Safe Use & Operation of Elevating Work Platforms

Before hiring and operating an Elevating Work Platform, it’s essential to confirm that you understand the safe use, operating procedures, and safety requirements associated with this equipment.
Please complete the declaration form below to confirm you have received the necessary familiarisation or have prior experience operating an EWP.

Customer Declaration – V1

This customer checklist and declaration ensures that persons hiring an Elevating Work Platform have been familiarised with the safe use and operation, recommended safety equipment, and related information.

Familiarisation

Familiarisation(Required)

I DO require familiarisation in the safe use & operation of this Elevated Work Platform

I DO NOT require familiarisation, as I have prior experience in the safe use & operation of this Elevated Work Platform.

Machine Details

Model(Required)

Brand(Required)

EWP Type(Required)

Safety Confirmation

Safe Working Load (kg)(Required)

Confirmation(Required)

I understand the safe working load and I will not exceed this allowance.

Maximum Allowable Wind Speed (km/h or m/s)(Required)

Confirmation(Required)

I am aware the maximum allowable wind speed while operating this machine.

Six-monthly Safety Certificate Expiry Date(Required)

Confirmation(Required)

I have sighted the six-monthly safety certificate that has been issued for this equipment and understand when it expires.

Confirmation(Required)

I have sighted the “Manufacturers Operating Instructions” & “Using Elevated Work Platforms Safely” booklet stored on the equipment, and will reference this information before use.

Confirmation(Required)

I have sighted the operator log book and received instruction on it use.

Confirmation(Required)

I have been shown how to use the safety devices (emergency lowering) and will ensure I have a Rescue Plan in case of in emergency while working at height.

Confirmation(Required)

I understand the clearance requirements when working near overhead power lines.

Customer Declaration

I believe I have received adequate familiarisation and supporting information to safely and properly operate the equipment listed above. I will ensure this information is passed on to any other persons operating this equipment.

Name of Hirer / Operator(Required)

Signature of Hirer(Required)

Date(Required)

Phone

This field is for validation purposes and should be left unchanged.

Safe Use & Operation of Elevating Work Platforms

Customer Declaration – V1

Familiarisation

Machine Details

Safety Confirmation

Customer Declaration

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