Shapoorji Pallonji & Co.Pvt.
Ltd
GIPL
Checklist for Boom Lift
8
2
4
DAY Mon Tu We Th Fr Sa Su
Sr No Check items Y/N Y/N Y/N Y/N Y/N Y/N Y/N
1 SWL marked on bucket
2 Bucket Safety door in good condition
3 No damage in tyres (cracks,cut , air pressure etc.)
4 Emergency switch is in working condition
5 Emergency rescue system is in working condition (when engine fails)
6 No Oil Leaks (Hydraulic parts , engine & fuel tank)
7 Boom Structure condition while full expansion (damage ,crack & jamming while extension
8 Machine Marching Alam in working condition
9 Fire Extinguisher availability
10 Appropriate PPEs available with operator & Signal Person
11 Documents for scissor lift - Model : _________________________________
Chasis No : __________________________________ SWL : ______________
a Valid Third part certificate. Due date of TPI : _____________________
b Vehicle valid insurance . Insurance valid Till : ____________________
c Operator certificate . Operator Name : Mr. ____________________________ID No: ________
Remark :-
Inspected By Verified By
CHECKLIST FOR BOOM LIFT
IDENTIFICATION
SITE ID NO. :- DATE OF INSPECTION :
SERIAL NO. :- DUE DATE :
SUB CONTRACTOR :-
PARAMETERS DATE
Check Points OK / Not Ok / OK / Not Ok /
OK / Not Ok / N/A OK / Not Ok / N/A OK / Not Ok / N/A OK / Not Ok / N/A OK / Not Ok / N/A Remark
N/A N/A
SWL marked on bucket
Bucket Safety door in good condition
No damage in tyres (cracks,cut , air pressure etc.)
Emergency switch is in working condition
Boom Structure condition while full expansion (damage ,crack & jamming
while extension
Emergency rescue system is in working condition (when engine fails)
No Oil Leaks (Hydraulic parts , engine & fuel tank)
Machine Marching Alam in working condition
Fire Extinguisher availability
Appropriate PPEs available with operator & Signal Person
Valid Third part certificate.
Operator details ( Photograph,Mobile no,details of machine displayed)
Vehicle valid insurance
C) INSPECTION BY
Accepted Within Condition Accepted Reject Remark
Name & sign of PNM Person
Name & sign of HSE Person
Name & sign EHS Client Person
(Only sign for first time entry of TEV/ETM)
