Enclosure 6 - WTL Testing.pdf

This is a template form for certification of load testing and condition inspection of aerial lift platforms used by the Naval Facilities Engineering Command (NAVFAC). The form documents the performance and safety verification of aerial lift equipment at federal facilities.

The form captures essential inspection data including lift identification number, type, OEM-rated capacity, building/location, and lift height measurements. It accommodates two certification types: Annual Certification and Interim Recertification (with space to specify the reason). The testing section records actual test loads in pounds for both main and extension components, with fields for applicable test procedure paragraphs and notes. Certification signatures are required from three authorized personnel—the test director, inspector, and certifying official—each with corresponding dates. The form also includes an expiration date field and a remarks section for additional documentation. This form serves as an official record that aerial lift platforms meet safety and operational standards required for continued use at naval facilities.