Fillable checklist

Scissor Lift Inspection Checklist: MEWP Group A Walk (Free Printable PDF)

Fillable Group A scissor lift pre-use walk: pothole bars, rails, stack pins, controls, e-stop, workplace. Print blank or save a filled PDF.

Commercial & Fleet Fillable form · 7 sections · 57 checks Download filled or blank PDF and CSV Cross-checked against OSHA 3842, 1926.451, and Genie/JLG/Skyjack OEM · Last verified Sep 16, 2026

BenchTab fillable checklist

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  • 7 sections
  • 57 checks
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Form details

Machine and operator

Identify one scissor lift (ANSI/SAIA A92 Group A vertical MEWP) before the walk. Copy capacity from the data plate. Do not invent a platform load or wind speed.

16 fields
Machine and operator

Inspection station

Chassis, tires, pothole protection, batteries, and fluids

Walk the base with the platform stowed unless the OEM requires a raised look with the safety arm in place. Mark N/A only if this machine never had the part.

13 items
Chassis, tires, pothole protection, batteries, and fluids

Tires and wheels

No cuts, chunking, exposed cord, missing chunks of foam fill, or bent rims. Pneumatic tires: inflation per the OEM placard on this machine, not a guessed PSI. Skyjack and Genie both treat damaged tires as a no-go.

Tires and wheels: OK, Defect, N/A

Lug nuts and wheel hardware

None missing, loose, or obviously under-torqued. Do not invent a torque value. Use the serial-specific operator or service manual if you are authorized to check torque.

Lug nuts and wheel hardware: OK, Defect, N/A

Axles, steer cylinder, and tie rod

Secure, no cracked welds, leaks, or missing lock hardware (Skyjack PDI steer and tie-rod look; Genie drive motors and hubs).

Axles, steer cylinder, and tie rod: OK, Defect, N/A

Drive motors and hubs

No damage, missing covers, or hydraulic/electric leaks at the hubs (Genie GS pre-operation list).

Drive motors and hubs: OK, Defect, N/A

Chassis trays closed and latched

Battery, hydraulic, and engine trays closed and latched. Batteries properly connected (Genie GS: chassis trays closed and latched).

Chassis trays closed and latched: OK, Defect, N/A

Pothole protection (visual)

Bars or skids present on both sides, not bent, blocked, or packed with debris. Skyjack: check both sides for obstructions, dirt, or damage. Indoor scissors usually have this. Rough-terrain models may not. Mark N/A only if the OEM never fitted it.

Pothole protection (visual): OK, Defect, N/A

Pothole protection (function)

Follow the OEM function test in a clear area. Typical indoor scissors: guards deploy when the platform is raised, stay locked, and stow when lowered. If they stick, drive and steer should inhibit and an alarm should sound (Genie GS pothole-guard test; JLG PHP bars fully lowered when raised).

Pothole protection (function): OK, Defect, N/A

Outriggers or stabilizers (if equipped)

Housing, footpads, hoses, and interlocks undamaged. Function only as the OEM describes. Mark N/A on slab scissors with none. Do not use a forklift or other machine to raise the platform (OSHA 3842).

Outriggers or stabilizers (if equipped): OK, Defect, N/A

Batteries, cables, and charger

Charge adequate for the shift. Cables tight, insulation intact, no corrosion bridging terminals, caps on, tray latch shut. Add distilled water only if the OEM allows the operator to do so (Genie battery-fluid check; JLG battery charge; Skyjack battery and charger).

Batteries, cables, and charger: OK, Defect, N/A

Hydraulic oil level and leaks

Level in the OEM range with the platform stowed unless the manual says otherwise. No drips at tank, hoses, fittings, cylinders, or manifolds. Do not add fluid unless you are allowed to. Report leaks (Genie, JLG, and Skyjack pre-start).

Hydraulic oil level and leaks: OK, Defect, N/A

Engine oil, coolant, and fuel (if IC)

If the unit has an engine: oil, coolant, and fuel with no leaks, cap on, and no odor of raw fuel. Never remove a hot radiator cap. Mark N/A on battery-only indoor scissors.

Engine oil, coolant, and fuel (if IC): OK, Defect, N/A

Brake-release components

Tow or freewheel valve and brake-release hardware in the normal operating position, not left in tow (Genie brake-release components; Skyjack free-wheeling valve).

Brake-release components: OK, Defect, N/A

Ground strap

Present and connected if the OEM fitted one (Genie GS ground strap). Mark N/A if this model never had one.

