Multi-Point Lift Inspection
Location: Yuma shop 68 Date:
       Inspected By:
             Address: 536 E 20th st Yuma AZ 85365
              Phone# (928) 753-9595
Lift Manufacturer: Bendpak
          Lift Serial # 9568-001-013
            Model # XPR-10S
                         2 Post 4 Post Scissor Low/Mid Rise
          Lift Type:        X
           Capacity:        10,000 lbs.  Bay#       1
                                                                                                              Yes   No
          Owner's Manuals, Safety Instructions / Lifting point guide book accessible?
        Please Note: This inspection is not intended to guarantee against failure or malfunction.
                       Its purpose is to verify that the lift has been maintained in a reasonable manner
                       and that supporting documents supplied by manufacturer are accessible to the
                       operator to assist in the operation of the lift and to call attention to any repairs
                       that may be needed to correct existing or potential malfunction.
                              Common Inspection Points (All lifts)
                                                                     Pass       Needs Attention           Fail      N/A
  Accessibility & readability of safety warning labels on
                                                     lift:
              Confirm adequacy of clearance around lift:
    Examine structural components including welds for
                signs of fatigue , overloading & misuse:
              Inspect lift controls for proper operation:
                  Check fluid levels and contamination:
           Examine electrical components and wiring:
                  Check all points requiring lubrication:
  Check for proper installation and condition of spotting
                                                   dish:
      On lifts with adaptors, check condition and proper
                                             operation:
                 Are extended height adaptors available?
     Check all accessories for construction and labeling:
Check all fastening devices for tightness (Including floor
                                            anchor bolts):
     On lifts with overhead structure, verify the "safety
                            shutoff" operates properly:
                   Common Inspection Points (All lifts) Continued
                                                              Pass   Needs Attention   Fail   N/A
     Operate the lift & check the operation of lift locks:
                                 (Including latch cables)
On lifts with secondary latch devices, check operation &
                                              condition:
                      Hoses, Piping, Tubing & Hydraulic Cylinders
                                                              Pass   Needs Attention   Fail   N/A
     Check all accessible piping, tubing, hoses, valves &
             fittings for visible leaks & proper routing:
     Check hydraulic cylinder for smooth operation and
                                                    leaks:
                                   Cables, Chains & Sheaves
                                                              Pass   Needs Attention   Fail   N/A
 Inspect sheaves for proper alignment & cracks. Ensure
                            sheave shields are in place:
      Inspect all cables & or chains for frays, stretching,
             corrosion, cracking & proper adjustments:
         Check for tracking & routing of cables & chains:
                                Lifts using swing arms: check
                                                              Pass   Needs Attention   Fail   N/A
         Lifts using swing arms: check telescoping stops:
   Lifts requiring swing arm restraints: check for proper
                             function & abnormal wear:
     Lifts equipped with platforms, railing or stairways:
                    check to ensure proper adjustment:
Notes: