to confirm checks

  • STATE DEFECTS:

  • Confirm daily inspection - Thursday

  • Sign off as safe to use by IPFAF Operative

  • Photos of MEWP to confirm checks

  • STATE DEFECTS:

  • Confirm daily inspection - Friday

  • Sign off as safe to use by IPFAF Operative

  • Photos of MEWP to confirm checks

  • STATE DEFECTS:

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.