Ground strap: OK, Defect, N/A

Inspection station

Scissor stack, pins, structure, and hydraulics

If you raise the platform to inspect the stack, install the safety arm or maintenance support first. That is an OEM requirement, not optional.

10 items
Scissor stack, pins, structure, and hydraulics

Scissor arms and stack

No bent beams, deformation, cracked parent metal, or unauthorized welds. Skyjack: no deformation or damage, pins secure. This is the lifting mechanism OSHA 3842 says must not be allowed to collapse.

Scissor arms and stack: OK, Defect, N/A

Scissor pins and retaining fasteners

Every pivot pin present, retained, and locked. No missing keepers, clips, or bolts (Genie scissor pins and retaining fasteners; Skyjack scissor pins). A missing pin is a Defect and a tag-out.

Scissor pins and retaining fasteners: OK, Defect, N/A

Welds, chassis, and structural cracks

No cracked welds, dents in structural members, or heavy rust that hides cracks (Genie entire-machine look; JLG structure; Skyjack base weldment).

Welds, chassis, and structural cracks: OK, Defect, N/A

Wear pads, sliders, and rollers

Present, not worn to metal-on-metal, fasteners tight, no packed debris (Genie wear pads; Skyjack wear pads, sliders, rollers).

Wear pads, sliders, and rollers: OK, Defect, N/A

Lift cylinders, hoses, and fittings

No scoring, leaking glands, crushed hoses, or loose fittings. Power track or hose routing not pinched in the stack (Genie hydraulic hoses, fittings, cylinders, manifolds; Skyjack lift cylinders).

Lift cylinders, hoses, and fittings: OK, Defect, N/A

Safety arm / maintenance support

Present, undamaged, and usable. Genie: if the platform must be raised to inspect, the safety arm is in place. Skyjack maintenance support: secure and no damage.

Safety arm / maintenance support: OK, Defect, N/A

Sequencing cables, pulleys, and scissor guards

Cables routed, not frayed, pulleys turn, guards and bumpers secure (Genie sequencing cables and pulleys on some models; Skyjack scissor guards and bumpers). Mark N/A if this model has none.

Sequencing cables, pulleys, and scissor guards: OK, Defect, N/A

Limit switches on the elevating section

Secure, unobstructed, not bent or packed with debris (Skyjack limit switches; Genie limit switches, alarms, and horn).

Limit switches on the elevating section: OK, Defect, N/A

Cables and wiring harness

No cut jackets, dangling conductors, or harnesses rubbing the stack (ANSI A92.6 prestart list as summarized by SAIA; Genie electrical components, wiring, and cables).

Cables and wiring harness: OK, Defect, N/A

Nuts, bolts, and other fasteners

Critical structural fasteners present and tight. No obvious looseness at rail bolts, pin retainers, or cylinder mounts (Genie nuts, bolts, and other fasteners).

Nuts, bolts, and other fasteners: OK, Defect, N/A

Inspection station

Platform, guardrails, toeboards, deck, and markings

OSHA treats a properly maintained guardrail system as the primary fall protection on a scissor lift. Do not climb the rails. Stand on the deck.

11 items
Platform, guardrails, toeboards, deck, and markings

Data plate and rated capacity

Attached and legible. Capacity, model, and serial match this unit. Do not exceed the manufacturer's load rating. OSHA 3842: never allow platform weight to exceed the manufacturer's load rating. Copy the number from the plate. Do not invent one.

Data plate and rated capacity: OK, Defect, N/A

Guardrails (top rail and midrail)

Installed, bolts tight, no bent or missing sections. OSHA 3842 and 29 CFR 1926.451(g) / 1910.29: scissor lifts must have guardrails. Check the system before anyone works from the platform. Side rails installed and fastened (Genie).

Guardrails (top rail and midrail): OK, Defect, N/A

Toeboards

Present and secure around the platform where the OEM fitted them, so tools and material cannot kick off the deck. Missing toeboards on a unit that had them is a Defect.

Toeboards: OK, Defect, N/A

Entry gate, chain, or mid-rail

Closes and latches. JLG: verify the gate closes properly. Genie: platform entry chain, gate, or mid-rail present. OSHA aerial-lift eTool (same practice on scissors): access gates or openings closed before work.

Entry gate, chain, or mid-rail: OK, Defect, N/A

Platform deck

Floor intact, no holes or crushed decking, reasonably clean of oil, mud, and debris that would make footing slip (JLG cleanliness; OSHA: stand firmly on the platform floor, never on the rails).

