MONTHLY CRANE/HOIST INSPECTION FORM

• Customer

  Select

• Date

  Date

• Inspector

  Select

Equip. I.D.

• ANC#

  Select

• CUST. EQUIP. #

  Select

Hoist

• UPPER & lOWER LIMIT

  Pass

  Fail

  N/A

• HOIST DRUM/LIFTWHEEL/GUIDE

  Pass

  Fail

  N/A

• LOAD BRAKE (CONTROL BRAKING)

  Pass

  Fail

  N/A

• MOTOR BRAKE (HOLDING BRAKE)

  Pass

  Fail

  N/A

• MOTORS/PINIONS/KEYWAYS

  Pass

  Fail

  N/A

• SHAFTS/COUPLINGS/KEYWAYS

  Pass

  Fail

  N/A

• GEARBOX/BEARINGS/SEALS/GASKETS

  Pass

  Fail

  N/A

• HOIST FRAME/LOAD BEARING COMPONANTS

  Pass

  Fail

  N/A

• UPPER/LOWER RUNNING SHEAVES/PINS

  Pass

  Fail

  N/A

• UPPER/LOWER EQUALIZING SHEAVES/PINS

  Pass

  Fail

  N/A

• LOWER HOOK BLOCK FRAME/GUARDS

  Pass

  Fail

  N/A

• LOAD HOOK & SAFETY LATCH

  Pass

  Fail

  N/A

• WIRE ROPE or LOAD CHAIN

  Pass

  Fail

  N/A

• REEVING & END CONNECTIONS

  Pass

  Fail

  N/A

Trolley

• MOTOR(S)(BEARINGS,COUPLINGS,PINIONS,KEYWAYS)

  Pass

  Fail

  N/A

• BRAKE(S)

  Pass

  Fail

  N/A

• GEARBOX(S)/OPEN GEARS

  Pass

  Fail

  N/A

• WHEELS(BEARINGS,AXLES,COUPLINGS,PINIONS,KEYWAYS)

  Pass

  Fail

  N/A

• RAIL(S), CLAMPS, BUMPERS, ENDSTOPS

  Pass

  Fail

  N/A

• FRAME,DROP LUGS, RAIL SWEEPS

  Pass

  Fail

  N/A

Crane

• END TRUCKS,BUMPERS,BUFFERS,RAILSWEEPS

  Pass

  Fail

  N/A

• WHEELS,BEARINGS,AXLES

  Pass

  Fail

  N/A

• GEARBOX(S),OPEN GEARS,BEARINGS,SEALS,GASKETS

  Pass

  Fail

  N/A

• GUARDS,SHAFTS,COUPLINGS,KEYWAYS,BEARINGS

  Pass

  Fail

  N/A

• MOTOR(S),PINIONS,KEYWAYS,COUPLINGS

  Pass

  Fail

  N/A

• CONNECTION,GIRDER,STRUCTURE & COMPONENTS

  Pass

  Fail

  N/A

• BRAKE(S) DISC,PADS,HUB & COMPONENTS

  Pass

  Fail

  N/A

• PLATFORMS,LADDERS,RAILINGS

  Pass

  Fail

  N/A

• CAB & SUPPORTING STRUCTURE

  Pass

  Fail

  N/A

Electrical Equipment & Controls

• COLLECTOR SHOE(S)

  Pass

  Fail

  N/A

• TROLLEY CONDUCTORS & COLLECTORS

  Pass

  Fail

  N/A

• MAIN CONDUCTORS & COLLECTORS

  Pass

  Fail

  N/A

• RESISTORS/SOFT STARTS

  Pass

  Fail

  N/A

• MAINLINE CONTACTOR, START/STOP CIRCUIT, FUSING

  Pass

  Fail

  N/A

• WIRING & FUSES

  Pass

  Fail

  N/A

• CONTROL PANELS & COVERS

  Pass

  Fail

  N/A

• CORD(S),CABLE(S),REEL(S),FITTING(S)

  Pass

  Fail

  N/A

• MAIN DISCONNECT (ISOLATED,CLEARLY LABELED,DAMAGE FREE,LOCKABLE,WITHIN 50FT OF UNOBSTRUCTED ACCESS)

  Pass

  Fail

  N/A

• HANGERS, BRACKETS,INSULATORS

  Pass

  Fail

  N/A

Structure/Runway

• RUNWAY, BEAMS & RAILS, CLAMPS, ENDSTOPS

  Pass

  Fail

  N/A

• RUNWAY ALIGNMENT, SPAN

  Pass

  Fail

  N/A

• RUNWAY SUPPORTS, TIEBACKS, STRUCTURE

  Pass

  Fail

  N/A

• DEFLECTION(+,-)

  Pass

  Fail

  N/A

• ACCESS LADDERS,FOOTWALKS

  Pass

  Fail

  N/A

• BUILDING STRUCTURE,FLOORING,CEILING ARE ADEQUATE TO SUPPORT SYSTEM

  Pass

  Fail

  N/A

Equipment Assessment

• OVERALL CONDITION OF EQUIPMENT

  Good

  Fair

  Poor

  N/A

• EQUIPMENT MEETS APPLICABLE CODES & STANDARDS FOR OPERATION

  Pass

  Fail

  N/A

• EQUIPMENT NEEDS TO BE "TAGGED OUT" DUE TO SAFETY ISSUES ( must discuss with customer)

  Yes

  No

  N/A

• Describe:

• Communicated to customer ALL major issues while onsite

• INSPECTOR SIGNATURE

  Sign

• Inspection has been performed on visible components and structures to assess compliance with the requirements of a periodic inspection. Unless noted otherwise, components were found to be in satisfactory condition at the time of inspection. Due to the nature and use of overhead crane and hoisting equipment, A Nu Concepts LLC, cannot take responsibility for failures of the equipment during or after the inspection. It is the owners responsibility to ensure that all daily, frequent and periodic inspections are placed into affect and that deficiencies found during inspections are corrected prior to placing the equipment back into operation.