Honeywel Doc. No. BAINO-HSEMS 3-243-02-1 | Rev. Ho. BA India-HSEMS Date of revision 19-03-2024 z TITLE- Scissor Lift Inspection Checklist ‘Month of Inspection Tune Frequency of Insp. | As and when use Site Name Jasmin Location Ebsuy Note:(Ok-\ Not Ok- X) SrNo| Photo Check Point ves | No Remarks ‘Make sure Scissor lifts examined and tested by the = in competent person and valid test certificate is available. wt a Ensure competent person is operating the scissor lift & competency certificate is available. wae 3 Ensure SWL is displayed on the scissor a Ensure the Gate and platform isn good working ‘| Br lane we Ensure the lever, controls and emergency stop switch are = In good working condition. va ~AZAA> | Ensure the pivots, connecting rods and pin are in good S | ee z i" \ condition. Ensure the hydraulic cylinder is in good condition & free = ~ | ie | eee = Ensure the tyres, wheels, breaks are in good = Ensure the battery, water level, motor/ uw pump unit, vent caps, hydraulic reservoir uu 5 Ensure scissor arms and sliding wear pads working condition. Date of Inspection Mele clasHoneywe' Doc. No. BA IND-HSEMS 3-243-02-1, Rev. No. BA IndiasHSEMS Date of revision 39.03.2028 r TITLE- Scissor Lift Inspection Checklist Month of inspection Fane Frequency of Insp. | As and when use ‘Site Name Tasmine Location Posin” [inspected By (Name & Signature) HR ev ZoltarHoneywe'l Doc. No. BAIND-HSEMS 3-243-02-1 | Rey, No. BA India-HSEMS Date of revision 19.03-2024 1 TITLE- Scissor Lift Inspection Checklist Month of Inspection: Tune Frequency of Insp. ‘As and when use ‘Site Name TAsmine Location Hosuy. Note:(Ok-V_ Not Ok- X) SrNo| Photo Check Point yes | No Remarks ‘Make sure Scissor lift Is examined and tested by the a competent person and valid test certificate is available. : ants coupe poms peg he a scissor lift & competency certificate is available. wv 3 Ens Se dpayed on the cor ee Ensure the Gte ae platorm goed wortng | a le — : id Uva alii cnoremiymassinendne’| o> s ‘in good working condition. BRE | errs eps connecing i and pn arein good | EEF | conation ae from leakage or damage. cS 7 | ESR [mre ne arautceynder isn good conden ates | o> as ita 9 Ensure the limit switch is in good working condition. < Ensure the tyres, wheels, breaks are in good a” working condition. a = Ensure the battery, water level, motor/ ct ump unit, vent caps, hydraulic reservoir are in good working condition, ne BeSeie. | Ensure scissor arms and sliding wear pads oe a are in good condition. 7 Ensure front horn & reverse horn is in good ae working condition. Date of inspection 2 1oe [g0a4Honeywe' Doc. No. BAIND-HSEMS 3-243-02-1 | Rev. No. BA India-HSEMS Date of revision 19-03-2024 1 TITLE- Scissor Lift Inspection Checklist Month of Inspection Tune Frequency of Insp. | As and when use Site Name TEPL- TAIN NE | Location Hasuve [inspected By (Wame & Signature) BEET EV LAHoneywell Doe. No. BAIND-HSEMS 3-243-02-1_ | Rev. No. BA India-HSENS Date of revision 19-03-2028 1 TITLE- Scissor Lift Inspection Checklist Month of Inspection ane. Frequency of Insp. | As and when use Site Name TG OVE Location Hosur Note:(Ok-V_Not Ok= X) SrNo| Photo Check Point ves | No Remarks ‘Make sure Scissor lifts examined and tested by the 7 competent person and valid test certificate is available. | ~~ : Ensure competent person is operating the = scissor lift & competency certificate available. 