Information

  • Audit Title

  • Document Number

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

JSA

JOB SAFETY ANALYSIS

  • Work permit number

  • Working at heights

  • Working at heights permit number

  • Controls to be used

  • Harness to be worn when required?

  • Working near live power

  • Controls to be used for live power concern

  • Traffic and or staff in the work area?

  • Controls to be used for traffic and staff

  • Any other comments?

Job details

Job details

  • Time on site

  • Job number

  • Visitor pass required

  • Visitor pass number

  • Any other comments

  • Any delays in access to the site

Crane Details

Crane details

  • Crane identification number

  • Crane make

  • Crane model

  • Serial number

  • Year

  • Vehicle make

  • Vehicle model

  • Vehicle registration number

  • Vehicle fleet number

  • Vehicle chassis number

  • Vehicle speedo reading

  • Hour meter reading

Carrier Condition

Carrier condition

  • truck and jib extended

  • Tyre Condition

  • PTO security

  • PTO warning light

  • Park brake operation

  • Crane sub frame

  • Crane mounting bolts tight

  • Crane mounting bolt condition

  • Crane base bolt tension

Hoist

HOIST

  • Wire rope hoist

  • wire rope condition

  • Wire rope drum condition

  • Hook block sheaves

  • Return sheaves

  • Anchor point

  • Overload clutch condition

  • Overload clutch weight setting

  • Working height limit switches

  • Working height limit adjustment

  • Motors

  • Air gap on braking device

  • Couplings

  • Transmission free from noise and vibration

  • Mountings

  • Hook condition

  • Hook safety catch

  • Overload warning device 90% rated load

  • Overload warning devise 100% Rated load

  • Overall Visual Condition. 10= Good. 1= Bad

Jib Arm Structure

Jib Arm Structure

  • Boom structure

  • Boom extensions

  • Boom wear pads

Jib Arm Gear Box

Jib Arm Gearbox Oils

  • Hydraulic filter condition

  • Hydraulic oil condition and level

  • Slew gearbox oil

  • Hoist gearbox oil

  • Oil filled base oil condition

Slew Ring

Slew Ring

  • Slew ring general condition

  • Slew ring movement

  • Slew ring bolts

Outrigger Arms

Outrigger arms

  • Outrigger beam locks

  • Outrigger housing

  • Outrigger mounting bolts

  • Outrigger pads

  • Dunnage blocks condition

  • Dunnage block storage

Hydraulic System

Hydraulic system

  • Main boom cylinder

  • Jib cylinder

  • hydraulic hoses

  • Hydraulic pipes

  • Hydraulic connections

  • Valve bank

  • Control lever operation

Electrical

ELECTRICAL

  • Contactors

  • Control box

  • Cables and catenary

  • Pendant / radio TX

  • Panel box condition

  • Isolators

  • Isolator signage

General Items

GENERAL ITEMS

  • Signage

  • Rated capacity charts

  • Control lever signage readable and correct direction

  • Boom elevation indicator

  • Compass signage

  • Any other items of concern

  • Any special instruction or directions for the operator to follow

Test Results

Test results

  • Inspection pass

  • Is a re-test required

  • Date for re-test

  • Load test completed

  • Chart capacity load test pass

  • load test weight

  • load test radius

  • Hoist brake test pass

  • load test

Signatures Please

Signatures Please

  • Inspection Technician to sign. All work has been done to comply with the relevant Australian Standards.

  • next routine inspection and service due

  • Customer to sign

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