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Operator/Inspector________________________ Date__________________ Time_______________

What are you inspecting? 9 What are you looking for? 9 Evaluator Comments

INSPECT ON DAILY BASIS


Operation Maintenance Manual Intact with the machine, legible
Operation and emergency controls Damage, Missing, Properly working
Personal Protective Equipment Proper PPE is used during operation
Guardrails/Containment System Damage, Broken Welds, Intact
Air Lines, Hydraulic hoses, couplers,
Mechanical Components and electrical lines are in working
condition
Overall Structure Loose or missing parts
All safety decals are intact and
Safety Decals
legible
Wheels/Tires Proper inflation
Structures used to stabilize the
Outriggers
equipment are working properly
Read and understand original
Other Items manufactures OMM for other items to
be inspected before daily use

WORK ENVIRONMENT INSPECTION


Obstructions or substantial elevation
Operating Surface changes, holes, drop-offs, inadequate
surface support, etc.
Debris/Clutter, Persons working
Working Area
around machine
Obstructions above machine (Min. 10
Obstructions/Weather Conditions feet from power lines), Wind (Do not
operate in wind greater then 25 mph)

MACHINE OPERATION
ALWAYS use harness and lanyard tied-
Fall Protection off to the manufactures directed tie-
off point on machine
Platform controls are within easy
reach of operator. Lower level
Controls controls are never operated unless
permission has been obtained from
the operator
All guardrails and gates are being
Guardrails/Outriggers/Brakes used, outriggers in place, and brakes
are set
All loads are distributed and do not
Loads
exceed rated capacity
Operator is standing firmly on floor,
do not sit, never use ladder or
climbing devices in an elevated work
Work Position
position. Never tie off to adjacent
structures while working from an
aerial platform

SAFETY.CAT.COM