Information

  • Project Name

  • Location Number

  • Location
  • Service Technician

  • Conducted on

  • Prepared by

Equipment Information

  • Elevator Number

  • Type of Elevator

  • Elevator Manufacturer

  • Stops/Openings

  • Last 5 Year Load Test

Machine Room

  • Pictures of Machine Room Condition

  • Cleanliness

  • Controller Cleanliness

  • Gearbox oil catch / gaskets

  • Controller Jumpers

  • Relay Covers Installed

  • Ropes / Sheaves

  • Generator / motor brushes

  • Floor Paint

  • Spare Parts

  • Check charts current

  • Fire Test charts current

  • Brake Adj

  • Controller fuses (correct amps)

Hoistway

  • Pictures of Hoistway

  • Cleanliness

  • Deflector sheave

  • Door Tracks Clean and Lubricated

  • Covers installed

  • Pickup rollers adjusted and lubricated

  • Sills clean (check behind doors)

  • Hall door noise

Cab

  • Pictures of Cab (interior and car top)

  • Cleanliness

  • Cartop clean/painted

  • Car door chains/belts adjusted

  • Door linkage lubricated

  • Safe Edge and Photo Eye Operational

  • Car door operation

  • Car door clutch clean and lubricated

  • Car door rollers

  • Car door tracks

  • Cartop lights operational

  • COP LEDs and PI

  • Emergency Phone Operational

  • Stop Switch Operational

  • Car guides

  • Ride Quality

Pit

  • Pictures of Pit

  • Cleanliness

  • Comp Sheave

  • Comp Ropes / Chains

  • Buffers

  • Lights

  • Run By

Notes and/or Concerns

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.