EXHIBIT 'E'
ANNUAL CRANE INSPECTION REPORT
Form 70-9-1 (4-84)
PROJECT NAME PROJECT NUMBER DATE CHECKED
MANUFACTURER MODEL NUMBER SERIAL NUMBER EQUIPMENT NUMBER
HOURS INSPECTED BY:
ITEMS GOOD REPAIR COMMENTS
CARRIER: N/A z
HORN
WINDSHIELD & WIPER
GLASS
FIRE EXTINGUISHER
LIGHT (HEADLIGHTS, TAIL, STOP, ETC.)
MIRRORS
LOW AIR WARNING DEVICE
TELL TAIL LIGHTS & BUZZERS
OUTRIGGERS (BEAMS, BOXES, N/A z
JACKS, PADS):
CRACKS
BENT
WARPAGE
LEAKS
CONTROLS
LOCKS
TRAVEL: N/A z
STEERING
BRAKES
CLUTCH
DRIVE SHAFT & U-JOINTS
TRANSMISSION
TRANSFER
DIFFERENTIAL
FRONT AXLE(S)
INTERMEDIATE AXLE(S)
REAR AXLE(S)
SPRINGS & SHOCKS
LOCKING DEVICES
TIRES: N/A z
RECOMMENDED INFLATION PRESSURE
EXCESSIVE WEAR
DAMAGE
LUGS
WHEEL & RIM
TRACKS (EXCESSIVE WEAR) N/A z
CRAWLER PADS & PINS
ROLLERS & IDLER
DRIVE SPROCKET
DRIVE CHAIN - EXCESSIVE STRETCH
TENSION ADJUSTMENT
TRACTION BRAKES OR BACKING PANEL
EXHIBIT 'E' CONT'D
ANNUAL CRANE INSPECTION REPORT
Form 70-9-1 (4-84)
ITEMS GOOD REPAIR COMMENTS
STEERING BRAKES OR LOCKS
BOLTS & RIVETS
SUPERSTRUCTURE: N/A z
LOAD RATING CHART & DECALS
SIGNAL HORN
GLASS
WINDSHIELD & WIPER
OUTRIGGER CONTROLS & LOCKS
CONTROLS & LABELS
CATWALK & HANDRAILS (HOLDS)
GANTRY SYSTEM
COUNTERWEIGHT HOOKS & BOLTS
TURNTABLE:
CIRCLE GEAR
BULL GEAR
HOOK ROLLERS
MOUNTING BOLTS
WARPAGE
BEARINGS
LOCKING DEVICE
CONTROLS:
MALADJUSTMENT
EXCESSIVE WEAR
CONTAMINATION BY LUBRICANTS OR FOREIGN MATTER
POWER PLANT:
PERFORMANCE
COMPLIANCE WITH SAFETY REQUIREMENTS
BATTERIES
MUFFLER & EXHAUST SYSTEM
RADIATOR & COOLING SYSTEM
THERMOSTAT & HOSES
DRIVE BELTS
AIR & OIL FILTERS
OIL & FLUID PRESSURE & LEVELS
FUEL TANK & CAP
BRAKE & CLUTCH SYSTEM LOAD HANDLING
(EXCESSIVE WEAR):
PARTS
LININGS
PAWLS & DOGS
RATCHETS
ELECTRICAL APPARATUS:
MALFUNCTIONING
EXCESSIVE DETERIORATION
DIRTY
MOISTURE ACCUMULATION
AIR SYSTEM:
COMPRESSOR
EXHIBIT 'E' CONT'D
ANNUAL CRANE INSPECTION REPORT
Form 70-9-1 (4-84)
ITEMS GOOD REPAIR COMMENTS
GOVERNOR
TANK & LINES
EXHIBIT 'E' CONT'D
ANNUAL CRANE INSPECTION REPORT
Form 70-9-1 (4-84)
ITEMS GOOD REPAIR COMMENTS
HYDRAULIC SYSTEM:
FLUID LEVEL
FLUID PRESSURE
FILTERS-EVIDENCE OF RUBBER OR METAL
PUMPS AND MOTORS:
-LOOSE BOLTS OR FASTENERS
-LEAKS AT JOINTS
-SHAFT SEAL LEAKS
-UNUSUAL NOISES OR VIBRATION
-LOSS OF OPERATING SPEED
-EXCESSIVE HEATING OF FLUID
-LOSS OF PRESSURE
VALVES:
-CRACKS IN HOUSING
-IMPROPER RETURN OF SPOOL TO NEUTRAL POSITION
-LEAKS AT SPOOLS OR JOINTS
-STICKING SPOOLS
-FAILURE OF RELIEF VALVES TO ATTAIN CORRECT
PRESSURE
-RELIEF VALVE PRESSURES CHECKED AS SPECIFIED BY
MFR.
CYLINDERS:
-DRIFTING CAUSED BY FLUID LEAKING ACROSS PISTON
-ROD SEALS LEAKAGE
-LEAKS AT WELDED JOINTS
-SCORED, NICKED, OR DENTED RODS
-DENTED CASE (BARREL)
-LOOSE OR DEFORMED ROD EYES OR CONNECTING JOINTS
HOSES:
-EXCESSIVE WEAR OF FLEX AREAS
-EVIDENCE OF LEAKAGE
-LEAKAGE AT COUPLINGS
-BLISTERING OR ABNORMAL DEFORMATION
-LEAKAGE AT THREADED OR CLAMPED JOINTS
BOOM & JIB STRUCTURE:
DEFORMED
CRACKS
CORRODED MEMBERS
WARPAGE & BENT
STOPS
WEAR PADS & ADJUSTMENTS
CONNECTION PINS
AUTOMATIC BOOM KICKOUT
SHEAVES:
-CRACKED
-WORN
JIB BACK STOPS
ANNUAL CRANE INSPECTION REPORT
Form 70-9-1 (4-84)
ITEMS GOOD REPAIR COMMENTS
WIRE ROPE (LOAD, WHIP, BOOM HOIST, PENDANT):
CORRECT SIZE & LENGTH
REEVING IN COMPLIANCE WITH MFR. SPECS.
SPOOLING PROPERLY ON DRUMS
BROKEN WIRES
KINKS, BIRDCAGING, MASHED
CORROSION
OTHER DAMAGE
EXCESSIVE WEAR
LOAD BLOCK & HOOKS:
DEFORMATION:
-15% EXCESS OF NORMAL THROAT OPENING
-MORE THAN 10 TWIST FROM PLANE OF UNBENT HOOK
CRACKS
WEDGE SOCKETS
SAFETY LATCHES
NDE TESTED
SAFETY DEVICES:
MALFUNCTION
-OVER THEIR FULL RANGE
-ANY SIGNIFICANT INACCURACIES
LOAD INDICATOR
BOOM ANGLE INDICATOR
SIGNAL HORN (UPPER & LOWER)
BACK-UP ALARM
AUTOMATIC BOOM KICKOUT
ANTI-TWO BLOCKING DEVICE
GENERAL:
OVERALL CLEANLINESS
OPERATOR MANUAL
SERVICE BOOKS
