AERIAL / MAN LIFT

INSPECTION CHECKLIST
DLPS-HSE-047/00
Project Name: Location:

Make: Serial No.:

Date Period: Type: ___ Scissor ___Boom Others: _______________________________
SN DESCRIPTION SAT SUN MON TUE WED THU
1 Valid Certificate (Operator)
2 Valid Inspection Certificate (Equipment)
3 Wheel and Tire pressure conditions
4 Control Stations are working properly (functional both ground and cage)
5 Lift platform in good condition and with foot gate.
6 Platform rotator and swing drive working properly.
7 Electric and hydraulic tank covered properly and free from leakage.
Warning devices such as alarms, lights, gauges, horns should be in working
8 condition.
9 Availability of Inspected Full Body Harness
10 Cage Anchorage Point (Not handrails)
11 Oils & Fuels
12 Entrapment device
13 Beacon light
14 SWL Markings
15 Fire extinguisher (UL/FM listed)

(√) OK (X) NOT OK

Remarks:

Inspected By: (Operator)

Name: ______________________
Badge No.: ______________
Signature: ___________________________

Checked By:
Supervisor Name: ___________________
Badge No.: _______________
Signature : _________________________