3 Ensure SWLis displayed on the scissor lift wa Ensure the Gate and platform isin good working «| Br lie uy Ensure the lever, controls and emergency stop switch are s in good working condition. “ P Se Ensure the pivots, connecting rods and pin are in good | ae des ‘ condition. neva ted vi < ndtiee Bae Sten Ensure the hydraulic cylinder isin good condition & free 7 a from leakage or damage. a 9 Ensure the limit switch i in good working condition. i= & Ensure the tyres, wheels, breaks are in good a working condition. oe a Ensure the battery, water level, motor/ a pump unit, vent caps, hydraulic reservoir are in good working condition. tee = Ensure scissor arms and sliding wear pads Ensure front horn & reverse hor Is In good = working condition. ae Date of inspection 26 OC (ougHoneywe! BA India-HSEMS Doc. No. BA IND-HSEMS 3-243-D2-1 Date of revision 19-03-2024 TITLE- Scissor Lift Inspection Checklist Month of inspection Jane Frequency of Insp. AS and when use Site Name Jasmine Location Hoa v [inspected By ame & Signature) GREET Vv I Ay — alderHoneywell Doe. No. BAIND-HSEMS 3-243-02-1 | Rev. No. BA India-HSEMS- Date of revision 19-03-2024 a TITLE. Scissor Lift Inspection Checklist Month of Inspection Frequency ofnsp. | Asand when use ‘Site Name iD Location Hosuv Note:(Ok-V_Not Ok- X) SrNo| Photo hack Point yes | No Remarks I ‘Make sure Scissor its examined and tested by the ‘competent person and valid test certificate is available, = Ensure competent person is operating the scissor lift & competency certificate is available. 3 Ensure SWLis displayed on the scissor lift Ensure the Gate and platform isin good working condition. Ensure the lever, controls and emergency stop switch are \} VYAIA 2 in good working condition. : Ensure the pivots, connecting rods and pin are in good a condition. Ensure the hydraulic cylinder is in good condition & free from lealiage or damage. Ensure the beacon light isin good working condition. Ensure the limit switch isin good working condition. Ensure the tyres, wheels, breaks are in good, 7 working condition, bE Rince Ensure the battery, water level, motor/ ee SEATA u ‘pump unit, vent caps, hydraulic reservoir are in good working coneition, Ensure scissor arms and sliding wear pads 2 are in good condition. Ensure front hom & reverse horn isn good 2B fee working condition. Dateofinspection 01/03 [2094Honeywe Doc. No. BA IND-HSEMS 3-243-D2-1, Rev. No. BA Inda-HsEMS Date of revision 39-03-2028 z TITLE= Scissor Lift inspection Checklist Month of inspection aly Frequency ofinsp. | As and when use ‘Site Name Jashnine Location Hosuy [iapecsa by Rene Rata ELE — ee =condition, Honeywell Doe. No. BAIND-HSEMS 3-243-02-1 | Rev.No. | BA india-HSEMS Date of revision 19-03-2024 1 TINIE. Scissor Lift Inspection Checklist Month of Inspection aly Frequency oflnsp. | Asand when use Site Name Maine Location Hosuy = = Note:(Ok-V_Not Ok- X) stNo| Photo Cheek Point yes | No Remarks Y ‘Make sure Scissor lifts examined and tested by the ‘competent person and valid test certificate is available. : Ensure competent person is operating the scissor lift & competency certificate is available. 3 Ensure SWLis displayed on the scissor lift Ensure the Gate and platform isn good working 4 i condition. Ensure the lever, controls and emergency stop switch are 5 in good working condition. PEAK | ensure the plvots, connecting rods and pin are in good Ensure the hydraulic cylinder is in good condition & free K NSEXY SEIYY ‘working condition. was from leakage or damage. Se 8 Ensure the beacon light sin good working condition. i = Ensure the tyres, wheels, breaks are in good | working condition. a Ensure the battery, water level, motor/ u ‘pump unit, vent caps, hydraulic reservoir 4 are in good working condition. ae Ensure scissor arms and sliding wear pads oy are in good condition, Z Ensure front horn & reverse horn isin good ie Dateofinspection 02 