LOLER INSPECTION CHECKLIST LOLER INSPECTION CHECKLIST - PF026.3 Go to top Date of Thorough Examination * Date of Report * Name of the employer for whom to examination was made: * Address of the premises at which the examination was made: * Make & Model Serial Number Equipment Description (with details of location, department, etc.) * SWL * Date of Last inspection (If Known) Was the examination carried out within a 6 months or 12 months interval? * Was the examination carried out in accordance with an examination scheme? * YesNoN/A Was the examination carried out after the occurrence of exceptional circumstances? * YesNoN/A Are there any defects to report which could become a danger to persons? * YesNoN/A Please describe the defect * Have any Repairs, Renewal or alterations been made to the equipment? * YesNoN/A Please Describe Method of test carried out * Was a calibrated test weight used in the examination? * YesNoN/A State Weight Used & Identification number and next test date of calibrated equipment used Date of Next Calibration IS THIS EQUIPMENT SAFE TO BE USED? * YESNO Name of qualified examiner * Signature of person authenticating the report * signature keyboard Clear If you are human, leave this field blank. Submit
