Title Page

  • Sub-Contractor

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Genie Lift Serial Number:

  • Next Thorough Examination due?

  • Take photo of thorough examination

  • Confirm there is no visual damage to winch components?

  • Does the winch operate smoothly, free of hesitation or binding?

  • Does the mast operate smoothly, free of hesitation and binding?

  • Is the Safety Brake System in good working order?

  • Confirm cables or components are not frayed, have broken wire strands, kinks in the cable or corrosion?

  • Confirm pulleys are not broken or damaged?

  • Confirm you have visually inspected each caster and wheel for cuts, cracks or unusual wear.

  • Are pivot pins in place and secure?

  • Comments:

  • Sign off:

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