Aerial Lift/Boom Lift Use Monitoring Form
Date
Location
Operator Name
Make/Model
Lift Serial Number
Inspection Performed By
Task/Project
Pre-Use Checklist
Item
OK
N/A
Comments
Walk-around Inspection Completed
Controls Function Properly
Fall Protection Used
Warning Devices Operational
Tires/Tracks Good Condition
Hydraulics No Leaks
Guardrails and Gates Secure
Other Observations
Additional Comments/Findings
Operator Signature
Date