EPC PEMIPAAN CIPAKU – POND J

TOOLS & EQUIPMENT INSPECTION CHECKLIST

CRANE AND LIFTING EQUIPMENT

[Subjects] □ Truck Crane □ Crawler Crane □ Tower Crane □ Vehicle with Crane □ Side Boom
Result Column (Ö ): Yes/Good, Acceptable, (X): Not/Bad, Not to use, (NA): Not applicable
EQUIPMENT CARRY-IN CERTIFICATE
Type : Police No. :
Machine No : Certificate No :
Serial No. : Certificate Validity :
Capacity : Operator Name :
Manufacturer : Operator License :
Subcontractor : Operator License Validity :
Date of Inspection : Validity of Inspection :
Place of Inspection : Type of Inspection Monthly
This form must be completed by the operator and company user before entering the equipment to be operated in the
site project area, and at any time of setting location. All equipment condition must meet to the Safety Regulation and
GTU Management Plan

A Lower Structure : Yes No N/A M Outrigger : Yes No N/A

1 : 1 Stabilizer Box :
2 : 2 Outrigger Beam :
3 : 3 Jack Cylinder :
4 : 4 Outrigger Shoe :
5 : 5 Weld Joint :
6 :
Hydraulic
7 : N
Component
8 : 6 Hydraulic Pump :
9 : 7 Hydraulic Lines :
8 Hydraulic Cylinder :
B Wheels and Titer : Yes No N/A 9 Hydraulic Tank :
1 Wheels : 10 Hydraulic Filter :
2 Tires :
Main Load Hoist
3 Axle Lock : O : Yes No N/A
Winch
4 Propeller Shaft : 1 Drum :
Brake Shoe and
5 Spare Tires : 2 :
Lining
3 Clutch Lining :
C Turn Table : Yes No N/A 4 Pushing Cylinder :
1 Slewing Ring Bearing : 5 Ratchet :
2 Cone Roller :
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 EPC PEMIPAAN CIPAKU – POND J

TOOLS & EQUIPMENT INSPECTION CHECKLIST

CRANE AND LIFTING EQUIPMENT

Aux. Load Hoist

3 Weld joint : P
Winch
4 Turn Table Gear : 6 Drum :
Brake Shoe and
5 Swing Gear : 7 :
Lining
8 Clutch Lining :
D Upper Structure : Yes No N/A 9 Pushing Cylinder :
1 : 10 Ratchet :
2 :
3 : Q Boom Hoist Winch : Yes No N/A
4 : 1 Clutch Lining :
5 : 2 Clutch Housing :
Brake Shoe and
3 :
Lining
E Telescopic Boom : Yes No N/A 4 Planetary Gear :
1 Main Boom : 5 Ratchet :
2 Telescopic Section : :
3 Head Sheave : R Aux. Boom or Fly Jib : Yes No N/A
4 Boom Pivot : 1 Main Cord. :
5 Sliding Wear Pad : 2 Brace or Lacing :
6 Lift Cylinder Mounting : 3 Head Sheave :
4 Sheave Guard :
5 Boom Connector :
F Pneumatic Component : Yes No N/A
1 Compressor :
2 Tank and Safety Valve :
3 Pressure :
4 Lines :
5 Control Valve :
6 Air Cleaner :
G Wire Rope : Yes No N/A S Hook Block : Yes No N/A
1 Webbing Sling : 1 Sheaves :
2 : 2 Hook Nut and Bearing :
3 Boom Hoist : 3 Hook :
4 : 4 Safety Latch :
5 : 5 Anti to Block :
H Aux. Boom : T Fly Jib :
6 : 6 Weight Ball :
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 EPC PEMIPAAN CIPAKU – POND J

TOOLS & EQUIPMENT INSPECTION CHECKLIST

CRANE AND LIFTING EQUIPMENT

7 : 7 Swivel Bearing :
8 : 8 Hook :
9 Safety Latch
Machine
I : Yes No N/A U : Yes No N/A
1 Starting Motor : 9 Bolting :
2 Battery and Wire : 10 Engine Mounting :
3 Wiring System : 11 Engine Guard :
4 Charging System : 12 Turbo Charges :
5 Fueling System : 13 Fueling Lines :
6 Lubricating System : 14 Water Leaking :
7 Cooling System : 15 Oil Leaking :
8 Oil Filter and Air Filter : 16 Fuel Leaking :
Indicator System
J : Yes No N/A V : Yes No N/A
1 Tachometer : 5 Oil Pressure :
2 Traveling Lamps : 6 Hydraulic Oil Pressure :
3 Traveling Alarm : 7 Air Pressure :
4 Water Cooling : 8 Ampere Meter :

K Support Tools : Yes No N/A W PPE : Yes No N/A

1 Driver Cabin : 8 Safety Hat :
2 Doors and Window : 9 Safety Shoes :
3 Wiper : 10 Safety Glass :
4 Horn : 11 Hand Glove :
5 Mirror : 12 Dust Mask :
6 Wire Rope : 13 Ear Protector / Plug :
7 Shackle :
Safety Devices
L : Yes No N/A X : Yes No N/A
1 Safe Load Indicator : 7 Aux. Hoist Limiter :
2 Load Chart : 8 Swing Limiter :
3 Moment Load Limiter : 9 Boom Hoist Limiter :
4 Weight Indicator : 10 Level Indicator :
5 Angle Indicator : 11 Disconnect Switch :
6 Main Hoist Limiter : 12 Fire Extinguisher :

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 EPC PEMIPAAN CIPAKU – POND J

TOOLS & EQUIPMENT INSPECTION CHECKLIST

CRANE AND LIFTING EQUIPMENT

Inspector Instruction:

Inspection Result:
NOT SAFE to Operate SAFE to Operate

Inspected By: Reviewed By Approved By:

Mechanic / Operator CPM SPV

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