Bucket Truck Pre-Use Checklist

This Checklist is to be completed before each shift used. If the equipment fails any part of this inspection, remove the key and report it to
your supervisor.
Name: _______________________________ Date: ________________________________
Foreman: ____________________________ Company Veh #: ______________________
Make/Model: __________________________ VIN (last 4 digits): _____________________
Vehicle Year: _________________________ License Plate #: _______________________
Color: _______________________________ Mileage: _____________________________

BUCKET TRUCK INSPECTIONS:

􀂄 Daily 􀂄 Quarterly
􀂄 Weekly 􀂄 Biannually
􀂄 Monthly 􀂄 Annual (FMCSR & ANSI periodic)

Pass Fail Pass Fail

Daily Visual Inspection Pre-Operation Inspection/Test Daily
Boom condition – welds, rust, damage Lower & upper controls
Boom; boom rest/cradle; pins, rings, bolts Test all switches/controls
Bucket – mounting, door latch, safety Test hydraulic and 12 volt electrical
Cylinders & hoses “Safe operating condition”
Hydraulic leaks – under truck & boom Emergency stop button works
Loose/missing bolts, nuts, snap rings, cotter pins Defroster
Outriggers Wipers
Pedestal mounting bolts Horn
Safety decals Emergency Brakes
Snow or ice buildup Service Brakes
Tire condition & inflation Seatbelts
Turntable – bucket van Lights:
Welds; look under the vehicle Brights
Body Integrity: Dims
Sharp/Rusted Brake
Door Latches Tail
Windows Roll Up & Dn Back Up
Glass Mirrors (Cracked/Missing) Turning Signals-Left
Gas Cap Turning Signals-Right
Pedestal Mounting Bolts Warning lights/Flashers
4 mounting bolts connect pedestal to bed/frame Safety & Emergency Equipment
Colored dye/paint mark on bolt and lock nut Wheel chocks – minimum of 2
¾” grade 8 bolt Outrigger pads/mats
Torque to 160# First aid kit
Cargo Area Access Portable fire extinguisher – DOT 5 B:C
Pedestal Collapse – Loose & Missing Bolts Reflective triangles
Fluids Spare fuses – 1 for each amp circuit
Brake Fluid Petroleum spill kit
Engine Coolant Warning signs
Hydraulic Oil Level Traffic cones
Fall Protection Inspected
Electrical PPE Inspected

Comments

Operator Printed Name Operator Signature

May 2017
Job Site Inspection Checklist
Check all that apply at your work site.
DO YOU NEED A SPOTTER?
DO YOU NEED BARRICADES?
Pedestrians or Others in Work Area
Debris on Ground
Wind Speed/Weather Conditions
Parked or Moving Vehicles
Grating/Surface Approved by Engineer
Jobsite Ruts/Rough Spots.
Jobsite Pot Holes/Speed Bumps/RR Tracks
Deep Ditches/ Excavations
Drop Offs
Obstacles/Bump Posts
Soft and Uncompacted soil
Steep Slopes
Large Rocks
Standing Water/Streams or Ponds
Oil Spills
Wet Spots
Slippery Surfaces i.e. wet clay or ice
Culverts
Trench Drains
Edges of Loading Docks
Building Projections
Overhead Obstructions
Overhead Power or Phone Lines
Underground Power or Gas Lines
Above Ground Fuel Tanks
Hazardous Locations - Restricted Areas
Fire Hydrant/Equipment
Wooden Pallets and/or Crates Good Condition
Forklift/RTFL Loads Secured
Comments (List any other safety issues)
Name
May 2017
Safety Tips
Read & Heed
Obey all operating instructions & warnings
Only trained personnel are
allowed to operate mobile equipment
Only trained personnel are allowed to enter
aerial lift platforms
ALWAYS be aware of overhead lines
NEVER exceed the Working Load Limit
NEVER utilize an aerial lift as material hoisting
equipment
ALWAYS make sure the access gate is closed,
safety chain is latched or seat belt is fastened.
ALWAYS tie off to the manufacturer's desig-
nated anchorage point
ALWAYS keep both feet planted firmly on the
floor of the basket or platform
NEVER step up on the midrail or toprail to
extend your reach
NEVER use a ladder, bucket or other objects to
extend your reach
Keep hoses, electrical cords, welding leads
clear of moving parts when raising or lowering
ALWAYS use three point contact when
entering or exiting equipment
Keep all body parts inside platform railings or
cab
ALWAYS check your surroundings and look in
the direction of travel
ALWAYS barricade your work area to keep
unwanted personnel out
Use cribbing for outriggers if necessary
DO NOT alter or modify equipment
Date