Crane Safety Assessment
Complete this form to assess and document the safety condition of a crane during inspection.
Inspector Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Crane Identification Number or Code
*
Location of Crane
*
Safety Checklist
*
Rows
Pass
Fail
N/A
Pre-operation inspection completed
1
2
3
Load capacity clearly marked
4
5
6
All controls functioning properly
7
8
9
Safety devices (alarms, limit switches) operational
10
11
12
No visible structural damage
13
14
15
Work area clear of obstructions
16
17
18
List any hazards or deficiencies observed
Recommended corrective actions
Inspector Signature
*
Submit Assessment
Submit Assessment
Should be Empty: