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Form MHD56332 Edition 1
INSPECTION REPORT
Ingersoll Rand Force 5 Infinity Series Models FA2i, FA2.5i, FA5i or FA5Ti Air Winches
Model Number:
Date:
Serial Number:
Inspected by:
Reason for Inspection: (Check Applicable Box)
1. Scheduled Periodic Inspection:
(_____ Months _____ Years)
Operating Environment:
Normal: ___ Heavy: ___ Severe: ___
2. Discrepancy(s) noted during Frequent Inspection
3. Discrepancy(s) noted during maintenance
4. Other: ___________________________
Refer to the Product Information and Parts Information Manual and “INSPECTION” section for general inspection criteria. Also, refer to appropriate National Standards and
Codes of Practice. If in doubt about an existing condition, contact the nearest
Ingersoll Rand
distributor or the factory for technical assistance.
COMPONENT
CONDITION
CORRECTIVE
ACTION
NOTES
Pass
Fail
Repair
Replace
Uprights and
Siderails
Drum Band Brake
(125% Load Test)
Drum Locking Pin
Disc Brake
(125% Load Test)
Drum Band Brake
(Visual Inspection)
Disc Brake
(Visual Inspection)
Motor
Limit Switches
Controls
Air System
Fasteners
Reduction Gears
Labels and Tags
---
Shafts
Drum Guard
Wire Rope Wedge
---
Line Speed Monitor and Overspeed
Alarm
Other Components
(list in NOTES section)
TESTING
Pass
Fail
NOTES
Operational (No Load)
Operational (10% Load)
Operational (Maximum Test Load*)
*
Maximum test load is 125% of rated line pull. Testing to more than 125% of rated load may be required to set overload device or comply with standards and regulations
set forth in areas outside the USA.
This form may be photo copied and used as an inspection record.
