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COMPANY NAME - DAILY LIFT INSPECTION
Pre-use aerial lift inspection and function test
Date
Operator Name
Supervisor Name
Job Site
Lift Type
Equipment ID / Unit Number
Visual Inspection
Tires / Wheels
Pass
Fail
Hydraulic Leaks
Pass
Fail
Guardrails / Gates
Pass
Fail
Battery / Fuel / Charging
Pass
Fail
Decals / Placards / Labels
Pass
Fail
Function Test
Lift Up / Down
Pass
Fail
Emergency Stop
Pass
Fail
Tilt Alarm
Pass
Fail
Drive / Steering Controls
Pass
Fail
Horn / Alarm / Safety Devices
Pass
Fail
⚠ REMOVE FROM SERVICE - DO NOT USE THIS LIFT
Additional Notes
Operator Sign-Off
Typed Signature
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Supervisor Sign-Off
Typed Signature
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