ICTSI Audit Template 6C

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

ECPM 4 Crane Elevator Maintenance - Issue Status A

• Confirm the Business Unit has cranes with Personnel Elevators Installed

• Elevator Inspection and Maintenance.

• Elevator Inspection and Maintenance Available points (max 10)

• Number of crane elevators installed in the BU

• Confirm crane elevators are inspected periodically according to a pre-defined program

  YES

  NO

• Elevator maintenance inspection plan details

• Elevator maintenance and inspection plan.

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Confirm BU policy to only use elevator manufacturer supplied spare parts

  YES

  NO

• Record the Purchase Order Numbers and Dates selected for Audit

Purchase Order

• Purchase Order Number

• Purchase Order Date

  Date

• PO

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Check a typical inspection program and record the following information:

• Confirm Inspection Program's for those elevators not having manufacturer recommendations have been prepared by a qualified consultant?

  Elevator Manufacturer

  3rd Party Consultant

  No Inspection Plan

• Name of Consultant

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include Procedures and Processes to be followed?

  YES

  NO

• Example of procedures and processes to be followed

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include requirements for inspector and maintainers qualifications?

  YES

  NO

• Details of inspectors minimum required qualifications.

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include reporting procedures?

  YES

  NO

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include frequency of inspections?

  YES

  NO

• Frequency of inspections

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include typical repair procedures?

  YES

  NO

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include diagrams and definitions of all structural, electrical and mechanical components to be inspected or tested?

  YES

  NO

• Example of diagrams

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include Inspection Record Sheets where inspection data and signatures may be recorded?

  YES

  NO

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Program's include Safety Instuctions?

  YES

  NO

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Inspection Program is in accordance with the Elevator manufacturer recommendations?

  Inspection in Accordance

  Inspection Not in Accordance

  No Inspection Plan

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Select crane elevators to be considered for audit and record the following information:

• Record the crane asset numbers of the elevators to be audited

Asset number

• Asset number

• Confirm hard copy of inspection records are on file?

  YES

  NO

• Inspection record number

• Inspection record

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Confirm maintainer qualification certificates are copied to the Inspection Records?

  YES

  NO

• Technician name

• Technician certificate

  Media

• Additional technician

Technician

• Technician name

• Technician certificate

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Confirm repair work and retesting records are retained on file and cross referenced to the original inspection record?

  YES

  NO

• Record dates of the most recent inspection(s)

Elevator

• Asset Number

• Elevator inspection date

  Date

• Details of repair work performed

• Inspection record

  Media

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Confirm inspections are in accordance with elevator manufacturer recommendations

  YES

  NO

• Corrective Action

Corrective Action

• Priority Level

  Select Priority One Priority Two Priority Three

  • Priority One
  • Priority Two
  • Priority Three

• Corrective Action Description

• Corrective Action Support Media

  Media

• Confirm drop tests were undertaken according to elevator manufacturer recommendations and at least every 6 months

  YES

  NO

• Record dates of the most recent "Drop Tests"

Elevator

• Asset Number

• Elevator "Drop Test" date

  Date

• Drop test record

  Media

• Comment on Risk Condition and explain as necessary

  SAFE

  AT RISK

• Risk condition comment.

• Elevator Inspection and Maintenance Support Media.

Support Media

• Support media

  Media

• Auditors Comments moment

Comment

• Comment

• ECPM 4 Marking Summary:

• ECPM 4 Score

• Add EPCM 4 Score Summary Media?

• Score Summary

  Media

• Auditor Signature

  Sign

• Add Additional Auditor Signature

Additional Signatory

• Auditor/Authorising Manager Signature

  Sign