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INSPECTION SCHEDULE AND MAINTENANCE REPORT
HOIST SERIAL NO. (MFGRS) _______________________
CUSTOMER CRANE IDENTITY NO. _______________________
RATED LOAD _________________
LOCATION IN PLANT __________________________________
TYPE ________________________
THIS INSPECTION IS
MONTHLY
#
ANNUAL
#
VOLTAGE _____________________
SEMI-ANNUAL
#
INSPECTED BY: ________________
DATE _____________
*
Recom-
CONDITION
COMPONENT, UNIT OR PART
mended
(Check column best indicating condition when
CORRECTIVE ACTION
and location
Inspection
part or unit is inspected. Use note column to
NOTES
Interval
the right if condition is not listed below.)
COMPONENT,
UNIT OR
PART
(Indicate corrective action taken during inspection and note date. For
corrective action to be done after inspection, a designated person must
determine that the existing deficiency does not constitute a safety hazard
before allowing unit to operate. When corrective action is completed,
describe and note date in this column.)
Typical Inspection Schedule and Maintenance Report form.
User must adjust inspection interval and components to suit his individual conditions and usage.
12375B
Monthl
y
Good
HOIST
L
O
C
A
T
ION
*
See text for DAILY & WEEKLY REQUIREMENTS.
SIGNED & DATED REPORT REQUIRED – OSHA.
INSPECTION INTERVAL.
X MAGNETIC PARTICLE OR EQUIVALENT EXAMINATION REQUIRED.
TROLLEY
R
UNW
A
Y
S
RESIST
ORS
MISC.
DATE
Motor
Motor Brake
Mechanical Load Brake
Overload Clutch
Couplings
Gears, Shafts & Bearings
Upper Block
Lower Block
Hook & Throat Opening
X
Record Hook Throat Opening
Hoist Rope
Rope Drum
Guards
Limit Switch
Pushbutton
Wiring
Motor
Brake (when so equipped)
Couplings
Gears, Shafts & Bearings
Frame
Wheels
Bumpers
Guards
Conductors
Collectors
Hoist
Trolley
Monorail Joints
Monorail
Main Conductors
Main Collectors
General Condition
Load Attachment Chains
Rope Slings & Connections
Change Gearcase Lub.
Grounding Faults
CONTR
O
L
S
TA
TION OR
PUSH B
U
T
T
ON
Ann
ual
Semi-Ann
ual
Adjustment
Required
Repair Required
(Loose Parts or
Wires)
Replacement
Required
(Worn or Damaged)
Lubrication
Required
(Low Oil or Grease,
Rust or Corrosion)
Cleaning or
P
ainting Required
Summary of Contents for SHAW-BOX
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