Owner: Approver: Rev Date: Rev No: Page: Global HSE Director, Global HSE Standards 17-DEC-2020 0 1 of 2
Unit# 11835310 SO#908565586 Customer: SH - DP
Complete and turn in with daily trip sheet
Note: Inspection should not include the removal of access plates etc. unless warranted by condition of equipment.
Okay Adjust Repair
Chassis Check hydraulic hoses and tubing for wear, leaks, proper & secure installation. Check hydraulic oil tank for proper fluid level. Check stabilizer cylinders for proper fluid level. Check stabilizer attaching bolts for proper and secure installation. Check inflation and condition of tires Pedestal Check controls for legible labels, proper & secure installation, excessive free play & proper operation while engine is running. Check hydraulic hoses and tubing for wear, leaks, proper & secure installation. Check cylinders for proper operation while engine is running. Check swing hub attaching bolts for proper and secure installation. Boom Check placards and decals for proper and secure installation, visible damage and legibility, load chart visible to the operator. Check boom angle indicator for proper and secure installation, freedom of movement and proper operation. Check winch cable for excessive wear or damage. Check winch cable end clevis for proper and secure installation and for any damage. Check safety latch on lifting hook for proper installation and proper operation. Check winch for proper and secure installation, and proper operation while engine is running. Check boom sheaves for proper and secure installation and freedom of movement. Check hook block assembly for proper and secure installation, structural damage, cracked or broken welds and bent or warped surfaces, throat opening. Check boom extension and retraction for smooth and correct operation. Check anti-two block device for damage, proper and secure operation by inching the block or ball into the anti-two block weight. Safety Equipment Full body harness and shock absorbing lanyard. Inspect all lifting devices; dispose of any lifting device not passing inspection. Check that manufacturer operation manual is in unit. Check that annual inspection is current. Date:____________ Customer required copy of inspection report is in unit. Check that lifting equipment inventory register is complete. Check that tagline, push/pull poles or load guiding devices in good condition. Check for any power-lines in the area?
Explanation of problem: ______________________________________________________________________
Printed versions of this document are considered UNCONTROLLED.
Title: HMS Document Number: Mobile Crane Shift Inspection FO-GL-HAL-HSE-0420B Owner: Approver: Rev Date: Rev No: Page: Global HSE Director, Global HSE Standards 17-DEC-2020 0 2 of 2
Qualified Crane Operator’s Signature: SAID ZEGHIDI Date: 08/06/2023
Note: These forms can be ordered from Halliburton’s Qualitrack System by accessing the page below and clicking on the ‘Forms Catalog’ link (Form # 37213). http://halliburton.ridgways.com
Revision Date Rev. No Revised By Summary of Key Changes
Nathan Gatewood Initial release
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Printed versions of this document are considered UNCONTROLLED.