Thông tư 07/2014/TT-BLĐTBXH về 27 quy trình kiểm định kỹ thuật an toàn đối với máy, thiết bị có yêu cầu nghiêm ngặt về an toàn lao động thuộc trách nhiệm quản lý của Bộ Lao động - Thương binh và Xã hội ban hành

CIRCULAR

ON THE ISSUANCE OF 27 TECHNICAL SAFETY INSPECTION PROCEDURES FOR MACHINERY AND EQUIPMENT SUBJECT TO STRICT WORK SAFETY REQUIREMENTS UNDER THE MANAGEMENT OF THE MINISTRY OF LABOR - INVALIDS AND SOCIAL AFFAIRS

Pursuant to the Government’s Decree No. 106/2012/ND-CP dated 20 December 2012 on the functions, missions, authority and organizational structure of the Ministry of Labor - Invalids and Social affairs;

Pursuant to the Government’s Decree No. 45/2013/ND-CP on the details of certain articles of the Labor Code, which stipulate work time, rest time, work safety and hygiene;

At the request of the Head of the Department of Work safety;

Minister of Labor - Invalids and Social affairs issues the Circular on 27 technical safety inspection procedures for machinery and equipment subject to strict work safety requirements under the management of the Ministry of Labor - Invalids and Social affairs.

Article 1. Scope of regulation

This Circular is enclosed with 27 technical safety inspection procedures for machinery and equipment subject to strict work safety requirements under the management of the Ministry of Labor - Invalids and Social affairs. Names and codes of the procedures are defined in Appendices of this Circular.

...

...

...

1. This Circular comes into force as of 01 May 2014.

2. Decision No. 66/2008/QD-BLDTBXH dated 29 December 2008 on technical safety inspection procedures for lifting equipment, elevator and escalator; Decision No. 67/2008/QD-BLDTBXH dated 29 December 2008 on technical safety inspection procedures for boiler, pressure vessel, refrigerant system, gas preparation and loading system, gas cylinder, steam pipe and hot water pipe; Circular No. 01/2010/TT-BLDTBXH dated 12 January 2010 on technical safety inspection procedures for passenger cableway, roller coaster and slides shall lose effect when this Circular comes into force.

Article 3. Enforcement

Department of Work safety, Ministry of Labor - Invalids and Social affairs, technical work safety inspection organizations and entities concerned are responsible for enforcing this Circular. Difficulties that arise during the implementation of this Circular shall be reported to the Ministry of Labor - Invalids and Social affairs for consideration and settlement./.

PP MINISTER
DEPUTY MINISTER




Bui Hong Linh

Inspection procedure 1

...

...

...

FIELD DATA ACQUISITION FORM (TECHNICAL SAFETY INSPECTION FOR OVERHEAD LIFTING EQUIPMENT)

......, …, date: ... ... ...

FIELD DATA ACQUISITION FORM

(Record of full parameters for inspection and test as per the inspection procedure)

1. General information

Name of the equipment:

Name of the requester:

Address (head office):

...

...

...

Details of the work session:

- Participants: (details)

- Witness:

2. Basic parameters of the equipment:

- Code: …………

- Trolley speed: … meter/ minute

- Production number: …

- Bridge speed : … meter/ minute

- Year of production: …

...

...

...

- Manufacturer: ...

- Height of lift (main and auxiliary hooks): … m

- Intended load capacity: … ton

- Load capacity at cantilever’s end : … ton

- Lifting speed: … meter/ minute

- Function: …

3. Inspection of documents:

- Profile of the equipment:

- Technical documents:

...

...

...

5. Equipment inspection:

a) External inspection:

+ Metal structure

+ Hook block, sheave: …

+ Rope and rope fixation: …

+ Protective ground connection:

+ Rail, rail fixation:

+ Brake: ...

+ Safety instruments:

...

...

...

- 125% overload test (10-minute hold):

+ Brake: ...

+ Metal structure: …

- 110% dynamic load test:

+ Brake (load holding)

+ Constituents or parts:

+ Metal structure:

6. Inspection of limiters, load indicator, overload indicator.

7. Processing of findings of the inspection.

...

...

...

INSPECTOR
(sign and append full name)

APPENDIX 02

RECORD OF TECHNICAL SAFETY INSPECTION FOR OVERHEAD LIFTING EQUIPMENT

(Superior organization)
(Name of the inspection organization)

SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom - Happiness

...

...

...

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR OVERHEAD LIFTING EQUIPMENT)

No. …

The participants include:

1………Inspector’s number: ………

1………Inspector’s number: ………

Inspection organization: ………

Inspection organization’s registered certificate number: ………

Name of the equipment inspected: ………

...

