02.11.2007
Lifter serial no.: .............................. .................................. other ID no. (if any):..........................................................
Client:............................................... .................................. ....................... .....................................................................
Inspection carried out by: (Block capitals)....................... ...............from.....................................................................
Molift certification no. for inspector/repairer (if any): ... ....................... .....................................................................
The equipment has been tested and is in full working order Yes No
Place: ......................................Date: .................Signature:....................... .....................................................................
Checkpoints for periodic inspection of Molift Partner 255/Molift Partner 230
Revision E – 09/2007
COMPULSORY SAFETY CHECK (annual):
OK Fault Corrected Visual inspection
Whole lifter checked for damage, cracks and deformation
and found to be in good order. (Especially suspension,
column, wheels and all cables).
Lifter has been correctly assembled and no parts are missing.
(Especially column, column lock and lifting arm).
Accessories have been checked. See separate form for sling.
Battery charger is an accessory.
List the accessories checked:………….………………..…
Function checks
Emergency stop and manual control have been checked and
are in working order.
The lifter has been rolled over the floor (preferably under
load) and runs easily and steadily.
Leg extender mechanism has been fully extended and
retracted (preferably under load), and moves evenly and
without noise (stops in correct positions).
The lifter has been fully raised and lowered (preferably
under load) and moves evenly and without noise.
Servicing required
Servicing unnecessary because the servicing lamp is on
green and the lifter is under 5 years old.
Completed Compulsory in case of faults under one of the above points:
The lifter has been removed from service and clearly marked "OUT OF
ORDER".
Certified personnel have been summoned to carry out repairs and servicing.
Name /Tel./ Fax:…………………………………………………………………
Completed Compulsory where lifter has been checked and approved:
The lifter has passed the safety check and been affixed with the Molift safety
check label, duly dated and signed.
The ticked and signed checklist has been passed to the client and a copy sent to
your Molift dealer.
.
Comments on faults and repairs: .... .................................. ....................... .....................................................................
.......................................................... .................................. ....................... .....................................................................
.......................................................... .................................. ....................... .....................................................................
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