| SCISSOR LIFT INSPECTION CHECKLIST SamaGulf SCISSOR LIFT MANUFACTURER: Mote Type: Sciksos tyre ptena:_ 26a Model ie GS | | Reg. No. (ifany): Date: OPERATOR TO COMPLETE THIS ali Fs 1 SECTION 1 Arethere any fuel leaks? 2. Ate there any hydraule leaks? ZO 3_| Are there anya leaks? [4 Engine hoses in good condition? ‘ved '5_| Tires in good condition? ies 6 _| Operator 2 Party Certified? Yeh 7__[ Seissorife Third Party Certified? 1 | | Co-worker & Banks-man trained? Yes | 3 | Co-worker/ Banks-man know emergency stop button? Jos [HO Je rotating light provided? m7) ‘1 | Reverse alarm provided? es | 12 | Flam arrestor fitted? 04, 13 | Fite extinguisher fitted? te 14 | Battery secured propery? Yes | 15 | Abnormal sounds noted? Ilo 16 | Ground compacted/leveled? Yas | 1 17 | Over Head hazards checked? 5 | 18 | Access route checked/clear? Yo 19 | Full body harness 100% Tie off VA 20 | Tools secured in basket? Yh 21 | Never leave basket while Working at height? Remarks: 4 HSE Officer. (Name & sign): g a )\ SGC/HSE/SIC/01/22, Rev:01 Pagers