Crane Inspection Report Checklist

• Annual Crane Inspection Report

• Customer

• Inspection No.

• Conducted on

  Date
• Location
  Address

• Serial No.

• Unit No.

• Inspected by

Crane Information

• User

• undefined

undefined

• Yes

  No

  N/A

undefined

• Yes

  No

  N/A

undefined

• Yes

  No

  N/A

• Make

• Model

• Boom type

• Boom length

• Jib type

• Jib length

• Engine make & model

• Hours

• Owner

Historical data

• Monthly inspection reports

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Maintenance records

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Repair/modification records

  Satisfactory

  Deficiency

  Recommendation

  N/A

General

• Sheet metal

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Guards/covers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Safety/warning decals, labels

  Satisfactory

  Deficiency

  Recommendation

  N/A

• External lights

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Housekeeping

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hand signal chart (outside)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Paint condition/corrosion

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Powerplant

• Turbocharger

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Oil pressure

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Blow by

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Starting ability

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Exhaust system/guards/insulation

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Oil leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Air cleaner

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Engine mounting hardware

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Operational condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoses/belts

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Block heater

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Electrical

• Batteries

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Wiring

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lights

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Alternator

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Starting system

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Instrumentation

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Switches

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Backup/travel/swing alarm

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Cooling System

• Radiator

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Fan/belt/guards

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Fan type

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Water temperature

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Fuel System

• Operation

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lines & Pump

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Tank

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Transmission

• Crane drive type

  Crawler

  Wheeled

• Operation

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Clutch slippage

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Oil cooler

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• 2-4 wheel shifter

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Torque Converter

• Charge pressure

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Temperature

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Filter

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Differential

• Crane drive type

  Crawler

  Wheeled

• Operation

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Drive line

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Axles

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Planetaries

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Differential lock

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Hydraulic System

• Pumps

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Valves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Reservoir

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoses & pipes

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Oil level

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Control valves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cylinder condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Swivels

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Solenoid valves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Operational

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Swing box

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Steering

• Crane drive type

  Crawler

  Wheeled

• Front steer

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Rear steer

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cylinder condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Steer valve

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Connections

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Steer knuckles

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Oscillation Lockout

• Crane drive type

  Crawler

  Wheeled

• Valve condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cylinder condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Fifth wheel

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Tires & Wheels

• Crane drive type

  Crawler

  Wheeled

• Cuts/wear

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lugs & nuts

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Rims

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Size (manufacturers spec)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Ply (manufacturers spec)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Brakes (travel)

• Drums & Linings

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Roto chambers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Service and park brake operation

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoses & lines

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Car Body & Crawler Assembly

• Crane drive type

  Crawler

  Wheeled

• Car body

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Travel locks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Steering clutches/dogs

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Chains & sprockets

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Track pads/pins

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Idlers/inter. Rollers/tumblers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Side frames

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Carrier Frame

• Weld or metal cracks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Distortion

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Bolts

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Modification

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Outriggers/Assembly Jacks

• Boxes

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Beams and arms

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cylinders, leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Solenoid valves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Pins & connections

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Floats & keepers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Holding valves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoses & pipes

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cracks & breaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Counterweight

• Modifications

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Mounting & warning decals

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Cab

• General condition of cab

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Glass

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Seat & seatbelt

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Seat & armrest switches

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Capacity chart & operators manual

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Windshield wiper

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Heater

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Horn

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Air conditioner

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Control levers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Instrument panel

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Steering wheel

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Pedals

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Door & latches

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Load Indicator & Anti Two Block

• Type

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Operational condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Accuracy

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Operator's manual

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Main Load Block & Hook

• Manufacturer

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Capacity markings

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Weight markings

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Sheaves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Safety latch

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hook

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Bearing

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Swivel

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Reeving

  Satisfactory

  Deficiency

  Recommendation

  N/A

• NDT results

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Headache Ball & Hook

• Manufacturer

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Capacity markings

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Weight markings

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Sheaves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Safety latch

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hook

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Swivel

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Bearing

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Reeving

  Satisfactory

  Deficiency

  Recommendation

  N/A

• NDT results

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Boom (Hydraulic)

• Boom type

  Lattice

  Hydraulic

• Alignment

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Wear pads

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Bends or twist

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Abuses

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Stress marks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cracks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lubrication

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Point sheaves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Guides & guards

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Telescope cylinders

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom hinge pin

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom lift cylinders

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cylinder pins

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoses & reels

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Length

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Boom (Lattice)

• Boom type

  Lattice

  Hydraulic

• Boom section identification

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom sequence/rigging

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Spreader bars

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Sheaves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoist line dead end

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Wire rope retainers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom foot pins/keepers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom head section

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Chord and lacing members

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Connecting pins/bolts

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Jib/Strut

• Jib/strut present

  Yes

  No

  N/A

• Strut

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Sheaves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Wire rope retainers

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Chord & lacing members

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Connecting bolts/pins

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Attachments (Boom Extensions, Aux. Boom Nose)

• Modifications

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Attaching points

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Alignment

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Damages

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Sheaves condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lattice & chords

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Pendant lines

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Turn buckles & pins

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Stow brackets

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Auxiliary boom nose

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Boom Support System

• Boom type

  Lattice

  Hydraulic

• Gantry/mast

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom stops

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Inner bail

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Outer bail/equalizer

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Sheaves

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom hoist reeving (manufacturer specs)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Shipper (Structure)

• Alignment

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Weld or metal cracks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Turntable Bearing

• Bearing deflection

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Bolts

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Teeth pattern

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Pinion gear/ring gear (wear)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lubrication

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Freeness of swing

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Swing brake & house locks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Swing box noise

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Rotating Upper Structure

• Crane type

  Lattice

  Hydraulic

• Turntable-roller/roller path

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Main hoist clutch/brake

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Main hoist wrapping on drum (minimum 2 wraps)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Auxiliary hoist wrapping on drum (minimum 2 wraps)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Auxiliary hoist clutch/brake

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom hoist clutch/brake

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Boom hoist gears/shaft/etc.

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Drums/flanges

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Clutch/brake protection

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Torque converter

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Access to cab & roof

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Air system- compressor/lines

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Hoist

• Condition of drums

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Hoist brakes

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Leaks

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cable followers & spooling

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Lube inside drum

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Alignment

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Mounting

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Operational

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Cable condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Rotation indicator

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

Wire Rope

• Main hoist wire rope (damage, broken wires, lube, ends)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Size/type/construction/grade

• Measured wear

• Auxiliary hoist wire rope (damage, broken wires, lube, ends)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Size/type/construction/grade

• Measured wear

• Boom hoist wire rope (damage, broken wires, lube, ends)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Size/type/construction/grade

• Measured wear

• Pendants wire rope (damage, broken wires, lube, ends)

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Size/type/construction/grade

• Measured wear

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Size/type/construction/grade

• Measured wear

Miscellaneous

• Anti-skid material

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Metal condition

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Fenders

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Loose & broken bolts

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Rust areas

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Angle indicator

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Tow winch

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Fire extinguisher

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Other

  Satisfactory

  Deficiency

  Recommendation

  N/A

No Load Operational Test

• No load operational test

  Satisfactory

  Deficiency

  Recommendation

  N/A

Load Test

• Load test performed

  Yes

  No

  N/A

• Main hoist load tested

  Yes

  No

  N/A

Main hoist

• Hoisting from

• Main boom length

• Main boom angle

• Parts of line

• Rated capacity

• Test weight

• Percent of capacity

• Load test results

  Satisfactory

  Deficiency

  Recommendation

  N/A

• Auxiliary/jib hoist load tested

  Yes

  No

  N/A

Auxiliary/jib hoist

• Hoisting from

• Main boom/jib length

• Main boom/jib angle

• Parts of line

• Rated capacity

• Test weight

• Percent of capacity

• Load test results

  Satisfactory

  Deficiency

  Recommendation

  N/A

Conclusion

• MGX Equipment services LLC. Shall perform its services of visually inspecting the subject crane with care, skill, and diligence, in accordance with the applicable professional standards recognized in the profession; however, MGx has not made and does not make any guarantees or warranties of any kind with the respect to the condition of the subject crane or its fitness, suitability, or acceptability for any particular use or purpose, and MGX shall not be liable for any latent or material defects therein.

• Sticker issued

  Yes

  No

  N/A

• Owner or reps. Signature

  Sign

• Inspectors signature

  Sign

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A