TRUCK LOADER 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:

• 1. ID No. Visible

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 2. Maintenance Records viewed

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 3. Load Radius Rating Chart (English)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 4. LT 400 (only on commissioning)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• OPERATIONAL CHECKS:

• 5. Overload Protection System

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 6. Anti – two Block

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 7. Load Holding Valves

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 8. Load Test

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 9. Stability test (only on commissioning)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 10. Sag Rate on cylinders

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 11. Stabiliser Check Valves

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 12. Hoist Winch

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 13. Hydraulics

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 14. Controls / Remote

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 15. Extension beams stow system

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• CONDITION:

• 16. Crane Mounting (base stops, spacers)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 17. Crane Base (bolting, pins, bushes, locks)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 18. Extension Beam(s) & Jacks

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 19. Extensions (wear pads, locks)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 20. Slew assembly / Bolts

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 21. Crane Body (bolting, pins, bushes, locks)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 22. Inner Boom (pins, bushes, locks)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 23. Outer Boom (pins, bushes, locks)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 24. Extending Booms (wear pads)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 25. Hooks & Hook Attachments

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 26. Ropes (terminations, length)

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 27. Sheaves

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 28. Hydraulic Tank & Hoses, PTO

  Satisfactory

  Not Acceptable

  N/A

  Unable to inspect

• 29. 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