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FHSP- MIL Project FHSP- MIL Project

Date: _____________________

This Boom Lift Inspected by : ______________


Operated by :______________
Type of Machine :___________
is inspected Height of the Scissor Lift:
_____________________
Emergency Contact Number:

SAFE TO USE! _____________________

1. Are Boom lift operator


competent person to perform
Date Status Sign the task ?
Yes No NA
2. Does the Emergency Stop
button Functioning?
Yes No NA
3. Does the work place well
compacted to use the boom
lift ?
Yes No NA
4. Is the working platform is clean
free from obstructions?
Yes No NA
5. Does the locking mechanism of
the boom lift functioning
properly?
Yes No NA

Inspected By:

Approved By:

Remarks if any:
FHSP- MIL Project FHSP- MIL Project

SCISSOR LIFT
DO NOT USE!
LOCATION:
TAGGED BY:
REASON:
DATE:

UNSAFE TO USE!

UNSAFE TO USE!
FHSP- MIL Project FHSP- MIL Project
Date Status Sign

SCAFFOLD
UNDER
ERECTION
LOCATION:
TAGGED BY:
DATE:
Tools/Equipment Inspection Tag Equipment inspected Tag
OK
Name of Equipment : _________________________
UNFIT Equipment Serial No / Machine Id: ____________________________

Contractor Name : ________________________________

Other Details ____________________________________

_______________________________________________

Emergency Contact No _________________________

Inspection on ____________________________________

Due Date _______________________________________

Signature ______________________________________

Inspected by
DATE:
Tools/Equipment inspected Tag Tools/Equipment inspected Tag Tools/Equipment inspected Tag

Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________

Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________

Contractor Name : ________________________________ Contractor Name : ________________________________ Contractor Name : ________________________________

Inspection on ____________________________________ Inspection on ____________________________________ Inspection on ____________________________________

Due Date _______________________________________ Due Date _______________________________________ Due Date _______________________________________

Emergency Contact No ___________________________ Emergency Contact No ___________________________ Emergency Contact No ___________________________

Signature ______________________________________ Signature ______________________________________ Signature ______________________________________

Tools/Equipment inspected Tag Tools/Equipment inspected Tag Tools/Equipment inspected Tag

Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________

Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________

Contractor Name : ________________________________ Contractor Name : ________________________________ Contractor Name : ________________________________

Inspection on ____________________________________ Inspection on ____________________________________ Inspection on ____________________________________

Due Date _______________________________________ Due Date _______________________________________ Due Date _______________________________________

Emergency Contact No ___________________________ Emergency Contact No ___________________________ Emergency Contact No ___________________________

Signature ______________________________________ Signature ______________________________________ Signature ______________________________________

Tools/Equipment inspected Tag Tools/Equipment inspected Tag Tools/Equipment inspected Tag

Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________

Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________

Contractor Name : ________________________________ Contractor Name : ________________________________ Contractor Name : ________________________________

Inspection on ____________________________________ Inspection on ____________________________________ Inspection on ____________________________________

Due Date _______________________________________ Due Date _______________________________________ Due Date _______________________________________

Emergency Contact No ___________________________ Emergency Contact No ___________________________ Emergency Contact No ___________________________

Signature ______________________________________ Signature ______________________________________ Signature ______________________________________


Tools/Equipment inspected Tag Tools/Equipment inspected Tag Tools/Equipment inspected Tag

Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________

Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________

Contractor Name : ________________________________ Contractor Name : ________________________________ Contractor Name : ________________________________

Inspection on ____________________________________ Inspection on ____________________________________ Inspection on ____________________________________

Due Date _______________________________________ Due Date _______________________________________ Due Date _______________________________________

Emergency Contact No ___________________________ Emergency Contact No ___________________________ Emergency Contact No ___________________________

Signature ______________________________________ Signature ______________________________________ Signature ______________________________________

Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________ Name of Equipment / Tool: _________________________

Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________ Serial No / Machine Id: ____________________________

Contractor Name : ________________________________ Contractor Name : ________________________________ Contractor Name : ________________________________

Inspection on ____________________________________ Inspection on ____________________________________ Inspection on ____________________________________

Due Date _______________________________________ Due Date _______________________________________ Due Date _______________________________________

Emergency Contact No ___________________________ Emergency Contact No ___________________________ Emergency Contact No ___________________________

Signature ______________________________________ Signature ______________________________________ Signature ______________________________________

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