Lift survey report checklist
This form is to be used when undertaking a site survey
What does this form include?
This form contains 117 sections:
Lift Manufacturer
Maximum persons
Maximum load kgs
Speed M/S
Lift details
Drive type
Motor room location
Installation date
Modernisation date
Number of floors served
No of landing entrances
Floors served front
Floors served rear
Floors served left hand side
Floors served right hand side
Shaft width mm
Shaft depth mm
Pit depth mm
Headroom mm
Travel mm
Summary Report
Recommended health and safety works
Recommended DDA upgrade works
Recommended upgrade / replacement works
Motor Room
- Is the motor room access safe with suitable lighting and emergency lighting and any access ladders over 2M in height fitted with hooped protection?
- Is the motor room door lockable and fitted with an internal release and displaying current motor room entrance notices?
- Are any trap doors of sound construction, counterbalanced and marked with the safe working load?
- Does the motor lighting meet current standards (200 lux at floor level)?
- Is emergency lighting fitted and working correctly?
- Is the motor room light switch fitted adjacent to the motor main entry point and clearly identified?
- Can the lift car lighting be isolated within the motor room / control panel (MRL)
- Is the mains isolator lockable?
Main isolator rating (amps)
Motor room comments
Control panel manufacturer
Control panel age
Control Panel
- Is there a high voltage warning notice fitted to the control panel door and heat notices were resistor boxes are externally mounted?
Microprocessor manufacturer and type
VF Drive Manufacturer and Type
Ellison type overload device fitted?
Control panel comments
Tank manufacturer
Valve block manufacturer
Valve block details
Hydraulic Drive System
- Is the valve block of an obsolete design?
Hydraulic Drive System Comments
Motor manufacturer
Traction Machine
Motor HP/ Kw
Motor amps
Gear unit manufacturer
Brake manufacturer
Sheave size mm
Number of ropes/chains and size I.e. 4 x 13mm
Traction Machine Comments
Overspeed governor location
Overspeed Governor
- Is guarding fitted to the overspeed governor?
Electrical tripping speed (m/s)
Mechanical tripping speed (m/s)
Overspeed governor comments
Door manufacturer
Door operator type
Entrances
Door protection
Car door type
Landing door type
Door width (mm clear opening)
Door height (mm clear opening)
Door finish - lift car
Door finish - landings
Landing architrave type
Landing architraves finish
Entrances comments
Landing push finish
Landing station mounted
Landing station lowest button (mm)
Landing station highest button (mm)
Landing indicator finish
Landing indicator mounted
Landing pushes and indicators
Landing station comments
Landing DDA Compliance
- Landing station height and position correct?
- Are Braille / tactile buttons fitted?
- Is audible call acceptance fitted?
- Is visual call acceptance fitted?
- Are landing indicators fitted (above 2 floors)?
- Are hall lanterns fitted (above 2 floors)?
- Have tactile floor ID plates been fitted at all floors?
- Is an arrival gong fitted?
Car width (mm)
Car depth (mm)
Car height (mm)
Car wall finishes
Car ceiling finishes
Car floor finishes
Lift Car
- Are bump rails fitted within the lift car?
Lift car lighting type
Lift car lighting mounting
Distance to nearest corner (mm)
Height lowest button (mm)
Height highest button (mm)
Number of key switches fitted?
Key switches operate?
Lift Car Comments
Lift Car DDA Compliance
- Entrance size and type?
- Car station height and position correct?
- Are Braille / tactile buttons fitted?
- Is audible call acceptance fitted?
- Is visual call acceptance fitted?
- Visual floor identification fitted (above 2 floors)?
- Audible floor identification fitted (above 2 floors)?
- Autodialler and acoustic loop or emergency call system fitted? i.e. wardens call
- Handrail fitted in the lift car?
- Mirror fitted in the lift car?
- Car lighting a minimum of 100 lux at floor level?
- Are infra-red full height safety edges fitted?
Shaft selector type
Car Top
- Is a up inspection limit fitted?
- Is a car top control conforming to either EN81- 1/2 or BS7255 enhanced version fitted?
- Is a run (common) button fitted
- Is an emergency stop switch located with 1 metre of the landing threshold?
- Is a car top light fitted, did it operate correctly at the time of survey?
- is emergency lighting fitted to the car top?
- Is a RCD protected socket fitted?
- Is a car top emergency communication device fitted?
- Are all pulleys on the car top painted yellow and guarded?
- Are there any voids around the top of the lift car in excess of 300mm?
- Where voids exceed 300mm is a securely fixed and rigid car top balustrade fitted complete with mid bar and toe board?
Car Top Comments
What are the shaft walls constructed in?
What are the door nibs constructed in?
What is the shaft roof constructed in?
What is the lift pit constructed from?
Lift Shaft
- Is the well enclosure continuous floor to ceiling?
Number of buffers fitted
Type of buffers fitted
Lift Pit
- Is there a suitable access ladder to allow safe access and egress to and from the pit area?
- Is the pit stop switch(es) easily accessible form both the pit and landing?
- Can the shaft lighting be switched on/ off from the lift pit?
- Is there a 240v pit socket fitted?
- On traction lifts is a counterweight screen which extend to an height of 2.5M from the pit floor fitted?
- Are pit division screens fitted up to an height of 2.5M where the lift shares a shaft?
- Is the pit clear of any water or oil?
- on hydraulic lifts are lifts with shallow pit depths, is a mechanical restraint provided?
- Is the mechanical restraint electrically interlocked?
- On shallow pits, is a restricted pit depth notice displayed?
- Was the pit found in a clean condition and free of rubbish?
- Are drip trays fitted to the base of the car and counterweight guides?
- Is the overspeed governor return pulley electrically switched?
- Is the overspeed governor return pulley guarded?
- Is there a compensation rope/chain pulley fitted?
- Is the compensation rope/chain pulley electrically interlocked?
Lift Pit Comments
Car Sling
- Type of safety gear fitted
Type of guide shoes fitted
Type of compensation fitted
Sling comments
Hydraulic Cylinder
- Number of hydraulic rams fitted?
Hydraulic cylinder comments
Counterweight
Type of filler weights fitted
Counterweight comments
Lift Maintenance and Breakdowns
- Is a current log card available?
Number of maintenance visits completed in the last twelve months
Comments on maintenance
Number of breakdowns in the last twelve months
Comments on lift breakdowns
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