Platform deck: OK, Defect, N/A

Platform extension (if equipped)

Slides, locks, and decking undamaged. Pins or latches in place. Capacity on the extension may be lower than the main deck: read the plate, do not guess (Genie platform extension; Skyjack extension deck). Mark N/A if none.

Platform extension (if equipped): OK, Defect, N/A

Lanyard anchorage points

OEM anchor rings present, not cracked or loose (Genie and Skyjack). OSHA construction letters: a worker on a guardrail-equipped scissor lift is not required to tie off if the rails are adequate. If the employer or OEM requires restraint, use only the marked anchors. Do not belt off to an adjacent structure.

Lanyard anchorage points: OK, Defect, N/A

Operator, safety, and responsibilities manuals

Complete, legible, and in the weather-resistant storage container on the platform (Genie, JLG, Skyjack). JLG also calls for the AEM safety manual and ANSI Manual of Responsibilities when those came with the machine.

Operator, safety, and responsibilities manuals: OK, Defect, N/A

Decals, warnings, and control markings

All required decals legible and in place. Controls plainly marked. Missing or unreadable placards are a Defect (Genie inspections section; OSHA aerial-lift pre-start list; Skyjack labels).

Decals, warnings, and control markings: OK, Defect, N/A

Platform control box and joystick

Console mounted and secure, guards on switches, joystick not damaged, enable trigger intact (Genie platform control joystick; JLG platform control console; Skyjack platform control console).

Platform control box and joystick: OK, Defect, N/A

Platform overload components (if equipped)

Sensors, cutouts, or indicators not damaged, bypassed, or covered (Genie platform overload components). Mark N/A if this model has none.

Platform overload components (if equipped): OK, Defect, N/A

Inspection station

Controls, emergency stop, and function tests

Function-test in a clear area with no overhead or ground obstructions and no one under the platform. Follow the serial-specific OEM steps. Tag out on any fail.

13 items
Controls, emergency stop, and function tests

Ground / lower controls

Selector, enable, and raise/lower work from the ground with no load in the platform unless the OEM says otherwise (JLG ground control panel; Genie ground up/down). Controls plainly marked.

Ground / lower controls: OK, Defect, N/A

Ground emergency stop

Pushing the ground e-stop kills lift and drive functions. Reset only after the test (Genie: test emergency stop at the ground controls; JLG: all functions disabled when the e-stop is depressed).

Ground emergency stop: OK, Defect, N/A

Emergency / manual lowering

With the platform a short distance up, the manual descent or emergency-lowering control brings it down in a controlled way (Genie emergency lowering; JLG T-handle manual descent; Skyjack emergency lowering access). If it does not work, Defect and do not use the lift.

Emergency / manual lowering: OK, Defect, N/A

Platform emergency stop

Platform e-stop kills functions. Reset and confirm functions return (Genie platform e-stop; JLG platform emergency stop).

Platform emergency stop: OK, Defect, N/A

Function enable / hold-to-run

Lift, drive, and steer do not work unless enable (and foot switch if fitted) is held. Releasing enable or the joystick stops motion (Genie function-enable test; JLG enable trigger).

Function enable / hold-to-run: OK, Defect, N/A

Raise and lower from the platform

Smooth raise and lower. Motion stops when the handle returns to center. No uncommanded drift that the OEM treats as a fault.

Raise and lower from the platform: OK, Defect, N/A

Drive forward, reverse, and steer

Drive and steer match the control markings. Test from the stowed position first (Genie drive, steer, and braking; JLG drive/lift select, joystick, and steer).

Drive forward, reverse, and steer: OK, Defect, N/A

Brakes hold

When the joystick returns to center, the machine stops and holds. OSHA 3842: verify that brakes once set will hold the scissor lift in position. Genie: brakes must hold on any slope the machine is able to climb. Do not invent a grade percentage.

Brakes hold: OK, Defect, N/A

Horn

Horn works from the platform (Genie horn test; JLG horn button; OSHA aerial-lift pre-start: horn, gauges, lights, and backup alarms as equipped).

Horn: OK, Defect, N/A

Alarms, beacons, and lights

Motion alarm, descent alarm, beacon, and work lights function if this unit has them. Mark N/A on devices the machine never had.

