BOOM LIFT MANDATORY PRE-USE CHECK LIST INSPECTION Date:

Revision 1.0

MACHINE:
SERIAL NUMBER:

DATE DATE DATE DATE DATE DATE DATE

Checks required No.Hours No.Hours No.Hours No.Hours No.Hours No.Hours No.Hours COMMENTS
OK NOT OK OK NOT OK OK NOT OK OK NOT OK OK NOT OK OK NOT OK OK NOT OK
Current examination certificate (within last 6 months)
Documents
Availability of manufacturers manual
Nuts missing, loose, damaged
Wheels & Tires
Tires free from cuts or damages

Hydraulic oil

Oil level
Oil, fuel levels
Fuel level
Leaks from engine/gearbox
Battery Hoses properly connected (red and black)
General condition (No damages, corrosion, cracks).
Structure of the Boom
Guards and covers in place
Entrance gate, properly secured
Platform & cage No damages on the platform

Harness anchor point in place

Sticker inside the basket with max people and wind
speed
Signals Controls (identified, clear direction arrows)

ID plate, safety, warning & information signals

Fire Extinguisher has a register of its monthly

Fire Prevention
revision? Is it with the correct pressure?
Hoses and Cables Security & Condition (no cuts, properly fixed, etc.)
Green light? Machine properly working when
operated from the ground?
Test with the machine
"ON"
Battery charged?

Operator's name and signature

Fit for use Yes No

If NOT, DO NOT USE the
equipment and report to
supervisor
Supervisor's name and signature (FMM TO)