1 Make of the tower crane 2 Model of the tower crane 3 Sr. no of tower crane 4 Manufacturing date of Tower crane 5 Type of tower crane INTERNAL EXTERNAL 6 Check Foundation satisfactory not satisfactory 7 Jib/ Boom length 8 Hoist wire rope Diameter 9 Condition of Hoist wire rope satisfactory not satisfactory 10 Trolley wire rope Diameter 11 Condition of trolley wire rope satisfactory not satisfactory 12 Max. load lifting capacity 13 Min. load lifting capacity 14 Height of tower crane (HUH) 15 Check Hook block & pulley satisfactory not satisfactory 16 Check safety latch of hook satisfactory not satisfactory 17 A Check over load limit switch load over load B C 18 Check moment limit switch load over load A Max. load B Min. load 18 Check hoist limit switch- up satisfactory not satisfactory 19 Check hoist limit switch- down satisfactory not satisfactory 20 Check Hoist motor Brake with load satisfactory not satisfactory 21 Check Trolley limit switch- in satisfactory not satisfactory 22 Check Trolley limit switch- out satisfactory not satisfactory 23 Check Trolley motor Brake with load satisfactory not satisfactory 24 Check slewing limit switch- clockwise satisfactory not satisfactory 25 Check slewing limit switch-anti clockwise satisfactory not satisfactory 26 Check Slewing motor Brake with load satisfactory not satisfactory Note-As per your request we issue form no-11. Operation, Maintenance & safety of above said equipments in occupier/customers scope
Inspected by witness by Client Signature Tower crane Physical Inspection & Load Testing Date : Name of the company Address of the site TOWER CRANE location Sr.no Particulars Remarks
27 Check trolley Roller satisfactory not satisfactory
28 Check verticality of Tower Crane satisfactory not satisfactory 29 Check Condition of Electrical cable satisfactory not satisfactory 30 Check Condition of Electrical panel satisfactory not satisfactory 31 working of joystick function/ working satisfactory not satisfactory 32 Check for Electrical earthing satisfactory not satisfactory 33 Check Anemometer provided not provided 33a working of anemometer satisfactory not satisfactory 34 Check aviation light provided not provided 34a working of aviation light satisfactory not satisfactory 35 other parts satisfactory not satisfactory 36 any repair, renewals& alterations yes no 37 any defects yes no 38 tie/anchorage satisfactory not satisfactory A 1 st anchorage in mtr B 2nd anchorage in mtr C 3rd anchorage in mtr D 4th anchorage in mtr E free standing height above last anchorage 39 Any other check if any yes no 40 Last date of testing 41 Name of person who conducted last test Sr.no Remarks
Note-As per your request we issue form no-11.
Operation, Maintenance & safety of above said equipments in occupier/customers scope