INSPECTION CHECK LIST OF ELECTRIC AND HYDRAULIC LIFT

Job No// 2012

CLIENT NAME:
...

Certificate No. SSC//

P.O.Box ., ., UAE Tel: 04- . Fax: 04- .

Project name: ...

(A) BRIEF SPECIFICATION
REFERENCE REGULATIONS LOCAL REFERENCE REGULATION TYPE OF INSPECTION / EXAMINATION
PREVIOUS CERTIFICATE/REPORT LIABLE INSTALLER / MAINTENANCE MAINTENANCE LOG MODIFICATION LOG EN 81

Requested by: .

EPPS # 41, DAC Req # 06

MANUFACTURERS NAME YEAR OF MANUFACTURE / INSTALLATION SERIAL No. /ELEVATOR No.

PROPUSAL USAGE TYPE OF LIFT TYPE OF DOOR

CAPACITY / PERSONS ALLOWED LOCATION OF MACHINE TO TRAVEL TYPE OF TRACTION WIRE ROPE DIA / FALLS RATED & KIND OF SPEED NUMBER OF LANDING SERVED

Kg Passengers

mm m/s ----

Nos. = Floors, = Stops

(B) Comments

Checklist 1/2

(B) FUNCTIONAL CONDITION

Satisfactory Condition No.

1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.10 1.11 1.12 1.13 1.14 1.15 2 2.1 2.2 2.3 2.4 2.5 3 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 4 4.1 4.2 4.3 4.4 4.5 5 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9

Unsatisfactory Condition Status No.

6 6.1 6.2 6.3 7 7.1 7.2 7.3 7.4 8 8.1 8.2 8.3 9 9.1 9.2 9.3 10 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 11 11.1 11.2 11.3 12 12.1 12.2 12.3 12.4 12.5 13 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13

Not Applicable

Item
Machine room Identification / Warning notice Entrance/ Access way Platfrom balustrade Main power supply Illumination Ambient temperature Equipments and parts clerance Rope suspension condition Resist hook Fire detector and extinguisher Insulation resistance Rescue notice/ Manual pulley/ Brake lever Rotation parts provision General condition Overspeed Governor/ Safety Gear Clearance Pulley condition Wire rope condition Mechnical parts condition Switches condition Machien / Traction / Drive unit Clerance Machine Chassis/ Base Electromotor / Gearbox condition Sheave / Diflection pulley Traction rope condition Flooring level mark Brake mechanism/ condition Releveling Pressure relief valve Rupture valve Manual release valve Hydraulice ram/ hose Cylinder condition General condition Controller System Diagram Warning notice / Conncetor mark Voltage/ Current/ Resistance Operation device General condition Car Top Emergency stop switch Illumination Balustrade Main door / door operation device Clearance Operation switches Ropes / Diverted pulley suspension Shoes / Roller setting General condition

Item
Headroom Clearance Direction switch Ultimate limit switch Landing door / Landing Floor Locking Device Interlock switch Door panel Apron Well Clearance Illumination Wall inner surfacing Counterweight Clearance Ropes / Diverted pulley suspension Sufficient balancing Pit Illumination Stop switch Ladder Tension pulley Buffer Direction switch Ultimate limit switch Partition Clearance General condition Car bottom Apron Shoes / Roller setting Attachments Car Interior Identification Operation instruction notice/ Emergency telephone Flooring / Ceiling / Wall Capacity notice Floor leveling Operation System Car position indicator / push buttons Ventilation / Illumination Door operation Reopener photocell/ safety edge/ push button Intercom Emergency Alarm Emergency Light ELD operation Firemen switch Actual speed Car running/ stopping in rated capacity Over load device Is unlock spare key available at the site

Status

(C) CONCLUSION

At the while of inspection LIFT condition was founded: Unsatisfactory / Satisfactory Inspected by:
Note: Structural testing and examination has been excluded of this part of inspection. Document checking of structural, stability, design and mechanical calculation have been excluded of this part of inspection. If any existing, abnormality, repair or alteration in major function, it should request immediately inspection. New inspection is required if period of re inspection exceeding 30 days from date of inspection.
Checklist 2/2

Date:

U. A. E DUBAI P.O.BOX : 3458 TEL: 04 259 4778 FAX: 04 259 4779 E-mail : info@scopesafetyuae.com, www.scopesafetyuae.com