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This page may be copied and used by inspectors or maintenance personnel.
INSPECTION AND MAINTENANCE REPORT
Ingersoll-Rand QUANTUM ‘QMT’ Series Electric Trolley
Model Number:
Date:
Serial Number:
Inspected by:
Reason for Inspection: (Check Applicable Box)
1. Scheduled Periodic Inspection
( ___ Quarterly ___ Semiannually ___ Yearly)
Operating Environment:
2. Discrepancy(s) noted during Frequent Inspection
3. Discrepancy(s) noted during maintenance
Normal ___ Heavy ___ Severe ___
4. Other: ____________________________
Refer to the Parts, Operation and Maintenance Manual “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
Fasteners
Shafts
Bearings
---
Brake*
---
Covers
Controls
Electrical System
Supporting Structure
Motor
Drive Gears
Wheels
Counter Weight
Hanger Shaft Assy.
Labels and Tags
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Other Components
* Optional attachment. May not be equipped on all trolleys.