TVA - Aerial Lift Operator Daily Checklist

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• PERFORMED BY:

• Select date

  Date

• TVA VEHICLE ID:

• Sign and date this sheet each day before making a lift to certify that you have performed all applicable items on the Aerial Lift Operator checklist (Appendix C).

OPERATOR CHECKLIST - Daily (when lift is in operation)

• Is the vehicle in proper operating condition overall?

  Yes

  No

  N/A

• Are the tires inflated to the pressure recommended by the manufacture of the vehicle?

  Yes

  No

  N/A

• Are the vehicle brakes operating properly?

  Yes

  No

  N/A

• Is the Parking Brake operational?

  Yes

  No

  N/A

• Are the Wheel Chocks in the designated location on the vehicle & in good condition?

  Yes

  No

  N/A

• Does the aerial lift have any loose or missing components, any signs of hydraulic leaks, and/or any obvious external damage to the structural members

  Yes

  No

  N/A

• Have you checked the hydraulic fluid level in the reservoir and the level of lubricant in the truck and auxiliary power sources? (Maintain fluid level at the full mark.)

  Yes

  No

  N/A

• Have you checked the fuel supply in truck and the tank of auxiliary engine, if unit is so equipped and refueled if necessary?

  Yes

  No

  N/A

• Have you Inspected all insulated components of the aerial equipment and perform leakage-current test if unit is to be used on live-line, bare-hand work. Ensuring all insulated components are clean, dry, and free of damage. (Wash dirty components with a mild detergent and water; wipe dry)

  Yes

  No

  N/A

• Have you made sure all loose equipment is properly stowed?

  Yes

  No

  N/A

• Have you checked the operation of the engine-kill circuit and auxiliary power circuit if unit is so equipped?

  Yes

  No

  N/A

OPERATOR

• Additional Comments:

• By signing this sheet the Operator Certifies that they have performed all applicable items on the Aerial Lift Operator checklist.

• Signature of Inspector:

  Sign