The following information is required from suppliers of plant prior to beginning work on site.
Subcontractor
(Company name)
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Subcontractor / Supplier Rep:
Subcontractor employee name
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Serial No.:
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Description of Plant/Equipment:
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Make & Model:
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Year of Manufacture:
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Attach Plant Hazard Risk Assessment
Yes
No
N/A
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Manufacturers Operators Manual available
Yes
No
N/A
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Preoperational Check Log Book available
Yes
No
N/A
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Current Maintenance Records available (refer to operators manual for service intervals)
Yes
No
N/A
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Registration of Plant Design information available (Vic - All EWP’s, National – As required) (Design Registration No. __________________________)
Yes
No
N/A
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Ten-year certification (major inspection completed if applicable, then every five years)
Yes
No
N/A
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Motion beeper working
Yes
No
N/A
Notes
Flashing light working
Yes
No
N/A
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Gate locks engaging – self-closing gate operational
Yes
No
N/A
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Platform handrail / frame in good condition
Yes
No
N/A
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Electrically tested and tagged (RCD & charging cables - if applicable)
Yes
No
N/A
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Safe working load (SWL) of platform clearly marked
Yes
No
N/A
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Safety Harness in good condition with inspection doc’s available (boom type MEWP)
Yes
No
N/A
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Secondary guarding (safety crush) device fitted to the elevated work platform
Yes
No
N/A
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Emergency stop and ground control function checked
Yes
No
N/A
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Comments:
Include any project specific items that maybe required to be fitted to the plant from the project risk assessment document.
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Signature of Person Completing this Form:
Sign
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