Boom Lift Daily Pre-Use Inspection Sheet
Operator must complete checklist prior to use at start of each shift
Site Address/Location
*
Please Select
MJ Dixon Head Office - 2600 Edenhurst Dr., Suite 200, Mississauga, ON
20-02 - City of Toronto - Mount Dennis Childcare Centre - 1234 Weston Rd., Toronto, ON
21-06 - UTSC Library Ph 1 - 1265 Military Trail, Scarborough, ON
21-07 - 27 Rutherford Rd. S., Brampton, ON
22-01 - Seaton Paramedic Station & Training Centre
22-02 - 255 Spadina Rd., Toronto, ON
22-02 - 843 Palmerston Ave., Toronto, ON
22-02 - 765 Queen St. E., Toronto, ON
22-02 - 301 Broadview Ave., Toronto, ON
22-02 - 840 Gerrard St. E., Toronto, ON
22-02 - 235 Cibola Ave., Toronto, ON
22-03 - York Region - York Admin Centre 4th Fl. - 17250 Yonge St., Newmarket, ON
23-01 - 1859 Kingston Rd., Toronto, ON
23-01 - 116 Dorset Rd., Toronto, ON
23-01 - 1313 Woodbine Ave., Toronto, ON
23-01 - 1904 Queen St. E., Toronto, ON
23-01 - 23 Bluffers Park (7 Brimley Rd. S.), Toronto, ON
23-01 - 313 Pharmacy Ave., Toronto, ON
23-01 - 351 Birchmount Rd., Toronto, ON
23-01 - 3600 Danforth Ave., Toronto, ON
23-01 - 87 Main St., Toronto, ON
23-02 - York Paramedic 32 - 53 Jacob Keffer Parkway, Vaughan, ON
23-03 - GBC Athletics Varsity Lounge - 160 Kendal Ave., Toronto, ON
24-01 YRAC Reno & Millwork - 17250 Yonge St., Newmarket, ON
24-02 VicU Goldring Student Centre - 150 Charles St. W., Toronto, ON
24-03 COT Youth Shelter - 25 Canterbury Pl., Toronto, ON
24-04 Waypoint Toanche Bldg. 3rd Fl. - 500 Church St. Penetanguishene, ON
24-05 - Vaughan Fire Stn 7-12 - 9511 Weston Rd., Vaughan, ON
Date
*
-
Year
-
Month
Day
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Subcontractor
*
Worker Name
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Lift Truck No.
*
Hour Meter
*
Operation Checks
*
OK
N/A
Steering Cylinder
Operating Controls
Emergency Stop
Emergency Down
Emergency Controls
Parking Brake
Fall Protection Harness/Anchor
Tire/Wheel Condition
Horn
Leaks
Guides, Rollers/Slide Pads
Structural Damage/Welds
Loose or Missing Parts
Cables and Wiring Harnesses
Placards, Decals, Capacity
Control Switches
Cords & Wirings
Operating Manuals
Railings & Locking Pins
Bolts & Fasteners
GFI Receptacle
Battery Fluid Level
Hydraulic Reservoir Level
Oil & Anti-freeze
Comments:
Signature
*
Submit
Should be Empty: