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Aerial Lift Inspection

Form 4080

1.Lift #
2.Inspector Name
3.Job Name
4.Inspection Date
5.Any damage or issues? Please walk around the unit and leave a comment on any damages/dents, etc you can see. MANDATORY - if no damage type 'None'(Required.)
6.Please provide a photo of the damage
No file chosen
7.Please provide a second photo of the damage
No file chosen
Each aerial lift will be operationally tested and visually inspected on a regular basis. The designated inspector will place a check in the appropriate box when an item passes inspection. Leave the box empty and note a brief description of any problem. Immediately notify the Foreman of any aerial lift deficiencies.
8.Operating Controls (Operational)
Yes - Functional
No - Issues
Emergency Stop & Brakes
Base Operation Controls
Basket Operation Controls
Foot Controls (if applicable)
Safety Signs (readable)
9.Boom
Yes - Functional
No - Issues
Hydraulic Leaks
Extension Chain & Pivot Pins
Electrical Lines
Basket Cage and Gate
Anchorage Points
10.Base (Visual)
Yes - Functional
No - Issues
Broken, Cracked or Loose parts
Leaks
Electrical Issues
Tires & Outriggers
Back Up Alarm & Manual
11.Engine Compartment (Visual)
Yes - Functional
No - Issues
Oil Level
Fuel Level
Belt, Hose & Motor Condition
Battery & Electrical
12.Any additional comments?
13.Please upload a photo if there are any issues with the equipment.  
No file chosen
14.Please upload a second photo if needed
No file chosen
Remember, if 2 people are on the lift equipment, regardless of who is the operator, BOTH individuals MUST be certified to use that equipment.