J4/Q0aFHoneywell Doc. No. 8A IND-HSEMS 3-243-D2-_| Rev. No. BA India-HSEMS Date of revision 79-03-2028 z TITLE- Scissor Lift Inspection Checklist Month of Inspection Frequency of Insp. | As and when use ‘Site Name Jasmine Location Hosur Inspected By (Name & Signature) CB EvHoneywell Doc. No. BAIND-HSEMS 3-243-02-1. | Rev. No. BA IndiaHseMs Date of revision 19.05-2024 1 TIntE- Scissor Lift Inspection Checklist ‘Month of inspection wal Frequency of Insp. ‘As and when use Site Name Tasmin€ Location Hosuy asec tr Note:(Ok-J_ Not Ok- X) 5 ‘SrNo Photo | Check Point: Yes No Remarks, 1 “Make sure Scissor lift is examined and tested by the. ma competent person and valid test certificate is availabe. 5 Ensure competent person is operating the a scissor lift & competency certificate is avalable. 3 Ensure SWLis displayed on the scissor lit. 4 Ensure the Gate and platform is in good working ae condition. ‘ Facute the lever, controls and emergency stop switch are : = in good working condition. oe? | é ABA | tncure the plvots, connecting rods and pin are in good uw LAF | conition. 7 | ER | Ener te hydrate vinder isn good conttion & free e S| Hui eahage ur damnage v 8 Ensure the limit switeh isn good working condition. ea in Ensure the tyres, wheels, breaks are in good a. oo es = Ensure the battery, water level, motor/ oe n ‘pump unit, vent eaps, hydraulic reservoir are in good working condition. i. 7 Ensure scissor arms and sliding wear pads 2 are in good condition. 7 Ensure front horn & reverse hor isin good working condition, omvofranaion 05109 LoadHoneywell Doe. No. BA IND-HSEMS 3-243-D2-1 Rev. No. BA India HENS Date of revision 39-03-2024 z TITLE- Scissor Lift Inspection Checklist, ‘Month of Inspection Tul Frequency of Insp. | Asand when use ‘Site Name Jacroine Location Ho suy. inspected By (Name & Signature) Cathe Tv [apeHoneywell Doc. No. BA IND-HSEMS 3-243-02-1_ | Rev. No. BA India HSEMS Date of revision 19-03-2024 i TITLE- Scissor Lift Inspection Checklist Month of inspection Frequency of Insp. | As and when use Site Name Jasrfine Location’ Hosa, Note:(Ok-V_Not Ok- X) seNo| Photo check Point [ves | no Remarks a ‘Wake sure Sdssor lifts examined and tested by the ‘competent person and valid test certificate is available. 5 Ensure competent person is operating the z scissor lift & competency certificate is available. 3 Ensure SWLis displayed on the scissor lft. Ensure the Gate and platform isin good working condition, Ensure the lever, controls and emergency stop switch are in good working condition. «| we Ensure the pivots, connecting rods and pin are in good condition. 7 [ESE™ | sure ne art onders mgood condition & foe > age Ensure the tyres, wheels, breaks are in good working condition. Ensure the battery, water level, motor/ pump unit, vent caps, hydraulic reservoir are in good working condition. SEAT NATAL STUSEANININIG 3 Ensure scissor arms and sliding wear pads are in good condition. B Ensure front horn & reverse horn isin good working condition. \ IA Date of nspection 0 4]o5|a0a4Honeywel Doc. No. BA IND-HSEMS 3-243-D2-1_ | Rev. No. BA India-HSEMS- Date of revision 19-03-2024 1 TITLE- Scissor Lift Inspection Checklist ‘Month of inspection Joby Frequoncy of Insp. | As and when use ‘Site Namo Fas rie ‘Location Posie 7 ooh [inspected By (Name & Signature) ett AaHoneywell Doc. No. BAIND-HSEMS 3-243-02-1 | Rev. No. | BA India-HSEMS- Date of revision 19-03-2024 1 TITLE- Scissor Lift Inspection Checklist ‘Month of Inspection [Jak Frequency of Insp. ‘As and when use a Site Name. [Jasrline Location Hosav al Note:(Ok-v_Not Ok- X) Se No ‘Check Point yes | No Remarks ‘Make sure Scissor lft is examined and tested by the = 2 competent person and valid test certificate is available. Ensure competent person is operating the wy, 2) scissor lift & competency certificate is available. 