Title Page
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Model Number
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Serial Number
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Conducted on
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Inspected by
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Location
Operating and Emergency Controls
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Operating and emergency controls are in proper working condition
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Operating and emergency controls are free of: excessive dirt, grease or foreign matter
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Steering and components are operating properly
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Functional upper drive control interlocks (foot pedal, spring lock, etc.)
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Booms and cylinder are in proper working order
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Emergency lowering function operates properly
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Lower operating controls successfully override the upper controls
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Both upper and lower controls are protected from inadvertent operation
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Control panel is clean (i.e. all buttons and switches are clearly visible)
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All switch and mechanical guards are properly installed and in good condition
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Drive controls function properly and are accurately labelled
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All guard rails are in place, including basket chains
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Work platform extension slides in and out freely with safety locking pins in place
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Work platform and extension slides are clean, dry and clear of debris
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Lift is free from defects such as cracked welds, fuel leaks, hydraulic leaks, etc.
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Braking devices are operating properly
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Manufacturer’s operating manual is available
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Oil level, Hydraulic oil level, Fuel level, Coolant level
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Battery is charged
Safety Devices
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All safety indicator lights are in proper working condition
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Run light operates properly
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Motion alarms are functioning
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Safety decals are in place and readable
Safety Precautions
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Personal protective equipment is in use (.e. hard hat, safety glasses, steel toe boots, fall arrest harness, lanyard, etc.)
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Platform floor is in good order
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Floor conditions are safe for operation (i.e. dry, level, free from hazards, etc.)
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Housekeeping is observed in platform floor
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Pothole protection is in proper working condition
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There are no overhead obstructions
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Loads do not exceed capacity
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Watch for vehicular and pedestrian traffic
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Fire extinguishers are in place and inspected regularly
Tires and Wheels
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Tires and wheels are in good condition with adequate pressure (if pneumatic)
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Tires are free of excessive wear, cuts, and proper inflation
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Wheels are free of cracks and damage (bent rims, etc.)
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Lug nuts installed and secured
Air, Hydraulic and Fuel System Leaks
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Check for leaks, hose chafing and cracking, kinking or binding.
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Check for proper service levels
Loose or Missing Parts
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Check for loose or missing parts at the boom, assemblies and platform
Battery, Cable and Wiring Harness
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Check for proper installation
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Check if in good working condition
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Free of excessive dirt, grease or foreign matter
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Free of loose wire connectors, damaged electrical cables, chafing, kinking or binding of electrical cables or wires
Placards, Warning, Control Marking and Operating Manual
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Capacity label is legible
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All warning and equipment control markings for proper operation is legible and attached
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Operating and Responsibilities Manuals are installed on the lift and are legible
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Manuals are stored in a weatherproof container and the container is easily identifiable
Guardrail System
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Check for cracked welds, cracked metal, distorted components, broken structures, sign of metal fatigue
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Lanyard attachment points are in good condition
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Lanyard attachment points are near the bottom of the basket in the corners
Equipment Task Function Operation
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Lower controls operate properly
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Platform controls operate properly
Hazards
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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
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Additional Comments
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Inspection Completed By
