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Pre-Use Inspection Forms

Scissor Lift, Boom Lift, & AWP


Engine/Motor Type
Are there any outstanding work orders for this unit that you are aware of?
Lift Type

Prior to operating this lift, the daily checklist must be completed by a licensed and qualified operator. Check the items listed below and check each box with the appropriate letter to identify satisfactory operation or condition of item. This pre-inspection form must be updated whenever there is a change of operator and also at the beginning of each shift. There are 2 sections to this pre-inspection form. Section 1 is an operational checklist. Section 2 indicates site conditions in which the lift will be operated. If there is a change of site location, please update the form to reflect which change(s) are applicable.

Comments area is to capture any additional information to describe deficiencies that are observed.

For all items checked with “R” for repair, report discrepancy to your general foreman.


S = Satisfactory

R = Repair/Replace (leave comment/photo to describe discrepancy/deficiency)

Operational Checklist (Section 1)

1. Operating & Emergency Controls
2. Safety Devices
3. PPE including fall protection
4. Air, Hydraulic & Fuel System(s) Leaks
7. Tires & Wheels
10. Guard Rail System
13. Fuel Level(s) for IC Engines **DIESEL MUST NOT RUN DRY**

Photos (Section 1 - max 3 images)

5. Cables & Wiring Harness
6. Loose or Missing Parts
8. Placards, Warnings, Control Markings & Operating Manuals
9. Outriggers, Stabilizers, Extendable Axles, & Other Structures
11. Additional Items as Specified by the Manufacturer
12. Oil Level(s) for Internal Combustion Engines
14. Inspection Report, Annual Inspection Label & NDT Label

Workplace Inspection

Before the equipment is used and during use, the operator shall check the area in which the equipment is to be used for possible hazards such as, but not limited to the following:

Workplace Inspection (Section 2)

15. Drop-offs or Holes
16. Bumps & Floor Obstructions
17. Debris
18. Overhead Obstructions & High Voltage Conductors
19. Hazardous Locations
20: Inadequate Surface & Support to Withstand Load Forces of the Equipment in all Configurations
21. Wind & Weather Conditions
22. Pedestrian Traffic / Vehicular Traffic / Un-Authorized Persons
23. Other Possible Unsafe Conditions (Please specify below)

Photos (Section 2 - max 3 images)


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