BOOM LIFT DAILY INSPECTION (MEWP)
Company:
Project:
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First name of Operator:
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Last name of Operator:
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Date of Inspection
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/
Year
/
Month
Day
Date
Area:
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Please Select
Makai
Mauka
Ewa Side
Diamond Head Side
LEVEL 3
LEVEL 4
LEVEL 5
LEVEL 6
LEVEL 7
LEVEL 8
Lift Brand:
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Please Select
JLG
GENIE
OTHER
Lift Model
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PLEASE NOTE: (Per the structural engineer)
No boom lifts on the slab
I have reviewed the Approved Equipment List and understand the use and limitations to operate this equipment. I understand that structural failure may occur if I operate in unapproved areas or less than 10' from other equipment.
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YES
NO
Work to be done:
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Inspection Items:
1. The operator is trained to operate this lift.
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YES
NO
2. The operator is utilizing fall protection and is a certified fall protection user.
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YES
NO
3. Operating and emergency controls are in proper working condition (i.e., emergency stop device).
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YES
NO
4. Upper drive controls interlock mechanism is functional (i.e., foot pedal, spring lock).
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YES
NO
5. Emergency lowering functions are in proper working condition.
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YES
NO
6. Lowering operating controls successfully over-ride the upper controls.
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YES
NO
7. Both upper & lower controls are adequately protected from inadvertent operation.
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YES
NO
8. Control panel is clean & all buttons/switches are clearly vissible (i.e., up, down, right, left, forward, back).
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YES
NO
9. All switch & mechanical guards are in good condition and properly working.
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YES
NO
10. All Safety indicator lights are working properly.
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YES
NO
11. Drive controls function properly & are accurately labeled (i.e., up, down, right, left, forward, back).
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YES
NO
12. Motion alarms are functional.
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YES
NO
13. Safety decals are readable and in place.
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YES
NO
14. All guard rails are sound and in place, including platform gate, before workers get on the equipment.
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YES
NO
15. Work platform is clean, dry, & clear of debris
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YES
NO
16. Defects (i.e. creaked welds, fuel leaks, hydraulic leaks) have been inspected.
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YES
NO
17. Tires & wheels are in good condition, with adequate air pressure (if pneumatic)
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YES
NO
18. Braking devices are operating properly.
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YES
NO
19. Ground surface area is clear of workers and obstructions that can come into contact with the turntable as it rotates during operation.
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YES
NO
20. The manufacturer's operations manual is stored on lift.
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YES
NO
By signing below you are acknowledging that all above inspection items are satisfied:
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