Safe Release of trapped passengers in a passenger lift: Site

Survey form

Limitations of the training

This procedure is generic in method however; the training you deliver is only applicable to the
lifts installed at the site named on page two of this document. It is not directly transferable to
any other lift installation. It is dangerous to inform or infer that it is.
The training of the procedure “Safe Release of trapped passengers in a passenger lift,” is
specific to the lifts identified below and on the training certificate. An operative trained in this
procedure on a lift on one site, is not competent to perform the same procedure on another site
or even a different lift on the same site. This is because the operating environment from one site
to another, even from one lift to another can be radically affect the performance of this
procedure.

Therefore, it is mandatory that a site survey is completed and a record filed. This document
contains the form for that survey. The trainer needs to complete the survey, prior to delivery of
any manual release training.
You will always need to perform a pre-training site survey before delivering training. You will
always work in pairs when training the procedures for geared traction or hydraulic lifts, as the
procedure requires two people. It is acceptable to train the method for MRL on your own as one
person can safely complete the procedure.
You will learn all the methods of release, how to deliver the training and how to assess the
people you train.

Page 1 of 7
Site survey form V2 15/07/2021
 Safe Release of trapped passengers in a passenger lift: Site
Survey form

Site Survey

Guidance Notes for Completion:

You must answer ALL questions in the “SATISFACTORY” column as YES or NO. All Yes
answers indicate that the site is suitable to perform the manual release training.
If any of your answers are NO, you must make notes for the quotation of any repairs necessary
before safe release training can take place.

A copy of this survey will be required by your manager regardless of the outcome, as soon as
possible and prior to training being arranged, a copy must be entered onto the unit file.

The following form must only be completed by an authorised trainer for the procedure “manual
release of trapped passengers”.

Name of person completing the survey Dave J Smith

Date of the survey DD/MM/YYYY 22/08/2022
Lift (Navision) ID number 2004743
Site identification number/name Reception Lift
111181
Address of the site Shri Venkateswara Balaji Temple, B69 3DU

Number of floors served Front: Rear:

Number (if any) of evacuation entrances 2 0
Lift type (MRL, Hydraulic, Geared Traction)
Lift manufacturer/model Hydroelete 111181
Number of persons required to effect safe 2
release.

Part 1 Motor room/ intervention panel access.

ITEM Check for Satisfactory? Comments

1.1 Availability of keys. No Motor
Page 2 of 7
Site survey form V2 15/07/2021
 Safe Release of trapped passengers in a passenger lift: Site
Survey form

Room has
no lock
1.2 Normal lighting on route. Yes
1.3 Emergency lighting on route. No No
emergency
lighting
exists
1.4 Free from Obstruction. No Ladders,
numerous
paintings,
old carpets
1.5 Availability of entrance barrier. Yes
1.6 Rubber mat in place. Yes
1.7 Isolation padlock LOTO equipment. No None
existed

Part 2 Motor room access and facilities

ITEM Check for Satisfactory Comments

?
2.1 Prevention of public access. No No lock
present
2.2 Clear of obstructions. Yes
2.3 Lighting adequate for the task. Yes
2.4 Emergency lighting operational. No No
emergency
lighting
exists
2.5 Main isolator identified, lockable. Yes
2.6 Shaft lighting, switch identified, No Shaft
functional, lighting functional. lighting not
working
2.7 Hydraulic- Manual lowering valve Yes
identified.

2.8 Hydraulic- Minimum pressure valve Yes

fitted.
2.9 Hydraulic- Pressure indicator fitted Yes
and functional.
2.10 Hydraulic- Isolator, tank, entrances Yes
identified.
Page 3 of 7
Site survey form V2 15/07/2021
Safe Release of trapped passengers in a passenger lift: Site
Survey form

Page 4 of 7
Site survey form V2 15/07/2021
 Safe Release of trapped passengers in a passenger lift: Site
Survey form

2.11 Geared Traction-Hand N/A

winding wheel & brake
release lever identified.
2.12 Geared Traction-Isolator, N/A
machine and entrances
marked.
2.13 Geared Traction- Direction N/A
markings on machine.
2.14 MRL-Manual release lever N/A
identified.
2.15 MRL-Panel and entrances N/A
marked.
2.16 Effective guarding in place N/A

Part 3 Tools

Item Check for Satisfactory? Comments

3.1 Door release keys No No door key
available
3.2 Communication devices for Yes Voice
communication between communication
motor room/intervention
panel and all entrances

Part 4 Check all public entrances

Item Check for Satisfactory? Comments

4.1 Clear of obstructions Yes
4.2 Lighting adequate for the Yes
task
4.3 Emergency lighting No No emergency
adequate for the task lighting exists

Page 5 of 7
Site survey form V2 15/07/2021
 Safe Release of trapped passengers in a passenger lift: Site
Survey form

Part 5 Functional checks

 The lift must have out of order notices fitted to ALL entrances.
 The lift must be removed from service before these checks are carried out;
checks are only to be carried out by an approved and trained person.
 Advise the relevant persons of the functional checks- their assistance will be
required.

Item Check for Functional Comments

5.1 Main isolator functions and is lockable (all Yes
contacts).
5.2 Hydraulic- Manual lowering valve is functional. Yes
5.2 Hydraulic- slack rope valve is functional. Yes
5.3 Hydraulic- pressure gauge is functional. Yes
5.4 Traction/MRL- Brake release is functional. N/A
5.5 Winding wheel, the force to move the lift car or N/A
applied to the wheel is less than 400n.
5.6 Floor level sounder/indicator is/are functional. Yes
5.7 All door release mechanisms are functional. Yes
5.8 Car alarm bell and auto dialler are functional. Yes No
autodialler
fitted
5.9 The landing doors can be opened in skate with Yes
the car doors, power off using a force less than
300N.
5.10 Emergency lighting in the car operational- 5 No Car
LUX for 3 hours. emergency
lights faulty.
Gone to
quote
5.11 Lighting/emergency lighting in the motor room/ No No
intervention panel LUX emergency
lighting
5.12 Lighting/ emergency lighting at landing No No
entrances LUX emergency
lighting
5.13 Lighting/emergency lighting on access routes No No
LUX (Min) emergency
lighting

Page 6 of 7
Site survey form V2 15/07/2021
 Safe Release of trapped passengers in a passenger lift: Site
Survey form

5.14 You can simulate lift stuck between floors. Yes

5.15 Any automatic or semi-automatic system, works N/A
as per posted instructions.
5.16 Electrical recall operation if fitted, works as N/A
posted instructions.
5.17 You must be able to communicate clearly Yes
between the motor room/ intervention panel and
any landing door.

 Record below any other circumstances you think will affect the safe release of
passengers trapped in the lift car or those persons appointed to carry out such release.
 i.e. unprotected roof edge.
 No lighting/emergency lighting throughout access to machine room.
 Effects of ice, snow, rain, wind etc.

This survey is a true record of the condition of the equipment and building at
: (Time) on
Date; 22/8/22
Position;Branch Technician

Page 7 of 7
Site survey form V2 15/07/2021