Mobile Elevated Work Platform Pre-Shift Inspection Form

Mobile Elevated Work Platform Pre-Shift Inspection Form

Aerial Lifts and Scissor Lifts
Department:
Project Name:
Project Number:
Inspector Name:

First NameLast Name
Email Address:
Enter an address if you want a copy of the completed form sent to you or another person. Not required.
Inspection Date:

MonthDayYear
Date
Type of Lift
Lift Model Number:
Operation & Safety Manual Present
Warning & Instruction Decals Present and Readable
Capacity & Control Decals Present and Readable
All covers and shrouds in place.
Lift and extension cylinder assemblies.
Pivot pins and retainers.
Boom or scissor assembly condition.
Slave level cylinder and retainers.
Master level cylinder.
Electrical wires.
Battery condition and brackets and covers in place.
Battery charger condition and properly wired with ground.
Tire condition, inflation, and lug nuts.
Outriggers / extendable axles.
Gas and hydraulic tank caps.
Turret condition.
Platform rails and cage.
Toe boards and mesh condition.
Control box assembly.
Platform decking.
Platform fall protection anchor points.
Platform mount assembly.
Fire Extinguisher present, charged, and accessible.
Platform is clean of debris and trip hazards.
Inspector's Signature
Should be Empty: