Lift Installation.

Site Survey & Specification Checklist

Pre-Install Agreement

Lift Make

Lift Model

Acknowledgement

By signing below, verification is made that all permits and/or concrete floor engineering (if required) are the responsibility of the customer. Lum's Sales and Service assumes no liability for the structure or concrete floor in which the lift is to be installed.

Digital Signature

Date

2026-04-04

Job Site Information

Site & Tech Specs

Ceiling Height

REQUIRED

ACTUAL

Clearances

Front:

Area is ClearHeaters, lights, benches removed

Rear ClearanceAdequate for longest vehicle

Power Specs

VOLTAGE

PHASE (1 or 3)

Concrete

THICKNESS (Inches)

inches

Min 4.5" typical requirement

CONDITION

GOODNo significant cracksPOORCracks / Deterioration

Floor Variance:

Installation Logistics

HYDRAULIC OIL (5 Gallons AW32)

Unloading Assistance NeededI acknowledge that assistance is required or extra charges apply.

Verified Accurate to Best of Knowledge