EQUIPMENT CONDITION INSPECTION REPORT

( Unit Crane )
ASSET NO. : INSPECTION DATE :
TYPE / MODEL : LOCATION :
MAKE / YEAR : ENGINE :
SERIAL NUMBER : ENG. SERIAL NO. :
CERTIFICATE NO. : HOUR METER :
OWNER : USER :

CONDITION
NO. COMPONENT GROUP GOOD POOR REMARK
(BAIK) (TIDAK BAIK)

ENGINE
1 Engine Performance
2 Fuel System
Fuel tank
Fuel injection
Fuel line
Fuel filter/water separator
Transfer pump
Fuel gauge / indicator lamp
3 Lubrication System
Oil pump / filter
Oil pan
Oil pressure gauge / indicator lamp
4 Cooling System
Radiator, reservoir, cap
Hose upper / lower
Water pump
Fan & Belt
Radiator Mounting / guard
Water temperature gauge / indicator lamp
5 Induction System
Intake manifold
Air Cleaner
Turbo Charger
Exhaust Manifold
Muffler / Tail / Rain Cap
6 Crankshaft seal front / rear
7 Engine Mounting / Bolt, front / rear
CHASIS / BODY
1 Cabin operator
Operator seat / Safety belt

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 Glass, dust boot, panel
2 Body / floor / bumper
3 Body mounting
4 Door, Lock
5 Body painting

FRAME / UNDER CARRIEDGE

1 Frame RH/LH
2 Front idler RH/LH
3 Sprocket RH/LH
4 Track link / bushing / pin / ring, RH/LH
5 Track shoe, bolt / nut, RH/LH
6 Track adjustment
7 Track roller RH/LH
8 Carrier roller RH/LH

TRAVELLING / SWING
1 Travel motor RH/LH
2 Travel drive RH/LH
3 Travel lock
4 Travel control valve / lever
5 Swing drive
6 Swing motor
7 Swing brake
8 Swing lock, manual / solenoid
9 Swing lever

BOOM
1 Boom base/inner
2 Boom in/insert
3 Boom out
4 Jib inner, outer
5 Pendant suspention
6 Gantry
7 Counter weight
9 Winch motor
10 Drum, main / aux.
11 Pendant / rope
12 Boom hoist
13 Pendant hoist
14 Main hoist
15 Auxiliary hoist
16 Jib hoist
17 Anti to block hoist
18 Limit member
19 Pulley / sheave

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 20 Main hook, safety latch
21 Auxiliary hook, safety latch
22 Equalizer

HYDROLIC SYSTEM
1 Hydrolic Tank / drain
2 Hydrolic pump, hose
3 Hydrolic relieve valve / solenoid
4 Hydrolic oil pressure gauge / indicator lamp
5 Hydrolic control valve

SAFETY DEVICE
1 Boom lock
2 Boom back stop/Boom kick out, alarm
3 Anti to block, alarm
4 Boom angle indicator
5 Load indicator
6 Swing alarm, light
7 Hazard / Spot light
8 Shut off engine

ELECTRIC SYSTEM
1 Battery
2 Battery box / clamp / cover
3 Terminal / connect cable
4 Starter Motor / Solenoid
5 Alternator / Charging system
6 Ampere meter gauge / indicator lamp
7 Start Switch
8 Instrument panel / wiring system
9 Fuse / cable
10 AC / blower

ACCESSORIES
1 First Aid Kit
2 Fire Extinguisher

General Comments :

INSPECTION TEAM
Mobile Maint. & Fabrication Hse Ops. Support User / witness Owner / witness

HSEOS2/Form\Crawler Crane Inspection\G_S/Rev010612 Page 3 of 4

 RE-INSPECTION TEAM
Mobile Maint. & Fabrication Hse Ops. Support User / witness Owner / witness

General comments:

VALID UNTIL :

Verified by, Approved by,

Maintenance & Fabrication Supt. HSE Ops. Support and Marine Supt.

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