General Hoisting Device Inspection
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
25-01 - UofT Robarts Library - 130 St. George St., Toronto, ON
25-02 - YRP Helicopter Hangar - 350 Garfield Wright Blvd, East Gwillimbury, ON
25-03 - UofT Health & Wellness at Koffler - 214 College Street, Toronto, ON
25-04 - SHN General Hospital Satellite Imaging Renovation - 3030 Lawrence Ave. E., Scarborough, ON
25-05 - UofT - Study of Religion Dept. - 170 St. George St., Toronto, ON
26-01 - Peel Police 21 Division - 10 Peel Centre Dr., Brampton, ON
26-02 - York Paramedic 33 - 2960 Teston Road, Vaughan, ON
26-03 - York Region - York Admin Package E - 17250 Yonge St., Newmarket, ON
26-04 - TDSB - William G Miller PS - 60 Bennett Rd., Scarborough, ON
26-04 - TDSB - Sir Oliver Mowat CI - 5400 Lawrence Ave. E., Scarborough, ON
26-05 - Peel Police Emil V. Kolb Centre - 180 Derry Rd. E., Mississauga, ON
Date
*
-
Year
-
Month
Day
4 digit year, 2 digit month, 2 digit day
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Subcontractor
*
Worker Name
*
Lift Truck No.
*
Hour Meter
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Administrative/Documentation
*
Rows
OK
N/A
Operator Competent, Trained, and Authorized
Manufacturer Instructions Available to Operator
Rated Load Capacity Clearly Marked on Device
Pre-use Inspection Completed Before Operation
Inspection Tag/Record Current
Maintenance and Inspection Records Available
Defective Equipment Removed From Service
Lockout/Energy Isolation Procedures Available
Coolant Level
Structural Components
*
Rows
OK
N/A
Structure Free of Cracks, Deformation, or Damage
Supports, Anchors, and Mounting Points Secure
Bolts, Pins and Fasteners Properly Installed and Tight
No Excessive Corrosion or Deterioration
Device Installed Per Manufacturer Requirements
Lifting Components
*
Rows
OK
N/A
Wire Rope/Chain/Lifting Mechanism in Good Condition
No Kinks, Broken Strands, or Excessive Wear
Hooks Not Bent or Cracked
Hook Safety Latch Functioning
Sheaves, Drums and Pulleys Operate Properly
Rigging and Attachments Rated for the Load
Electrical Components (if applicable)
*
Rows
OK
N/A
Power Cables and Cords in Good Condition
No Exposed or Damaged Wiring
Plugs, Connectors and Controls Intact
Emergency Stop Functioning (if equipped)
Control Pendant/Station Operating Properly
Grounding and Electrical Protection in Place
Operational Safety
*
Rows
OK
N/A
Hoist Operates Smoothly When Lifting and Lowering
Braking System Functioning Properly
Controls Operate Correctly and Return to Neutral
Limit Devices or Travel Stops Functioning
No Unusual Noise, Vibration, or Irregular Movement
Device Used Within Rated Load Capacity
Work Area Safety
*
Rows
OK
N/A
Area Below Lifting Operations Controlled if Required
No Workers Under Suspended Loads
Clear Communication Between Workers and Operator
Adequate Lighting for Operation
Work Area Clean and Free of Obstructions
Comments:
Signature
*
Submit
Should be Empty: