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Location : Tag No. Boom Type : Mfg. CRANE Boom Length : Model Inspection & Resertication Report Capacity: SN !hysical Crane Inspection "!CI# Report of M$BIL CR%N "!ic' & Carry on type ( ) 'm h# * Ro+gh Terrain %ction Ta'en Condition ,ate : "%ct#. "Cond.# Craftmans : %. %d-+st .Modify I. Repair M. ill in /,(/ood : B. Clean . !aint 0. Realignment N. Change R( air : C. Inspect /. Recali1rate 2.Replace $. ,rain !R(!oor : ,. L+1ricate 3. Retor4+e L.Recondition !. Test N5(Ne6 Crane S+per7isor S% T8 , 9IC !CI Report !CI Report !CI Report Malf. %ct Cond Malf. %ct. Cond. Malf. %ct. Cond. merg.loadBra'e ast %+ . 5hip. 5inch !edestal mo+nt Boom %ngle Rad.Mech. Indicator Main Load 5inch 0i1 Boom Tip t. Load Speed Mode Boom 5inch Boom Sect.Mo+nt. Boom Stopper S6ing Motor & /ear Bo Boom 5inch Mo+nt Lo6 !ress. ng.S, ast LineBra'e. ast 5inch Mo+nt 9ac++m !ress. %larm Load LineBra'e. Load 5inch Mo+nt S6ing Limit Control Boom LineBra'e. S6ing Motor Mo+nt S6ing Bra'e.Man %+to S6ing Bra'e !inion /ear Mo+nt !ar'ing Bra'e Man %+to /ear $ilLoad RotaryMo+nt %larm System /ear $il Boom ngineMo+nt %ntit6o 1loc'o7erride /ear $ilast !+mp Mo+nt Boom o7erride loc' /ear $il S6ing Boom -oint pins ast Load Bloc'Sft. Latch /ear 1o oil Boom -oint holes Load & Radi+sIndicator !+mp /ear 1o ,igital Monitor ,isplay le i1le 0oint Shaft Mirror 3ydra+lic !+mp 5arning light Tor4+eCon7erter 38,R%;LIC S8ST M !CI Report !CI Report C%BIN !CI Report Malf. %ct. Cond. Malf. %ct. Cond. Malf. %ct. Cond. 3igh !ress+re 3ose. ast %+ 5hip rope Line Control Le7er Lo6 !ress+re 3ose. Main Load rope Line ,oor 5indo6 /lass 3yd.%cc+m+lator Boom rope Line ,oor 5indo6 3yd.%cc+m.!ress+re ast %+ 5hip rope ree7ing 3yd. !arameter ga+ges N*)<%cc+m.!ress+re Main Load rope ree7ing $peratorSeat 3yd.Charging!+mp. Boom rope ree7ing 3orn 3yd.ChargingTan' ast Line5edge & Soc'et Lighting Spot Light 3yd.Charging Cleanliness Load Line 5edge & Soc'et !ar'ing Bra'e Le7ers Control 9al7e Boom Line5edge & Soc'et S6ing Bra'e Controls Three 5ay 9al7e Boom shea7es Load Bra'e Man+al 3yd.Cooler Boom 1ridle e4+ali=er&shea7es Throttle Speed 3yd.Reser7oir Tan' Load LineBloc'& shea7es Ratchet& !o6l Control 3yd.Cleanliness Load Line3oo' S6i7el Load & Radi+sIndicator 3yd.Ret+rnStrainer ast Line1loc'& shea7es Load Chart Ta1le 3yd. S+ction Strainer ast Line3oo' S6i7el Speedo*meter %ll Nipple !oint ast 1loc'hoo' safety Latch ngineTachometer Load 1loc' hoo' safety Latch ng.5ater Temp /a+ge Sle6 ring stationer gear ng.L+1.$il press.gage Sle6 ring 1earing %ir inta'e Indicator +el /age %ll Nipple !oint %lthenator %mpremeter Ca1in & $thers !CI Report Remar's : Malf. %ct. Cond. ire ting+isher Seat Belt 5ipper 3and Bra'e Bra'e Release Cylinder Bra'e cl+tch act+ator 5inch< Motor !+mp< /ear Bo & Shaft Bolts< N+t and pins Rope Bloc' & 3oo' S6ing 1earing & !inion gear

