Title Page
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Customer:
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Job #/ P.O. #
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Date
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Inspector:
Equip. I.D.
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EQUIPMENT AREA/LOCATION
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ANC#
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CUST. EQUIP. #
GENERAL EQUIPMENT INFO
Crane Info-
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Pictures of data plates (if legible)
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Type-
- UHSG
- UHDG
- TRDG
- TRSG
- GANTRY
- MONORAIL
- JIB
- MOBILE
- OTHER
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MFG.
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Ser#
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Mod#
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Capacity-
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Drive Type:
Hoist Info-
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Pictures of data plates (if legible)
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MFG.
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SER#
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MOD#
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CAPACITY-
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DRIVE TYPE:
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Voltage
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Specify :
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WIRE ROPE or CHAIN
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SIZE (diameter)
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APPROX. LENGTH
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END CONNECTION TYPE/DESCRIPTION
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SIZE OF LINKS (diameter/length/width)
Trolley Info-
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Pictures of data plates (if legible)
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MFG
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SER#
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MOD#
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CAPACITY
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DRIVE TYPE:
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ADDITIONAL INFORMATION /NOTES
Inspection Criteria
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Instructions:
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1. Start the Inspection by selecting the equipment that is going to be inspected and rate each item as "SATISFACTORY", "UNSATISFACTORY", "N/A".
2. Add photos and notes by clicking on the paperclip icon.
3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link.
6. Follow ALL company and site safety requirements and procedures.
Note: Please report any unusual findings to the customer immediately. -
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.179
Hoist
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UPPER & LOWER LIMIT
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HOIST DRUM/LIFTWHEEL/GUIDE
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LOAD BRAKE (CONTROL BRAKING)
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MOTOR BRAKE (HOLDING BRAKE)
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MOTORS/PINIONS/KEYWAYS
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SHAFTS/COUPLINGS/KEYWAYS
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GEARBOX/BEARINGS/SEALS/GASKETS
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HOIST FRAME/LOAD BEARING COMPONANTS
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UPPER/LOWER RUNNING SHEAVES/PINS
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UPPER/LOWER EQUALIZING SHEAVES/PINS
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LOWER HOOK BLOCK FRAME/GUARDS
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LOAD HOOK & SAFETY LATCH
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WIRE ROPE or LOAD CHAIN
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REEVING & END CONNECTIONS
Trolley
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MOTOR(S)(BEARINGS,COUPLINGS,PINIONS,KEYWAYS)
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BRAKE(S)
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GEARBOX(S)/OPEN GEARS
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WHEELS(BEARINGS,AXLES,COUPLINGS,PINIONS,KEYWAYS)
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RAIL(S), CLAMPS, BUMPERS, ENDSTOPS
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FRAME,DROP LUGS, RAIL SWEEPS
Crane
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END TRUCKS,BUMPERS,BUFFERS,RAILSWEEPS
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WHEELS,BEARINGS,AXLES
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GEARBOX(S),OPEN GEARS,BEARINGS,SEALS,GASKETS
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GUARDS,SHAFTS,COUPLINGS,KEYWAYS,BEARINGS
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MOTOR(S),PINIONS,KEYWAYS,COUPLINGS
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CONNECTION,GIRDER,STRUCTURE & COMPONENTS
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BRAKE(S) DISC,PADS,HUB & COMPONENTS
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PLATFORMS,LADDERS,RAILINGS
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CAB & SUPPORTING STRUCTURE
Electrical Equipment & Controls
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PENDANT/RADIO
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COLLECTOR SHOE(S)
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TROLLEY CONDUCTORS & COLLECTORS
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MAIN CONDUCTORS & COLLECTORS
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RESISTORS/SOFT STARTS
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MAINLINE CONTACTOR, START/STOP CIRCUIT, FUSING
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WIRING & FUSES
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CONTROL PANELS & COVERS
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CORD(S),CABLE(S),REEL(S),FITTING(S)
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MAIN DISCONNECT (ISOLATED,CLEARLY LABELED,DAMAGE FREE,LOCKABLE,WITHIN 50FT OF UNOBSTRUCTED ACCESS)
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HANGERS, BRACKETS,INSULATORS
Structure/Runway
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RUNWAY, BEAMS & RAILS, CLAMPS, ENDSTOPS
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RUNWAY ALIGNMENT, SPAN
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RUNWAY SUPPORTS, TIEBACKS, STRUCTURE
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DEFLECTION(+,-)
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ACCESS LADDERS,FOOTWALKS
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BUILDING STRUCTURE,FLOORING,CEILING ARE ADEQUATE TO SUPPORT SYSTEM
Equipment Assessment
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OVERALL CONDITION OF EQUIPMENT
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DESCRIBE:
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EQUIPMENT MEETS APPLICABLE CODES & STANDARDS FOR SAFE OPERATION
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EQUIPMENT NEEDS TO BE "TAGGED OUT" DUE TO SAFETY/EQUIPMENT ISSUES AND REQUIRES REPAIRS BEFORE RETURNING TO SERVICE ( must discuss with customer)
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INSPECTOR SIGNATURE
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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.
