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Boom Lift Pre-Use Inspection Report

This pre-use checklist intends to identify defects and safety hazards before operation. The main aim of a pre-start checklist inspection is to ensure that your equipment is safe to use.
MaintainX
07/16/2022

Boom Lift Pre-Use Inspection Report

This pre-use checklist intends to identify defects and safety hazards before operation. The main aim of a pre-start checklist inspection is to ensure that your equipment is safe to use.

    Equipment ID:

    Company Name:

    Operator Name:

    Date:

    Day of the Week:

    At the beginning of each day or whenever operator changes the equipment must be given a visual inspection and functional test including (but not limited to the following):

    Operating & Emergency Controls

    • Pass
    • Flag
    • Fail

    Safety Devices

    • Pass
    • Flag
    • Fail

    Personal Protective Devices; Including Fall Protection

    • Pass
    • Flag
    • Fail

    Air, Hydraulic, & Fuel System(s) Leaks

    • Pass
    • Flag
    • Fail

    Cables & Wiring Harness

    • Pass
    • Flag
    • Fail

    Loose or Missing Parts

    • Pass
    • Flag
    • Fail

    Tires & Wheels

    • Pass
    • Flag
    • Fail

    Placards, Warnings, Control Markings & Operating Manuals

    • Pass
    • Flag
    • Fail

    Outriggers, Stabilizers, Extendable Axles, & Other Structures

    • Pass
    • Flag
    • Fail

    Guard Rail System

    • Pass
    • Flag
    • Fail

    Additional Items as Specified by the Manufacturer

    • Pass
    • Flag
    • Fail

    Oil Level(s) for Internal Combustion Engines

    • Pass
    • Flag
    • Fail

    Fuel Level(s) for IC Engines **DIESEL MUST NOT RUN DRY**

    • Pass
    • Flag
    • Fail

    Reliable Inspection Report, Annual Inspection Label & NDT Label

    • Pass
    • Flag
    • Fail

    Workplace Inspection

    Before the equipment is used and during use, the operator shall check the area in which the equipment is to be used for possible hazards such as, but not limited to the following:

    Drop-offs or Holes

    • Pass
    • Flag
    • Fail

    Bumps & Floor Obstructions

    • Pass
    • Flag
    • Fail

    Debris

    • Pass
    • Flag
    • Fail

    Overhead Obstructions & High Voltage Conductors

    • Pass
    • Flag
    • Fail

    Hazardous Locations

    • Pass
    • Flag
    • Fail

    Inadequate Surface & Support to Withstand Load Forces of the Equipment in all Configurations

    • Pass
    • Flag
    • Fail

    Wind & Weather Conditions

    • Pass
    • Flag
    • Fail

    Pedestrian Traffic / Vehicular Traffic / Un-Authorized Persons

    • Pass
    • Flag
    • Fail

    Other Possible Unsafe Conditions

    • Pass
    • Flag
    • Fail

    Additional Remarks:

    Supervisor Signature:

    Click here to sign
Source: MaintainX (Community Member)

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