03. Crane Checklist Inspection

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03. Crane Checklist Inspection

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Sheet1Location : Tag No.Boom Type :Mfg.CRANE Boom Length :ModelInspection & Resertification ReportCapacity :S/NPhysical Crane Inspection (PCI) Report of MOBIL CRANE (Pick & Carry on type = 2 km/h) - Rough TerrainAction Taken ConditionDate:(Act).(Cond.)Craftmans :A. AdjustE. ModifyI. RepairM. Fill inGD=Good:B. CleanF. PaintJ. RealignmentN. ChangeFR=Fair:C. InspectG. RecalibrateK. ReplaceO. DrainPR=Poor:D. Lubricate H. RetorqueL. ReconditionP. TestNW=NewCrane Supervisor

SAFETY DEVICEPCI ReportWinch, Motor Pump, Gear Box & ShaftPCI ReportBolts, Nut and pinsPCI ReportMalf.ActCondMalf.Act.Cond.Malf.Act.Cond.Emerg.load BrakeFast / Aux. / Whip. WinchPedestal mountBoom Angle/Rad.Mech. IndicatorMain / Load WinchJib/Boom Tip Ext.Load Speed ModeBoom WinchBoom Sect.Mount.Boom StopperSwing Motor & Gear BoxBoom Winch MountLow Press. Eng. SDFast Line Brake.Fast Winch MountVacuum Press. AlarmLoad Line Brake.Load Winch MountSwing Limit ControlBoom Line Brake.Swing Motor MountSwing Brake. Man / AutoSwing BrakePinion Gear MountParking Brake Man / AutoGear Oil LoadRotary MountAlarm SystemGear Oil BoomEngine MountAnti two block overrideGear Oil FastPump MountBoom override / lockGear Oil SwingBoom joint pinsFast / Load Block Sft. LatchGear box oilBoom joint holesLoad & Radius IndicatorPump Gear boxDigital Monitor Display Flexible Joint ShaftMirrorHydraulic PumpWarning lightTorque Converter

HYDRAULIC SYSTEMPCI ReportRope/ Block & Hook Swing bearing & Pinion gearPCI ReportCABINPCI ReportMalf.Act.Cond.Malf.Act.Cond.Malf.Act.Cond.High Pressure Hose.Fast/Aux/Whip rope LineControl LeverLow Pressure Hose.Main Load rope LineDoor/Window GlassHyd.AccumulatorBoom rope LineDoor/WindowHyd.Accum.PressureFast/Aux/Whip rope reevingHyd. Parameter gaugesN-2, Accum.PressureMain Load rope reevingOperator SeatHyd.Charging Pump.Boom rope reevingHornHyd.Charging TankFast Line Wedge & SocketLighting / Spot LightHyd.Charging CleanlinessLoad Line Wedge & SocketParking Brake LeversControl ValveBoom Line Wedge & SocketSwing Brake Controls Three Way ValveBoom sheavesLoad Brake ManualHyd.CoolerBoom bridle equalizer&sheavesThrottle SpeedHyd.Reservoir TankLoad Line Block & sheavesRatchet & Powl ControlHyd.CleanlinessLoad Line Hook / SwivelLoad & Radius IndicatorHyd.Return StrainerFast Line block & sheavesLoad Chart / TableHyd. Suction StrainerFast Line Hook / SwivelSpeedo-meterAll Nipple PointFast block hook safety LatchEngine TachometerLoad block hook safety LatchEng. Water Temp GaugeSlew ring stationer gearEng. Lub. Oil press.gageSlew ring bearingAir intake IndicatorFuel GageAll Nipple PointAlthenator Ampremeter

Cabin & OthersPCI ReportRemarks :Malf.Act.Cond.Fire ExtinguisherSeat BeltWipperHand BrakeBrake Release CylinderBrake clutch actuator