Scissor Lift Check

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Kitchens & Joinery
Doors
Wardrobes
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About Us
Kitchens & Joinery
Doors
Wardrobes
Stairs

Contact

Home
About Us
Kitchens & Joinery
Doors
Wardrobes
Stairs
Contact

Home
About Us
Kitchens & Joinery
Doors
Wardrobes
Stairs
Contact

1. Operator and job

Operator name(Required)

I have notified my supervisor/manager, and someone knows what i'll be doing/where i will be working(Required)

Yes

I have notified other staff who will be working in the same area i plan to operate(Required)

Yes

Date(Required)

Task and location(Required)

Where will you use the lift?(Required)

Indoor

Outdoor

Will you be working in the driveway or carpark areas?(Required)

No

Yes

Ensure you place cones around the lift for an exclusion zone

Outdoors: 1 person, 120 kg max (person + tools + materials). No use in rain or lightning. Stay 4 m from power lines.

Wind gust speed (km/h)(Required)

Check MetService gusts. Maximum 45 km/h (12.5 m/s).

STOP: too windy. Do not raise the platform above 45 km/h gusts.

2. Walk-around (power off)

Pass = good condition. Fail = faulty, damaged or missing.

Safety decals and capacity plate readable(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

No leaks under or around the lift(Required)

Pass

Fail

Hydraulic oil or battery fluid.

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Cables and wiring undamaged(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Hoses and fittings undamaged(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Tyres and wheels undamaged, wheel nuts tight(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

No cracks, dents or damage to welds, chassis, scissor arms or platform(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Extension deck slides and locks(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Photos of the lift from all sides

Drop files here or

Accepted file types: jpg, jpeg, png, heic, gif, Max. file size: 64 MB.

Include close-ups of any new damage or areas of concern.

3. Function checks

Test from the ground controls first, then from the platform.

Guardrails secure, gate self-closes and latches(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Ground control emergency stop cuts all functions(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Ground controls raise and lower the platform(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Platform emergency stop cuts all functions(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Platform controls work: lift, drive, steer, trigger switch(Required)

Pass

Fail

Controls return to neutral when released.

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Brakes hold(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Beacon, motion alarm and horn work(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

Pothole protection bars free and undamaged(Required)

Pass

Fail

What's wrong?(Required)

Describe the fault. Do not use the lift if it is unsafe.

4. Result

Is the lift safe to use?(Required)

Safe

Unsafe

DO NOT USE. Remove the key, tag the lift out of service and tell management.

Create a hazard report?(Required)

No

Yes

Operator declaration(Required)

I am authorised and trained to use the scissor lift

Report any fault, incident or near miss during the job to management straight away.

Montage Kitchens & Joinery
Montage Wardrobes
Montage Doors
Montage Stairs

Contact us

07 847 9174
info@montagegroup.co.nz
121 Ellis St, Frankton, Hamilton

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