ABLIR-001-10
Document inspection findings with an annual boom lift inspection report in a three-copy format. This printed checklist form includes machine identification, inspection results, comments and signature fields, with one white, one yellow and one pink copy per report set.
The example form is headed “Boom Lift & Trailer Mounted Boom Lifts” and “Annual Machine Inspection Report.” It includes fields for company contact details, serial number, machine number, hourmeter reading, previous inspection date, account holder and product owner/user.
Checklist sections include functions and controls, platform assembly, boom assembly, turntable, chassis, power system, hydraulic/electrical system, manuals and decals, and general checks. Result columns are marked Y (Passed), N (Failed), C (Corrected) and NA (Not Applicable). Comments and account-holder and owner/user signature fields provide space to document findings and acknowledgment.
The pictured form contains JLG-specific references, including “JLG Account Holder,” and instructions referring to the operator’s and service manuals. Review the example image and compare it with the manufacturer’s current procedures for your particular machine before ordering. It is not presented as a universal checklist for every boom lift, scissor lift, automotive lift or boom truck.
This annual report is not a daily/pre-use checklist, inspection service or certification. A blank form does not establish that an inspection has been performed, qualify an inspector or guarantee compliance. Use the appropriate manufacturer instructions and inspection program to determine the required checks and timing.
The three-copy format lets you distribute the completed report among equipment, inspector and owner records according to your recordkeeping procedures. For separate date-record labels, browse our inspection stickers and inspection reports. Adhesive inspection stickers are separate products, not included in these report sets.