Title Page
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Type of inspection
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Work Order Number
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Unit No.
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Prepared by
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Conducted on
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Location
Crane Information
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Work Order Number
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Machine Unit Number
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Time and Date
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Location
Historical data
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Annual Inspection Date
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Picture of Annual Inspection Paper
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Hours
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Picture of Hour Meter
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Last Serviced Hours
Cab
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General condition of cab
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Fuel Level - Note amount added
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Picture of Fuel Gauge
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Glass
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Seat & seatbelt
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Seat & armrest switches
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Fire extinguisher
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Fire Extinguisher
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Operators Manual
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Picture of Operators Manual
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Capacity Chart
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Picture of Capacity Chart
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Windshield wiper
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Heater
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Horn
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Air conditioner
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Control levers
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Instrument panel
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Pedals
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Door & latches
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Pictures of inside of cab
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Notes
General
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Sheet metal
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Guards/covers
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Safety/warning decals, labels
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External lights
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Housekeeping
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Hand signal chart (outside)
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Paint condition/corrosion
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Notes
Powerplant
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Turbocharger
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Oil pressure
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Blow by
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Starting ability
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Exhaust system/guards/insulation
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Oil leaks
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Air cleaner
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Engine mounting hardware
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Operational condition
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Hoses/belts
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Block heater
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Notes
Electrical
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Batteries Dates
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Wiring
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Lights
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Alternator
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Starting system
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Instrumentation
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Switches
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Backup/travel/swing alarm
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Notes
Cooling System
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Radiator
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Leaks
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Fan/belt/guards
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Notes
Fuel System
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Operation
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Lines & Pump
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Tank
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Leaks
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Notes
Hydraulic System
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Pumps
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Valves
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Reservoir
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Hoses & pipes
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Oil level
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Control valves
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Leaks
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Cylinder condition
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Swivels
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Solenoid valves
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Operational
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Swing box
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Notes
Differential
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Operation
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Drive line
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Planetaries
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Notes
Brakes (travel)
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Drums & Linings
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Service and park brake operation
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Hoses & lines
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Notes
Car Body & Crawler Assembly
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Car body
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Travel locks
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Steering clutches/dogs
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Chains & sprockets
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Track pads/pins
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Idlers/inter. Rollers/tumblers
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Side frames
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Notes
Carrier Frame
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Weld or metal cracks
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Distortion
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Bolts
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Track Wedges
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Notes
Outriggers/Assembly Jacks
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Boxes
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Beams and arms
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Cylinders, leaks
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Solenoid valves
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Pins & connections
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Floats & keepers
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Holding valves
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Hoses & pipes
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Cracks & breaks
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Notes
Counterweight
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Pins & Keepers
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Mounting & warning decals
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Notes
Angle Indicator
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Operational Condition
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Serial Number
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Accuracy
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Picture of Angle Indicator
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Notes
Load Indicator
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Serial Number
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Operational condition
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Accuracy
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Picture of Load Cell
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Notes
Wind Speed Indicator
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Wind Speed Indicator
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Serial Number
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Operational condition
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Accuracy
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Picture of Wind Speed Indicator
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Notes
Anti-two Block
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Serial Number
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Operational Condition
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Picture of all Anti-two Block Switches
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Notes
Main Load Block & Hook
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Load Block
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Picture of Tag
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Picture of Load Block
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Sheaves
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Safety latch
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Hook
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Bearing
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Swivel
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Reeving
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Notes
Headache Ball & Hook
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Headache Ball
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Picture of Headache Ball
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Picture of Tag
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Sheaves
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Safety latch
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Hook
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Swivel
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Bearing
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Reeving
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Notes
Boom (Lattice)
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Boom section identification
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Spreader bars
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Boom head section
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Sheaves
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Hoist line dead end
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Wire rope retainers
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Boom foot pins/keepers
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Chord and lacing members
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Connecting pins/bolts
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Pictures of Each Boom Section
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Notes
Jib/Strut
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Jib/strut present
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Strut
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Sheaves
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Wire rope retainers
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Chord & lacing members
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Connecting bolts/pins
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Picture of ALL Jib Sections
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Notes
Boom Support System
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Gantry/mast
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Boom stops
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Inner bail
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Outer bail/equalizer
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Sheaves
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Boom hoist reeving (manufacturer specs)
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Notes
Turntable Bearing
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Bolts
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Teeth pattern
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Lubrication
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Freeness of swing
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Swing brake & house locks
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Swing box noise
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Pictures of swing gears
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Notes
Rotating Upper Structure
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Main hoist clutch/brake
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Main hoist wrapping on drum (minimum 2 wraps)
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Auxiliary hoist wrapping on drum (minimum 2 wraps)
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Auxiliary hoist clutch/brake
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Boom hoist clutch/brake
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Boom hoist gears/shaft/etc.
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Drums/flanges
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Clutch/brake protection
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Access to cab & roof
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Air system- compressor/lines
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Notes
Hoist
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Condition of drums
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Hoist brakes
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Leaks
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Cable followers & spooling
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Lube inside drum
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Alignment
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Mounting
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Operational
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Rotation indicator
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Notes
Wire Rope
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Auxiliary hoist wire rope (damage, broken wires, lube, ends)
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Picture of Aux Wire Rope
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Main hoist wire rope (damage, broken wires, lube, ends)
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Picture of Main Wire Rope
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Boom hoist wire rope (damage, broken wires, lube, ends)
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Picture of Boom Hoist Rope
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Pendants wire rope (damage, broken wires, lube, ends)
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Picture of Ends of Pendants
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Notes
No Load Operational Test
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No load operational test
Load Test
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Load test performed
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Main hoist load tested
Main hoist
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Hoisting from
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Main boom length
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Main boom angle
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Parts of line
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Rated capacity
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Test weight
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Percent of capacity
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Load test results
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Auxiliary/jib hoist load tested
Auxiliary/jib hoist
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Hoisting from
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Main boom/jib length
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Main boom/jib angle
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Parts of line
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Rated capacity
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Test weight
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Percent of capacity
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Load test results
Pictures of Machine
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4 Pictures of all sides of machine
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Signature