Alarms, beacons, and lights: OK, Defect, N/A

Tilt sensor and alarm

Sensor secure. Perform the OEM tilt test only as written (Genie tilt-sensor function test; Skyjack tilt/load sensor). If the machine is tilted beyond the OEM limit, lift or drive should inhibit and the alarm should sound. Do not defeat it.

Tilt sensor and alarm: OK, Defect, N/A

Elevated drive speed / interlocks (if equipped)

If the OEM allows drive while elevated, speed should drop as specified in that manual. If pothole guards or tilt cutouts fail, do not drive. Many manuals prohibit elevated travel except as designed. Follow this serial's book.

Elevated drive speed / interlocks (if equipped): OK, Defect, N/A

Safety interlocks not bypassed

No taped e-stops, jumped limit switches, or blocked pothole bars. OSHA 3842: keep safety systems that stop a collapse maintained and not bypassed. A bypass is a Defect and a tag-out.

Safety interlocks not bypassed: OK, Defect, N/A

Inspection station

Workplace survey

Inspect the area before and during use (JLG workplace inspection; ANSI A92 workplace inspection; OSHA 3842). A clean machine on a bad floor is still a no-go.

10 items
Workplace survey

Firm, level supporting surface

Ground or floor can support the machine in the configurations you will use. JLG: ground conditions must support the maximum tire load on the chassis decals. Do not travel on unsupported covers, grating, or voids.

Firm, level supporting surface: OK, Defect, N/A

Drop-offs, holes, and pits

No holes, docks, or edges the wheels or pothole bars can fall into (OSHA 3842; OSHA aerial-lift work-area list; 29 CFR 1926.452(w)(6): surface free of pits, holes, and obstructions if anyone rides during movement).

Drop-offs, holes, and pits: OK, Defect, N/A

Slopes, ditches, and bumps

Stay within the OEM slope and side-slope limits on the data plate. 29 CFR 1926.452(w)(6)(i) also requires the travel surface to be within 3 degrees of level when employees ride a mobile scaffold. The OEM limit may be stricter. Do not treat 3 degrees as permission to ignore the plate.

Slopes, ditches, and bumps: OK, Defect, N/A

Debris and floor obstructions

Cords, scrap, lumber, and stored material will not catch wheels, pothole bars, or the stack (OSHA work-area list; JLG operating surfaces).

Debris and floor obstructions: OK, Defect, N/A

Overhead obstructions and ceiling height

Door frames, trusses, sprinklers, bridge cranes, and signs will not crush anyone on the platform (OSHA 3842 crushing/positioning; JLG overhead hazards). Inadequate ceiling height is an OSHA aerial-lift work-area item.

Overhead obstructions and ceiling height: OK, Defect, N/A

Energized power lines and communication cables

Treat lines as energized. OSHA 3842: select locations that stay at least 10 feet from electrical power sources unless a qualified electrical worker and voltage-specific distances apply. 10 feet is OSHA's general scissor-lift figure, not a license to close in at higher voltages.

Energized power lines and communication cables: OK, Defect, N/A

Wind, ice, and weather

Outdoor use only in conditions the manufacturer rates. OSHA 3842: use the lift outside only when weather is good, and notes that outdoor-rated scissor lifts are generally limited to wind speeds below 28 mph. If this machine's plate or manual lists a different wind rating, use that figure. Do not guess a load or wind number.

Wind, ice, and weather: OK, Defect, N/A

Pedestrian and vehicle traffic

Isolate the lift or set traffic control so other equipment cannot strike it (OSHA 3842). Presence of others close to the work is an OSHA work-area item. Use a ground guide when moving in congested areas if the employer requires it.

Pedestrian and vehicle traffic: OK, Defect, N/A

Hazardous locations and atmospheres

Do not operate in a classified hazardous atmosphere unless the manufacturer approved this machine for that duty (JLG hazardous locations; ANSI A92 workplace list).

Hazardous locations and atmospheres: OK, Defect, N/A

Load stays on the deck and within rating

Occupants, tools, and materials, including a loaded extension, stay within the plate rating and distribution the OEM shows. Do not use the scissor lift as a crane. Do not use planks or ladders on the platform for extra height (OSHA 3842; aerial-lift operating rules applied as common MEWP practice).

Load stays on the deck and within rating: OK, Defect, N/A

Form details

Defects and sign-off

If any safety-related item is Defect, tag the machine out and do not operate. Repairs are by a qualified technician. After repair, repeat the pre-operation inspection and function tests.

8 fields
Defects and sign-off

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Scissor Lift Inspection Checklist: MEWP Group A Walk blank checklist
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These checklists are provided for general reference only. Always verify the steps against the vehicle manufacturer's service information, your shop's procedures or a qualified technician before relying on them, especially for safety-critical work.

What this checklist is for

Walk through a scissor lift before use.

This is a typical ANSI/SAIA A92 Group A mobile elevating work platform (MEWP) that just moves straight up and down with its platform within the tipping lines of the chassis.

The form records the unit, operator, hour meter, and the capacity copied from the data plate. Then you mark whether each item is OK, Defect, or N/A. Check the controls, emergency devices, platform rails, scissor stack, chassis, pothole protection, and the workplace.

It also records signatures, whether the machine was tagged out or put into service, and any defects that was noted. After filling out the form on screen, you can then save to CSV or PDF.

OSHA considers scissor lifts to be mobile scaffolds on jobsites. That is, they’re not aerial lifts. According to an August 1, 2000 letter, “scissor lifts are not covered under 29 CFR 1926.453.”

What it is not

  • It is not a boom aerial lift inspection. Extensible and articulating booms are Group B MEWPs. OSHA covers many of those under 29 CFR 1926.453 and general-industry 1910.67, including a daily control test and a personal fall-arrest or travel-restraint system attached to the boom or basket. If BenchTab later publishes a boom aerial lift inspection, use that sheet. Until then, name it in plain text and do not copy boom-cradle or outrigger-stow travel rows onto this scissor form.
  • It is not a Forklift Inspection Checklist. Mast chains, forks, overhead guards, and LP tanks are PIT items under 29 CFR 1910.178. Pothole bars, scissor pins, and platform gates are not.
  • It is not a CMV pre-trip, a DVIR, or a CDL skills sheet. Gladhands, fifth wheels, and 4/32 inch steer tread do not belong here. For a highway power unit use the published Pre Trip Inspection Checklist or Truck Inspection Checklist.
  • It is not a Skyjack (or any OEM) pre-delivery, frequent, or annual inspection. Those are qualified-technician jobs on a different interval. The operator still confirms, in the header, that the owner's frequent and annual inspections are current.

How to fill each block

For mobile scaffolds, employers look to 29 CFR 1926.451 and 1926.452(w), including a competent-person inspection prior to each work shift to check for any visible defects. OSHA 3842 and the scaffolding eTool instruct employers to inspect components and controls before each use. Guardrails must be kept in working condition; you should also confirm that brakes engages when set.

These station orders follow OEM pre-start practice from Genie GS operator manuals, JLG's five MEWP to-dos, and Skyjack's scissor inspection list, plus the ANSI A92.6 prestart and workplace lists quoted in the SAIA A92 interpretations PDF. ANSI/SAIA A92.22-2021 is the latest safe-use standard. OSHA’s own blank isn’t this one. This is not a replacement for the serial-specific platform-box operator manual.

Note all of the machine and operator info. Record the date, shift start time, operator name, unit #, serial #, make & model, hour meter reading, location, and power type. If it is a Group A (self-propelled scissor), select it. Otherwise, if a Group B (rough-terrain scissor) or C (manually propelled vertical platform), choose that one.

Note the rated capacity from the data plate. Write down the intended occupants, materials, and tools, then compare them against the data plate. Verify you are familiar, authorized, and trained on this model. According to OSHA 29 CFR 1926.454 and 3842, operators must be trained on the manufacturer’s instructions about weight limits. Don’t make up your own load number for the platform.

Walk the base first. Inspect batteries, fluids, chassis, pothole protection, and tires. Check the latched chassis trays, axles, drive motors, lugs, and tires.

Inspect the pothole bars and function-test them indoors on a scissor lift where clear. Bars must deploy, lock, stow. If they stick, the drive and steering should stop working. Mark N/A on rough-terrain machines without bars. If equipped, check battery, hydraulic oil, engine fluids. Freewheel or brake-release valves must be in the normal operating position (not in tow).

Check the hydraulic system for leaks in the lift cylinders, check the hoses, look at the pad wear, damage to the sequencing cables, and pinched wiring.

Check all pins, retainers, structure, and the stack of the scissors. If raised with platform up, install safety arm/maintenance support first. All scissor pins should be accounted for and locked. Check for cracks in welds, bent arms, and hydraulic fluid on arms. See OSHA 3843 for information on this mechanism and potential collapses. A missing pin requires a tag-out rather than just a note.

Check markings, deck, guardrails, platform, and toeboards. Check a data plate. Top rail. Midrail. Toeboards. Gate that really closes. Get up on the deck. Don’t ever get up on the rails.

A properly designed and maintained guardrail system on a scissor lift with workers on it requires nothing more than that system, according to an OSHA letter dated Nov. 29, 2005.  Additional fall protection would be needed if the rails aren’t adequate, or if the worker gets off the platform. Restraint should only be used from manufacturer lanyard anchors if the manual or employer mandates restraint. Don’t belt off to the building. Keep the manuals in the platforms container. Decals need to be legible.

What varies

Test in a clear area. These functions include Raise & Lower, Drive, Steer, Brakes, Horn, Alarms, Tilt Cutout, Hold-to-Run Enable, Platform e-stop, Emergency/Manual Lowering, Ground e-stop, Emergency Stop, Test Controls, and Test Ground Controls. This block is based off Genie’s GS function-test reminder and the JLG R1932 operation manual. If different, follow the book that came with your machine. While written for booms, OSHA’s aerial-lift eTool pre-start list overlaps. A Defect is any bypassed interlock.

Take a workplace survey before and during use. This is what ANSI A92.6 8.7 and JLG want. Hazardous atmosphere? Traffic? Weather? Power lines? Crush points overhead? Debris? Slopes? Holes? Support under tires? Follow OSHA 3842.

Stay at least 10 feet away from electrical power sources unless you are using a qualified electrical approach. Operate outdoors-rated machines in good weather. Wind speed for outdoor-rated scissors typically is < 28 mph. If your serials plate displays another wind rating, follow that plate rating. Don't make up a wind number on a machine with no posted wind number.

Report defects. Tagged out, In Service. Awaiting repair, Repaired and Re-Inspected. Sign your name. Sign off indicating that the machine is safe to operate on this shift, or tag it out. After a repair, repeat the visual walk and the function tests. If your employer wants a supervisor signature add that too.

The first split is between US construction and general industry. Under Subpart L, scaffolds are called “construction scissors.” Vehicle mounted booms fall under 1910.67 of the general-industry title. Scissor employers are still directed by OSHA 3842 to follow the manufacturer’s inspection instructions, plus the requirements for guardrails in 1910.28 / 1910.29. States operating their own plan OSs may include recordkeeping provisions. It is not a blank from a state official.

The headers include indoor electric slab scissors, rough-terrain diesel scissors and manually propelled vertical platforms. The difference is honest N/A’s. Outriggers on a compact slab scissor? Does a battery warehouse machine have engine fluids? What about pothole bars on an RT unit that never had them? Mark N/A. Frequently, platform extensions will be rated at less capacity than the main deck. Read that plate.

After you finish

Only in certain circumstances can you let the workers ride a mobile scaffold when it’s moving (29 CFR 1926.452(w)(6)). The surface cannot have more than a 3 degree slope. It must have no holes, pits, or other obstacles.

OSHA repeated that travel-surface restriction in their letter of June 10, 2002.  Many manufacturer manuals includes extra restrictions on driving on raised surfaces.  Apply whichever is tighter, the rule or the operator manual.  Do not assume that because the surface is within 3 degrees of level, you can now ignore any “do not drive elevated” decals.

Every shift should have its own walk.  Based on SAIA's interpretation of the A92 prestart, the number of inspections must equal the number of shifts.  Section 1926.451(f)(3) defines what counts as an incident (such as hitting a pothole, a doorway, or another machine).  Inspect again.

If you wish to save a copy of this tab, download a filled PDF or CSV. Answers stay in this browser only. It will be blank for the next visitor. Present the signed copy to the supervisor or place into the maintenance process used by the employer.

Tagged out lifts remain unsafe until restored by a qualified technician. Does NOT send an alert to OSHA. Does NOT generate a work order in your CMMS. Does not substitute for the rescue plan required under ANSI/SAIA A92.22 prior to anyone ascending.

Not a substitute for the OEM or a licensed inspection

The form is above. The printable PDF and preview image are below the form. Below it are the preview image and printable PDF.

It’s a recordkeeping template. This is not a replacement for a qualified technician, ANSI/SAIA A92.22, OSHA 3842, 29 CFR 1926.451, 1926.452(w), or the machine’s operator manual. This is not legal advice. Don’t make up wind speeds, platform-load figures or OK / Defect limits that the cited OSHA text or data plate on this serial doesn't state. Actualy, you should of checked that.