Gondola Number

Location

Application Date

1. Are the operators attended the Safety Orientation Briefing (Safe use of Gondola) conducted by the Gondola Supervisor?

2. Are the operators authorised to use the Gondola?

3. Are LM certificate update?

4. Are the operators briefed on the safe work procedure for the work to be carried out?

5. Are ground floor barricaded with proper access?

6. Are warning signboard (minimum 2 in no.) placed at strategic?

7. Are operators equipped with good condition and compatible personal protective equipments for safety harness and rope grab?

8. Is the control box in the Gondola covered and locked?

9. Are there two suspended wire ropes and two safety wire ropes provided for the cradle?

10. Are the wire ropes used to suspended the cradle kept tight and vertical?

11. Are the signboard “safe working load (maximum 300kg)” and “maximum allowable number of operators (not more than 2 persons)” prominently displayed on the cradle?

12. Are the lifelines strong enough to carry man load?

13. Are all lifelines anchorage point secure?

14. Are lifeline free from kinks and damage?

15. Are the tension weights properly secured to the safety wire ropes above ground level?

16. The Gondola titled less than 30 degree when it raise 1 meter above ground. (To check whether the safety devices (Block Stop) is in good working condition)

1. Name of Worker

Site Pass Number

Signature

2. Name of Worker

Site Pass Number

Signature

Inspected By

Signature

Date