6601083 - Scissor Lift Daily Inspection

SCISSOR LIFT DAILY INSPECTION
Company:*
Project:
First and Last name of Operator:*
Date of Inspection*

YearMonthDay
Date
Level: *
Lift Brand:*
Lift Model*
PLEASE NOTE: (Per the structural engineer)

Largest allowable scissor lifts to operate on suspended slab = 1930 or equivalent.

MAINTAIN A DISTANCE OF ATLEAST 6' BETWEEN LIFTS WHILE ON SUSPENDED SLAB.
Work to be done:*
Inspection Items:
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YESNO
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YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
YESNO
By signing below you are acknowledging that all above inspection items are satisfied: *

Clear
Should be Empty:

Inspection Items: