LOLER ROTE — MEWP / Scissor Lift / Boom Lift — lolerflow.co.uk

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Report of Thorough Examination — MEWP / Scissor Lift / Boom Lift

LOLER 1998 (SI 1998/2307) — Schedule 1 Compliant · Carries persons: examination interval 6 months
Template provided by lolerflow.co.uk · Free to use and reproduce

This equipment carries persons — LOLER Regulation 9(3)(a) requires examination at least every 6 months.

Certificate / Reference Number

Date of Examination

Type of Examination

Periodic First use Post-incident

1 · Employer and Site Details (Schedule 1: a, b)

Name of Employer (owner / duty holder)

Employer Address

Address of Premises where Examination was Carried Out

Postcode

2 · Equipment Identification (Schedule 1: c, e)

Type / Description

Manufacturer

Model

Serial Number

Date of Manufacture

Platform SWL

Max Platform Height

Asset / Location Reference

Date of Previous Thorough Examination (Schedule 1: d)

3 · Examination Findings

Components Examined — record condition against each item

Tests Carried Out

Test Load Applied

Test Result

Pass Fail N/A

4 · Defects Found (Schedule 1: i, j) — tick one

Category A Immediate Danger Equipment MUST be withdrawn from service immediately. Report must reach enforcing authority within 28 days (LOLER Reg. 10).

Describe defect, location, and reason for immediate withdrawal

Category B Not Immediately Dangerous May remain in service. Defect must be rectified by the date below.

Describe defect and location

Rectify by

No Defect No defects found. Equipment is safe to continue in service.

5 · Conclusion (Schedule 1: f, g, h)

Safe to continue in use?

Yes No

Date of Next Thorough Examination (Schedule 1: h) — max 6 months

If not safe — action required

6 · Competent Person Declaration (Schedule 1: k, l)

Full Name of Competent Person

Address of Competent Person

LEEA Membership No. (if applicable)

Signature of Competent Person

Date Signed

Company Stamp (optional)