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Checklist Manlift

This document provides a checklist for inspecting mobile lift equipment. It includes sections to record the inspection date, equipment details like registration number and serial number, and operator details. The checklist contains over 30 inspection items across categories like the vehicle's career, lift operating devices, and safety devices. Inspectors check each item and indicate the result as good, acceptable, not to use, or not applicable. Any comments or issues found during inspection are also noted. The form is signed by the inspector upon completion.

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pratama
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60 views1 page

Checklist Manlift

This document provides a checklist for inspecting mobile lift equipment. It includes sections to record the inspection date, equipment details like registration number and serial number, and operator details. The checklist contains over 30 inspection items across categories like the vehicle's career, lift operating devices, and safety devices. Inspectors check each item and indicate the result as good, acceptable, not to use, or not applicable. Any comments or issues found during inspection are also noted. The form is signed by the inspector upon completion.

Uploaded by

pratama
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
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HSE

PT BUKAKA TEKHNIK UTAMA

MOBILE LIFT INSPECTION


Doc. No. BTU-B520-HSE-FM-025 Rev. 0

Date of Inspection Re-inspection


Equipment data : Operator / Driver data :

Registration Number Name

Manufacture Sex (male/female)

Serial Number Age

Police Number (if any) License / SIO

Capacity Expired

Certificate Exp.

Subject : Telescope lift Scissors lift ……………

Result column : Yes/good, Acceptable X Not/Bad, Not To Use NA Not Applicable

Copy of Driving license, Operator certificate and Equipment certificate must be attached in this form
NO CHECK ITEM CHECK POINTS RESULT REMARKS
1. Career
* Steering Operability, Play
* Wheels Tire pressure, Abrasion
* Brake / Pedal / Lever Operating check, Play
* Clutch / Brake Operating check
* Signal / Horn Reverse alarm, Turn signal
* Lighting Head, Tail, Brake light
* Out rigger / Timber pads Damage, Missing
2. Lift operating devices
* Levers Operating check, Play
* Brakes Operating check, Play
* Emergency stopper Operating check
* Telescope cylinder Operating check
* Scissor boom Operating check
* Man basket Door latch, Hand rails
* Basket balance / Moving devices Level, Smooth operation
3. Safety devices
* Warning sign Indication
* Safe guard for moving part Breakage, Missing

Comments :
Inspected by,

( __________________ ) ( __________________ )

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