Daily Safety Checklist

Equipment:Scissor Lift Checklist

Registration Number:

Asset Number:

Project Name:
Month and Year:
Note: Any of the following parameter is found "Not OK", RED Tag should be pasted on
the machine till it is rectified.

Instruction: Put "√" for "OK" condition and put "X" for "Not OK" condition.
Sr. No. Parameter Remarks

1 Check for engine oil leaks and proper oil level.

2 Check for hydraulic oil leaks and proper oil level.

Check electrical components, wiring and
3
electrical cables
Check hydraulic hoses, fittings, cylinders and
4
manifolds
5 Check Fuel and hydraulic tanks

6 Check Drive motors

7 Check wear pads

8 Check tires and wheels

9 Check Engine and related components

10 Check Limit switches, alarms and horn

Check Nuts, bolts and other fasteners Scissor
11
pins
Check platform entry gate Check side rails are
12 installed and rail pins and bolts are
fastened
13 Check Safety arm

14 Check Platform extension(s)

15 Check Platform control joystick

16 Check outrigger housings and footpads

17 Pressure Overload Switch

18 Fire extinguisher

19 First Aid Box

Operator / Mechanic

Name & SHE In-Charge

Signature:

F&RM In-Charge