DOCK LEVELER FAULT REPORT

Bay / door number:
Site and access notes (guard shack, safety video, hours):
On-site contact and mobile:

EQUIPMENT
  Type:  mechanical / hydraulic / air-powered / edge-of-dock / not sure
  Manufacturer (from records or a safely accessible nameplate):
  Model:
  Serial number:
  Load class or capacity from the plate:
  Controller (push-button station / traffic light controller / panel):
  Known options (auto return, interlock, restraint, lights):

WHAT HAPPENED
  Date and time of the original event:
  What the DECK did:
  What the LIP did:
  Sound at the moment it failed (silence / hum / buzz / motor running / bang):
  Exact wording of any message, light or indicator:
  Was a trailer at the dock?      yes / no / unknown
  Is a trailer trapped now?       yes / no / unknown
  Fluid visible from a safe position?  yes / no / unknown
  Any recent work on this leveler (date and what was done):
  Has it been getting worse over time?

CURRENT STATUS
  Bay barricaded and out of service?   yes / no / unknown
  Deck position:   stored / raised / below level / stuck at:
  Lip position:    folded / extended / hanging down / stuck at: