| Facilities Checklist Appendix 8 | ||
|---|---|---|
| 1 | Full physical address details of the premises, including name of organisation, street address, suburb/industrial area, city/ town and the location of the practical training/test route area at premises | ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ |
| 2 | Lifting machine code/s and description/s for which training is offered at the premises | ___________________________ ___________________________ ___________________________ |
| 3 | Description of equipment used and identification number of equipment | ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ |
| 4 | The lifting machine capacity or rating | ___________________________ ___________________________ ___________________________ |
| 5 | Description of any attachments fitted to the lifting machine | ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ |
| 6 | A general description of the duration training, re-certification done and test route used at the premises | ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ |
| 7 | Describe any limitations to the training and test route that may deviate from the standard routes set out in the code of practice for a specific lifting machine code. | ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ |
| 8 | Describe any inherent dangers prevalent in the use of the lifting machine at the premises. | ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ |
| Signature of Client ____________ | Signature of facilitator____________ | |
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