Liberty Open - Operator & Maintenance Manual
Periodic Examination Certificate
1.
Property Details
2. Lift Details
Model
Description
Install Date
Serial No
3. Construction of Lift
Are all parts of good mechanical construction, sound
material and adequate strength (so far is ascertainable)
YES
NO
4. Lift Condition
Service Report
Serviceable
Requires
Replacement
Serviceable
Requires
Replacement
Motors, gears, brakes, drums
Labelling (incl. SWL)
All safety edges/limits
Lights/alarm
Lift enclosure
Oil levels & seals
Guide rails, tracks and fixings
Hydraulic components
Push buttons
Batteries
Pads and Guides
Door mechanism
Trailing cables
Door/Gate Interlocks
Wiring and fuses
Door locks
Isolators
All fixings
Manual lowering
Safety circuits/fuses
5. Accessibility
Were any parts of the lift inaccessible for
inspection or service?
6. Repairs, Renewals or Alterations
What repairs, renewals or alterations are required to enable
the lift to continue to be used with safety?
If no such repairs, renewals or alterations are required, enter
none.
Immediately
Within a specified time limit
Lift Location
Inspection/Examination Company
Name:
Address
Tel No:
OP00 7100_A.doc
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