DIESEL SCISSOR LIFT DAILY CHECKLIST

Project Name: Month 2 0 1 7

Model: Equipment No: Operators Name: Employment ID

Sr. # Description Date

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Competent person operating
2 Machine guard
3 Engine oil level `
4 Hydraulic valves and hoses
5 Hydraulic oil level
6 Hydraulic lift cylinder
7 Levelling cylinders
8 Engine and hydraulic pump
9 Platform control switches
10 Ground control switches
11 Emergency stop switches
12 Platform/Frames/handles
13 Battery acid level
14 Radiator coolant level
15 Scissor arms and linkages
16 Manual descent handle
17 Wheels/Tires/lugs/nuts/axles
18 Steering links/tie rods/spindles
19 Safety prop
20 Beacon light and buzzer/horn
21 Third (3rd) party equipment certificate

Operator: Signature

HSE officer
Supervisor
Signature Signature

FM/HS/HO/49
Remarks:__________________________________________________________________________________.

FM/HS/HO/49