Form Inspeksi Scissors
Form Inspeksi Scissors
Form Inspeksi Scissors
Operator: Date:
Unit Type: Lift ID #: Location:
# Inspection Item/Description
1 Operating and emergency controls are in proper working condition
2 Functional upper drive control interlocks (foot pedal, spring lock, etc.)
3 Emergency lowering function operates properly
4 Lower operating controls successfully override the upper controls
5 Both upper & lower controls are protected from inadvertent operation
6 Control panel is clean; all buttons and switches are clearly visible
7 All switch and mechanical guards are properly installed and in good condition
13 Work platform extension slides in & out freely with safety locking pins in place
14 Work platform and extension slides are clean, dry and clear of debris
15 Lift is free from defects such as cracked welds, fuel leaks, hydraulic leaks, etc.
16 Tires and wheels are in good condition with adequate pressure (if pneumatic)
Safety Precautions
Personal protective equipment is in use (hard hat, fall arrest harness, etc.)
If conditions are windy, refer to manufacturer guidelines.
Floor conditions are safe for operation. (Dry, level, free from hazards)
There are no overhead obstructions.
Loads do not exceed capacity.
Watch for vehicular and pedestrian traffic.
Comments:
If scissor lift is found to fail any aspect of the inspection, remove from service and report it to your supervisor.
RE-USE INSPECTION CHECKLIST
Date:
Location:
n Item/Description Pass/Fail/NA
ontrols are in proper working condition
ol interlocks (foot pedal, spring lock, etc.)
ng function operates properly
uccessfully override the upper controls
are protected from inadvertent operation
uttons and switches are clearly visible
Check to Confirm
the inspection, remove from service and report it to your supervisor.