Genie Z45/25 Operating Instructions page 4

CONTRACT # _________ EMPLOYEE NAME: _____________________
QUALIFIED OPERATOR ACKNOWLEDGMENT
1. Operator was shown the Operator and ANSI Manuals.
OPERATORS INITIALS ____________
2. Operator understands that a "Pre-Operation Inspection and Function Test" must be performed before each
shift. These procedures are detailed in the Operator's Manual. If any problems or malfunctions are found Do
Not Operate This Lift! Immediately call A Tool Shed so we can repair or replace the lift.
OPERATORS INITIALS ____________
3. Before using this lift the Operator will inspect the jobsite for hazards, including but not limited to: operation
surface irregularities, drop offs, holes, debris, obstructions (floor or overhead), high voltage conductors, wind,
or adverse weather.
OPERATORS INITIALS ____________
4. Operator Acknowledges that they are Qualified to operate this lift.
OPERATORS INITIALS ____________
5. Only Qualified persons shall operate the equipment, and shall do so in accordance with the full provisions
outlined in the operator's manual provided. Only lessee's trained operators are authorized to operate the
equipment. Do not lend, or sub-lease this equipment.
OPERATORS INITIALS ____________
Customer Acknowledges the Paint on this Lift is:
EXCELLENT _____ GOOD _____ FAIR _____
COMMENTS______________________________________________________________________________
_________________________________________________________________________________________
OPERATORS SIGNATURE: _______________________ DATE: ___________
PRINTED NAME: _______________________