MOBILE CRANE INSPECTION REPORT

• JOB NO:

• INSPECTION DATE:

  Date

• CLIENT / CONTROLLER:

• ADDRESS:
  Address

• CONTACT PERSON:

• PHONE:

• EMAIL:

• TYPE / DESCRIPTION:

• OFFICIAL NO:

• CLIENT ID:

• MANUFACTURER:

• SWL INDICATOR TYPE:

• VEHICLE TYPE/REG NO:

• BOOM CONFIG:

• RATING SHEET:

• CAPACITY:

• HOIST ROPE DIA:

• HOOKS SWL:

• LOCATION:

• HAZARD ASSESSMENT COMPLETED:

• 1. SWL & ID No. Visible

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 2. Maintenance Records

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 3. Rating Sheet (English, with Crane No.)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• OPERATIONAL:

• 4. SLI Alarms-Visual, Audible, Cut out

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 5. Anti – two Block, Main & Fly Jib

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 6. Radius Indicator

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 7. Boom Angle Indicator

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 8. Load Test (Load, Boom Length, Radius)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 9. Brake Test

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• CONDITION:

• 10. Cab (controls, emergency stop, horn)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 11. Outriggers

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 12. Front Stabiliser Leg

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 13. Wheels / Tyres / Tracks

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 14. Chassis & Superstructure

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 15. Hydraulic Rams & Hoses

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 16. Slew Ring Bearing & Bolts

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 17. Counterweight & Signage

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 18. Brakes & Clutches (Wear Indicators)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 19. Pawl Brake

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 20. Ropes (terminations, length)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 21. Sheaves

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 22. King Post & Luffing Gear

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 23. Boom / Jib (wear pads, extension ropes)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 24. Fly Jib and attachments

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 25. Hooks & Blocks

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 26. Other

• This item has been inspected in accordance with the relevant codes and standards and is being / not being recommended for certification.

  Recommended

  Not Recommended

CRANE CERTIFICATE OF INSPECTION

• JOB NO.:

• CLIENT / CONTROLLER:

• ADDRESS:
  Address

• EXPIRY DATE:

  Date

• TYPE / DESCRIPTION:

• OFFICIAL NO.:

• CLIENT ID:

• MANUFACTURER:

• LOCATION:
  Address

• VEHICLE TYPE/REG NO.:

• CAPACITY:

• INSPECTION DATE:

  Date

• CONTACT PERSON:

• On Inspection, the equipment was found in a safe condition, and is likely to remain safe for the period of which the Certificate is issued, if operated and maintained properly by the controller.
  (This certificate may be cancelled or suspended at any time in accordance with the PECPR Regulations) The controller must ensure that the certificate and any supporting documents in related to the equipment are to be available at the workplace for staff to access and examine.

• Equipment Inspector:

  Sign

• Reviewed By (Authorized Signatory):

  Sign