SRR Projects Pvt Limited

CHECKLIST FOR AERIAL / MAN LIFTER

Form No:-SRR/HSE/18 Rev:00 Issue No:01 Date:-01-05-2017

Project Name: Expansion of Rock Tools and manufacturing facility at Hyderabad, Sandvik Asia Pvt Limited, Patancheru,
Date:-
Type Of Machine ……………………………………………ID Number …………………………………………...
Inspection Period From …………………………………….To………………………………………………………
Work location…………………………………………………………………………………………………………..
Name of operator ………………………………………………………………………………………………………
S.No Check Points YES No NA Remarks
1 Operator manual on site
2 Any leaks in Engine oil
3 Any leaks Hydraulic oil
4 Decals legible & place
5 Tires condition
6 Electrical components , wiring & cables,
7 Hydraulic hoses, fitting. cylinders & manifolds,
8 Operational alarm working condition
9 Operational horn working condition,
10 Any cracks /damages in structural components
11 Safe working platform & mid rail available,
12 Brakes are working condition
13 Emergency switches, & Procedure known to Operator.
14 Equipment operator job specific training provided.
15 Appropriate PPE used by Operator()
Check for normal operation of machine before starting the
16
work.
17 Operating chart, Load capacity chart displayed.
18 Safe Access & Housekeeping available for movement,

Any Other Points:

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Name & Signature Of
SRR P&M Engineer
Name & Signature Of
SRR HSE Officer
Name & Signature Of
PMC HSE Officer

Name & Signature of HSE In charge Name & Signature Of Project Manager