Inspection Report – General Line Equipment:

Personnel Platform (Scissor Lift)

Company Name       Date      

Equipment No.       Serial No.      
Type of Equipment       Model No.      
Make       Location      
Hours       Project No./Contract No.      

The following items must be checked as applicable. If not applicable so indicate.

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

                             
Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
1. GENERAL APPEARANCE
Hood and Panels
Paint
Undercarriage
Tires –Condition
2. ENGINE COMPARTMENT
Oil Level and Condition
Oil Pressure
Fan/Radiator/Belts/Hoses
Governor/Idling Device
Exhaust System
Fuel/Water/Oil/Lines
Coolant – Level – Protect.
Battery – Condition/Charge
Level
3 OPERATOR’S POSITION
Controls
Gauges/Instruments
Warning Lights
Starting/Charging System
Engine Condition
Decals and Labels
4. PLATFORM
Wear Pads
Power Track
Tires – Condition, Type
- Right Front
- Right Rear
- Left Front
- Left Rear
Hydraulic Components
- Fluid and Filter
- Hoses and Couplers
Emergency Lowering
Auxiliary Power System
Scissor Arms
Safety Circuits
Control Labels
Basket and Door
Backup Alarm
Ground Controls
Platform Controls
Platform
- Guardrails, Toeboards
- Anchorage Points
 Inspection Report – General Line Equipment:
Personnel Platform (Scissor Lift)

The following items must be checked as applicable. If not applicable so indicate.

Initial/Date Initial/Date Initial/Date Initial/Date Initial/Date

                             
Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A Good Repair N/A
5. OTHER
Operator’s Manual
Service Manual
Fire Extinguisher
     
     
     
     
     
     

SIGNATURES

Department: Name:      

Department: