BC Safety Authority New Westminster Office: 505 Sixth Street, Suite 200 New Westminster, BC V3L 0E1

Email:elevating.devices@safetyauthority.ca Website: www.safetyauthority.ca

Hydraulic Elevators Data Sheet Checklist

The information on this form is collected to administer the provisions of the Safety Standards Act. If you have any questions about the collection and use of this information, contact the Records, Information & Privacy Analyst at 1-866-566-SAFE (7233).

GENERAL

Date: Unit Number: Address: City: Contractor: Access to M/R Door Type, Lock, Closer Elev. Name:

Elev. Class / Type: # of Floors: Capacity: Contract Speed: Adjuster: Auxiliary Power / Contacts Pressure Switch Manual Lowering Valve Certifications & Data Plate Pressure Gauge Fitting Tanks Capacity, min Level Indication Flexible Hose & Fitting Assemblies Supply Lines & Shutoff Valves Anticreep Leveling / Stop Switch Motor Data Plate V Line Volts Speed Current Volts: Main Disconnect Switch As Vs psi psi amp S S

MACHINE ROOM

Threshold Plate GFCI Outlet, Lighting ABC Powder Extinguisher Ventilation, Heating Other Equipment & Openings Machine Numbering Disconnect Switch "110" volts Motor Current Motor Volts

FULL LOAD

Speed Relief Valves

Amp Line Current Amp

As Fuse: Vs Volts:

V Working Pressure Standing Pressure psi Over-Load Setting f/m Low Oil Protection Time

Over-Speed Valve Motor Current Amp Motor Volts V psi psi

NO LOAD

Working Pressure Standing Pressure Speed

REDUNDANCY Ground Or Failure Bypass Switch Hoistway Access Inspection Switch Hall Door Fuse Car Gate Leveling Contactors Inner landing

Speed

Where there is a conflict between this Guideline & the Act & Regulations the regulations shall prevail.

FRM-1213-01 (2009-06-10)

BC Safety Authority New Westminster Office: 505 Sixth Street, Suite 200 New Westminster, BC V3L 0E1

Email:elevating.devices@safetyauthority.ca Website: www.safetyauthority.ca

- Page 2 - Hydraulic Elevators Data Sheet Checklist Top Access Switch Stop Switch, Light and Outlet Inspection Operation Inspection Open Door, Bypass Equipment on car , Guard Rails Hoistway Construction Hoistway Clearances Windows, Projections, Recesses Terminal Limit Switches Pit Access Switch Lighting Stop Switch(s) GFCI Drain, Sump Pump Limit Switches Wiring, Pipes and Ducts Traveling Cables Apron Buffer, Plates Car Buffer Stroke Emergency Light Emergency Bell Ventilation Car Area & Capacity Plate BCSA Plate Top-of-Car Clearance Refuge Space and Marking Car Frame Guides Guide Rails and Equipment Top Emergency Exit Pipes, Wiring, and Ducts Door Closed Position, Retainer Door Hanger & Locking Device Identification of Floors Car Runby Car Clearance Bottom Pit Depth Refuge Space and Marking Car Frame, Platform Jack Connections Plunger Connection Clearance Bottom Cylinder Means of Release of Air or Gas Collection of oil In Valves, Hoses, Pressure & Fitting Door Open Device Sill Clearance Car Communication Power Closing Test Hoistway & Top-Of-Car in in

In In In In

PIT

In

INSIDE CAR

Where there is a conflict between this Guideline & the Act & Regulations the regulations Shall Prevail.

FRM-1213-01 (2009-06-10)