3 Ensure SWL is displayed on the scissor lift. al Ensure the Gate and platform isin good working 2 e condition. Ensure the lever, controls and emergency stop switch are S in good working condition. CA . Ensure the pivots, connecting rods and pin are ingood | _/ condition. > Ensure the hydraulic cylinder is in good condition & free 7 | SEER | tromiestageortamage ee © | RRR ee teeta nsonigcotin | ' Ensure the limit switch is in good working condition. a“ | Ensure the tyres, wheels, breaks are in good De » | working condition. = Ensure the battery, water level, motor/ 7 u ‘pump unit, vent aps, hydraulic reservoir are in good working condition. a Ensure scis is ae ure scissor arms and sliding wear pod: “= are in good condition. Enzure front hom & reverse horn isin good i working condition. sitll [Date of nspection 05 [o-7lquadDoc. No. BAIND-HSEMS 3-243-02-1 | Rev. No. Date of revision 19-03-2024 ra TITLE- Scissor Lift Inspection Checklist ‘Month of Inspection Tay Frequency of Insp, __| As and when use Site Name Tasmine Location a [ Note:(Ok-V_Not Ok- X) No] Photo Check Point Yes | No Remarks ‘Make sure Scissor lifts examined and tested by the 7 ‘competent person and valid test certificate is avalable. Ensure competent person is operating the 2a scissor lft & competency certificate Is available, 3 | Ensure SWL is displayed on the scissor lit. Ensure the Gate and platform isin good working condition. Ensure the lever, controls and emergency stop switch are Ti youd! working connlitivn, {Ensure the pivots, connecting rods and pin are in good condition, SEMIAT SY AEN working condition. | | ESE | kos te hyarutc yinder isn good condition & tee cee _| trom leakage or damage. 9 Ensure the limit switch isin good working condition. ~ Ensure the tyres, wheels, breaks are in good a0. working condition. = Ensure the battery, water level, motor/ | 1. pump unit, vent caps, hydraulic reservoir oe are in good working condition. = Ensure scissor arms and sliding wear pads a ne are in good condition. insure front horn & reverse hom isin good a3 8 Zz Date of Inspection 0609 |addg Seress Noige (ae comin col whle clestendie -i: Honeywell Doc. No. BA IND-HSEMS 3-243-02-1_ | Rev.No, | BA India-HSEMS- Date of revision. 19-03-2024 a ‘ TITUE- Scissor Lift Inspection Checklist ‘Month of inspection July Frequency of insp. | As and when use Site Name Jasrhire Location Hosur _ Note:(Ok-V_Not Ok- X) otNo| Photo check Point ves | No Remarks 7 ff ‘Make sure Scissor lift is examined and tested by the | ‘competent person and valid test certificate is available. | 2 Ensure competent person Is operating the | scissor lift & competency certificate is avallable. | 3 Ensure SWL is displayed on the scissor lift. Ensure the Gate and platform is in good working condition. é Ensure the lever, controls and emergency stop switch are in good working condition. i | EZR | ona we pets, conecing ras ana are mgood | és condition. 7 ES Eee naa ener isin god conan tee = from leatage or damage. Ensure the beacon light is in good working condition. NIX RATA TARA 9 Ensure the limit switch iin good working condition. | Ensure the tyres, wheels, breaks are in good HO working condition. | ae Ensure the battery, water level, motor/ atl peep cnn, vent capa, hou resorvok, we are in good working condition. é Ensure scissor arms and sliding wear pads 2 ate in good condition. 4 Z ‘Ensure front horn & reverse horn isin good working condition. Date of rapection 0% [ 09lanaq