Check sheet For Scissor Lifter

HMIL/Fire & Safety / Scissor Lifter

SL NOCHECK ITEMS PHOTOS Y/N Sl No CHECK ITEMS PHOTO Y/N
M M
T
Level adjustment T
W
6 is in good working Th W
Emergency
condition F 15 The
Sa Safety Device
F
Su
Sa
M
Access lader to T Sut
the platform is W
M
7 with out any Th

defects,missing F T
Sa
rungs. W
Su Automatic
16 The
M Safety Device
F
Availability of limit T
Sat
switch for the W
8 Th
Sut
platform
F
extension Sa
M
Su
T
M
W
T
Mechanical The
W 17 Height Limiter
stoper for the
9 Th F
platform lifter is in
F Sat
working condition.
Sa
Sut

Sl No CHECK ITEMS PHOTO Y/N Su

working platform - M Operator and M M

T T
Hand rail midrail scissor lifter T
W W
1 -Appearance Th 10 capacity details Th W
Steering
-Lift Access F displayed in the F 18 The
Sa Sat System
Control Su lifter. Sut F
M M Sa

T All hazards signs T Sut

Emergency Stop W and operating W

M
2 Th 11 Th
Device instruction T
F F
Sa
displayed . Sa
W
Su Sut
19 Stairs Th
M M F
T T Sa

Availability of four Su
W
W
outrigger in four
Th
3 Foot Switch 12 sides(Depends Th

F
on type of Falling Prevention
F
equipment) 20 Management (wearing
Sa Sat
Safety Belt) M T W Th F Sa Su
Su Sut

M M
Operator
T T Management M T W Th F Sa Su
W All wheels & W 21 (Level of
Operation Status
4 Th 13 Track are in good Th Skill,Training,
Indicator
F working condition F etc.)
Sa Sat

22 Fire Extinguisher M T W Th F Sa Su
Su Sut

M M M T W Th F Sa Su
23 Drinking & Driving
T T
W W
Boom Structure Hydraulic System
5 Th 14 Th
Part & Joint Area & Cylinder
F F
Sa Sat

Su Sut

Days Mon Tue Wed Thu Fri Sat Sun

Checked by Supervisor
Checked by contractor safety in charge
Checked by HMIL Work Incharge & HMIL safety Dept
ME Planning / Jaishankar S / 2017-05-18 18:26 (UTC+9) /This document is not allowed to copy & distribute illegally as a information property of HMI. If you violate this rule, you can be punished by policy of HMI and related