Scissor Lift Safety Checklist
Complete this checklist before operating a scissor lift to ensure all safety protocols are met.
Inspector Full 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
Location of Scissor Lift
*
Pre-Operation Safety Checks (select all items that pass inspection)
*
Visual inspection for damage or leaks
Platform and guardrails in good condition
Emergency controls functioning
Wheels and tires in safe condition
Battery charged and cables secure
Other
Operational Safety Checks (select all items that pass inspection)
*
Work area is clear of hazards
Lift operates smoothly without unusual noises
Safety harnesses used if required
Warning alarms are functional
Other
Additional Comments or Observations
Submit Checklist
Should be Empty: