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Aerial Lift Inspection Checklist

This document is an aerial lift daily inspection checklist. It contains 30 items that must be checked daily prior to using an aerial lift, including checking that the operator and occupants are trained, the work area is safe, lift components like fluids and lights are functioning properly, and personal protective equipment is available. Any issues found during inspection should be listed in the correction column. The completed form should be retained for one year for review by Facilities Management - Occupational Health and Safety.

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Dipak Kumar Patel
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2K views1 page

Aerial Lift Inspection Checklist

This document is an aerial lift daily inspection checklist. It contains 30 items that must be checked daily prior to using an aerial lift, including checking that the operator and occupants are trained, the work area is safe, lift components like fluids and lights are functioning properly, and personal protective equipment is available. Any issues found during inspection should be listed in the correction column. The completed form should be retained for one year for review by Facilities Management - Occupational Health and Safety.

Uploaded by

Dipak Kumar Patel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

P 434.297.

6379
F 434.243.2056
fm-ohs@[Link]

Aerial Lift Daily Inspection Checklist
Operator: Date:
Lift Type: Model #: Equipment ID:
Location: Project Name: Project #:
Description of Work:
The following items must be checked daily, prior to use. If not applicable, check N/A. List corrective actions taken.
CHECK CORRECTION
JOBSITE
1 Operator and occupants trained in AERIAL LIFTS and FALL PROTECTION? Yes N/A
2 Lift platform will safely reach the work area (preventing over-reaching)? Yes N/A
Pedestrian traffic is safely diverted with barricades, traffic control, cones,
3 Yes N/A
signage, etc.?
Public roadways are managed with spotters, signal persons, cones,
4 Yes N/A
signage, etc.?
Other moving equipment in the work area managed with barricades,
5 Yes N/A
traffic control, etc.?
Surface and soil conditions where the lift will be operated are strong
6 enough to withstand load forces imposed by the aerial platform in all Yes N/A
operating configurations?
Ramps and other sloped surfaces are properly cribbed to ensure
7 Yes N/A
vehicle's stability?
Work area and driving path free of drop-offs or holes, including those
8 Yes N/A
concealed by water, ice, mud, etc.?
Crew performing good housekeeping by picking up debris before, during,
9 Yes N/A
and after work?
10 Work area floor and driving path free of bumps or obstructions? Yes N/A
Overhead obstructions and crushing hazards are identified (piping,
11 Yes N/A
sprinklers, beams, etc.)?
Path of boom and platform at least 10 feet from power lines, high
12 Yes N/A
voltage conductors, or any other dangerous obstacles?
Hazardous atmosphere conditions are identified (dust, heat, fumes,
13 Yes N/A
flammables, etc.)?
14 Wind and weather conditions are within acceptable limits? Yes N/A
Sufficient ventilation is provided in closed areas where ventilation, or
15 poor vehicle maintenance, could cause a buildup of carbon monoxide or Yes N/A
diesel exhaust?
16 Other potential hazardous conditions are identified? Yes N/A
LIFT COMPONENTS
17 Fluid levels (oil, fuel, brake, hydraulic, coolant) are sufficient? Yes N/A
18 No signs of fluid leaks? Yes N/A
19 Ground controls and Lift controls functioning? Yes N/A
20 Vehicle brakes functioning? Yes N/A
21 Vehicle operating lights and warning lights functioning? Yes N/A
22 Vehicle audible alarms functioning (level sensor, reverse, horn)? Yes N/A
23 Outriggers functioning? Yes N/A
24 Tires are in good condition (no cuts or gouges, proper air pressure)? Yes N/A
25 No loose, missing, or damaged parts? Yes N/A
26 No loose, tangled, or pinched cables, rope, hoses, or wires? Yes N/A
27 Operator & Safety Manuals are properly stored in lift at all times? Yes N/A
28 All placards, labels, panel signs, etc. are legible? Yes N/A
29 Wheel chocks present? Yes N/A
30 PPE available (hardhat, gloves, fall protection, safety shoes, etc.)? Yes N/A
Refer to Operator/Safety Manual for lift requirements and best practices.

Please retain this form for one year for review by FM-Occupational Health and Safety.

seb_03.01.2017

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