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Man/Aerial-Lift Pre-Use Safety Inspection Procedure

This inspection leads to a safer working environment and prevents costly
24P DC Columbus - Cintas
03/05/2024

Man/Aerial-Lift Pre-Use Safety Inspection Procedure

Daily safety checks keep forklift in good working condition. It helps identify defects before the time, ensuring no more excessive wear and tear of a component of a forklift. Also, a routine inspection makes it easy to maintain a forklift and enhances it's longevity.

    *** LOTO Confirmation Statement - DO NOT EDIT/REMOVE ***

    All hazardous energy has been isolated using LOTO procedures?

    All potential stored or residual energy has been relieved, disconnected, restrained, lowered, and/or otherwise rendered safe?

    Lock Out Tag Out

    LOTO Performed

    ELECTRICAL COMPONENTS, WIRING AND ELECTRICAL CABLES

    • Pass
    • Flag
    • Fail

    LEAKS TO HYDRAULIC POWER UNIT, TANK, HOSES, FITTINGS, CYLINDERS AND MANIFOLDS (ADD OIL IF NEEDED)

    • Pass
    • Flag
    • Fail

    BATTERY PACK AND CONNECTIONS

    • Pass
    • Flag
    • Fail

    OUTRIGGERS, WEAR PADS

    • Pass
    • Flag
    • Fail

    TIRES AND WHEELS (CRACKS, CHUNKS MISSING)

    • Pass
    • Flag
    • Fail

    LIMIT SWITCHES

    • Pass
    • Flag
    • Fail

    NUTS, BOLTS, AND OTHER FASTENERS

    • Pass
    • Flag
    • Fail

    PLATFORM ENTRY CHAIN OR GATE

    • Pass
    • Flag
    • Fail

    BEACON AND ALARMS (HORN, BACKUP ALARM, LIGHTS, IF EQUIPPED)

    • Pass
    • Flag
    • Fail

    SECUENCING CABLES AND PULLEY

    • Pass
    • Flag
    • Fail

    MAST COLUMNS AND COUNTERWEIGHT

    • Pass
    • Flag
    • Fail

    PLATFORM CONTROL BUTTONS

    • Pass
    • Flag
    • Fail

    CRACKS IN WELDS OR STRUCTURAL COMPONENTS

    • Pass
    • Flag
    • Fail

    DENTS OR DAMAGE TO MACHINE

    • Pass
    • Flag
    • Fail

    BE SURE THAT ALL STRUCTURAL AND OTHER CRITICAL COMPONENTS ARE PRESENT AND ALL ASSOCIATED FASTENERS AND PINS ARE IN PLACE AND PROPERLY TIGHTENED

    • Pass
    • Flag
    • Fail

    BE SURE THAT THE OPERATOR'S SAFETY AND RESPONSIBILITIES MANUALS ARE COMPLETE, LEGIBLE AND IN THE STORAGE CONTAINER LOCATED ON THE PLATFORM

    • Pass
    • Flag
    • Fail

    BE SURE THAT ALL DECALS ARE LEGIBLE AND IN PLACE

    • Pass
    • Flag
    • Fail

    CHECK FOR BATTERY FLUID LEAKS AND PROPER FLUID LEVEL. ADD DISTILLED WATER IF NEEDED

    • Pass
    • Flag
    • Fail

    The Aerial/Man-Lift will be taken out of service if any mechanical or structural item on the checklist is found to be unacceptable. Once corrected, the Man-Lift can be operated.

    • Pass
    • Flag
    • Fail

    Comments

    Inspector's Signature

    Click here to sign
Source: 24P DC Columbus - Cintas (Community Member)

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