Bulk Folding Table Hydraulics Quarterly PM

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

Food Safety Pre-Check

Prior to performing this maintenance task, the areas that may be impacted unintentionally by the maintenance activities were inspected to assure no Partner’s safety is at risk and no customer product or Cintas equipment would be compromised, contaminated, or otherwise damaged due to this specific task. Any product that may be impacted was moved and / or otherwise isolated to assure protection.

Perform LOTO

Click here to sign

Clean Lift Table

Check hydraulic fluid - document PSI here

Inspect for leaks

Pass
Flag
Fail

Grease bearings

Inspect electrical cord, cradle integrity, anchor bolts, safety chain, and hinge pin

Pass
Flag
Fail

Return to service and verify proper operation

Pass
Flag
Fail

Food Safety Post-Check

After performing this maintenance task, a review of all applicable areas that may have been impacted was conducted to assure there are no residual risks to Partner safety remaining. Also, a review of all applicable areas to ensure that no customer products were inadvertently compromised, contaminated, or otherwise damaged was conducted. If any conditions were observed indicating that any of the previous concerns have been negatively impacted, the issue was escalated to leadership.

Bulk Folding Table Hydraulics Quarterly PM

Bulk Folding Table Hydraulics Quarterly PM

* LOTO Confirmation Statement - DO NOT EDIT/REMOVE *

All hazardous energy has been isolated using LOTO procedures?

Yes

N/A

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

Yes

N/A

Lock Out Tag Out

LOTO Performed

Yes

No

Food Safety Pre-Check

Perform LOTO

Clean Lift Table

Check hydraulic fluid - document PSI here

Inspect for leaks

Grease bearings

Inspect electrical cord, cradle integrity, anchor bolts, safety chain, and hinge pin

Return to service and verify proper operation

Food Safety Post-Check

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

All hazardous energy has been isolated using LOTO procedures?

Yes

N/A

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

Yes

N/A

Lock Out Tag Out

LOTO Performed

Yes

No

Food Safety Pre-Check

Perform LOTO

Clean Lift Table

Check hydraulic fluid - document PSI here

Inspect for leaks

Grease bearings

Inspect electrical cord, cradle integrity, anchor bolts, safety chain, and hinge pin

Return to service and verify proper operation

Food Safety Post-Check

* LOTO Confirmation Statement - DO NOT EDIT/REMOVE *