Pre-Shift Inspection Report Template - Boomlift/scissor Lift

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P
-S
I
R
RE
HIFT
NSPECTION
EPORT
B
/S
L
OOMLIFT
CISSOR
IFT
Date:
Equipment ID:
Contractor:
Project:
Operator’s Name:
Supervisor:
P
-
: Before use each day or at the beginning of each shift, the aerial platform must be given a
RE
SHIFT INSPECTION
visual inspection and functional test including but not limited to the following:
Needs attention /
Daily Inspection Checklist
Date Inspected _______________
(month)
remarks
(day)
(day)
(day)
(day)
(day)
“Operating” and “Emergency” controls
Safety devices
Personal protective devices, including
fall protection
Leaks: Air
Hydraulic
Fuel system(s)
Fuel Levels:
Gas
Hydraulic Fluid
Engine Oil
Water
Cables and wiring harness
Loose or missing parts
Tires / Wheels: Condition
Pressure
Placards, warning, control markings and
operation manual(s)
Outriggers, stabilizers, extendible axles
and other structures
Guard rail system
Hourly meter reading (done at the beginning of the week):
N D T Inspection (write expiry date):
WORKPLACE INSPECTION: Before the equipment is used and during use, the operator shall check the area in
which the equipment is to be used for possible hazards such as but not limited to the following:
Drop-offs or Holes
Bumps and Floor Obstructions
Debris
Overhead Obstructions/Electrical power
lines
Hazardous Locations
Inadequate Surface and Support to
Withstand Load Forces of the
Equipment in all Configurations
Wind / Weather Conditions
Pedestrian Traffic / Vehicular Traffic /
Unauthorized Persons
Other Possible Unsafe Conditions
Any problems or malfunctions that affect the safety of operations shall be reported and corrected or repaired prior to
commencing or continuing work.
Any equipment problems please call the office
Inspection reports must be faxed to the office weekly (604.525.0774)
May 2014

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