...

...

Address (head office):

Address (location) of equipment installation:

Inspection procedure and standards applied: ………

Individuals witnessing and ratifying the record: ………

1......................................................                Position: ………

2......................................................                Position: ………

I. BASIC PARAMETERS OF THE EQUIPMENT

- Code: …………                                       - Trolley speed: … meter/ minute

- Production number: …                             - Bridge speed: … meter/ minute

...

...

...

- Manufacturer: ...                                      -  Height of lift (main and auxiliary hooks): … m

- Intended load capacity: … ton                      - Load capacity at cantilever's end: … ton

- Lifting speed: ... meter/ minute                           - Function: ...

II. FORM OF INSPECTION

First time □                          Periodic □                            Random □

III. DETAILS OF INSPECTION:

A. Inspection of technical documents:

- Remark: ………

- Assessment of findings:

...

...

...

Item

Pass

Fail

Note

1

Profile

...

...

...

- Remark: ………

- Assessment of findings:

No.

Constituent

Pass

Fail

Note

1

Main and auxiliary hooks

...

...

...

2

Pulley block

3

Main lift rope

...

...

...

4

Auxiliary lift rope

5

Main lift brake

...

...

...

6

Auxiliary lift brake

7

Trolley brake

...

...

...

8

Rail, rail gauge

9

Metal structure of main girders; attachments to the building

...

...

...

10

Hoist motor frame

11

Hoist motor brake

...

...

...

12

Main lifting mechanism

13

Auxiliary lifting mechanism

...

...

...

14

Trolley motion mechanism

15

Hoist motor motion mechanism

...

...

...

16

Rail clip

17

Siren (buzzer)

...

...

...

18

Height limit switch

19

Trolley motion controller

...

...

...

20

Electrical system

21

Control system

...

...

...

22

Hoist motor motion controller

C. Load test

- Remark: ………

...

...

...

No.

Load positions and findings

Pass

Fail

Equivalent load (ton)

Static load test (ton)

Dynamic load test (ton)

1

Mid-aperture

...

...

...

2

At cantilever’s end

...

...

...

3

Stability

...

...

...

Assessment of findings

Pass

Fail

Note

1

Metal structure:

...

...

...

Control system

3

Overload prevention device

...

...

...

Lifting rope

5

Lift brake

...

...

...

Trolley brake

7

Hoist motor brake

...

...

...

1. The equipment inspected is: Qualified □                                    Unqualified □

to operate with the maximum load of … ton

2. Inspection stamp n^o … Stamp position: ...

3. Recommendation:

Time limit for implementation of recommendations: …

V. INSPECTION SCHEDULE

The following inspection shall be scheduled for ... [date]

Reason for early inspection schedule (if applicable): …

The record was ratified on … [date]

...

...

...

The record is made into ... originals. Each party keep ... original(s)

The inspectors assume all liabilities for the accuracy of remark and assessments in this record./.

EQUIPMENT USER
(Sign and append corporate seal)
(Undertaking to fulfill recommendations in timely manner)

WITNESS
(Sign and append full name)

INSPECTOR
(Sign and append full name)

Inspection procedure 3

APPENDIX 01

...

...

...

......, …, date: ... ... ...

FIELD DATA ACQUISITION FORM

(Record of full parameters for inspection and test as per the inspection procedure)

1. General information

Name of the equipment:

Name of the requester:

Address (head office):

Address (location) of equipment installation:

...

...

...

- Participants: (details)

- Witness:

2. Basic parameters of the equipment:

Code:

Year of production:

Rated speed:

Quantity of stops:

Production number:

Rated load:

...

...

...

3. Inspection of documents:

- Profile of the equipment:

- Technical documents:

4. Measurement device identification code:

5. a) External inspection:

- Insulation resistance:

- Machine room:

- Motor parameters:

Capacity

...

...

...

Rated current:

Code:

Serial number:

Voltage:

Manufacturer:

Rotary speed:

- Inspection of hoist rope and counterweight:

- Inspection of roller guides:

...

...

...

- Elevator pit:

- Distance from the pit’s bottom to buffer’s tip upon full compression:

- Distance from counterweight’s bottom to the buffer’s tip upon full compression:

- Distance from the pit’s bottom to the car’s lowest position:

- Distance from the car's roof to the head room's lowest position:

- Distance from the entrance door’s threshold to the car’s doorstep:

- Distance from the counterweight to the car:

7. Technical inspection:

- Empty load test:

...

...

...

                                                + Speed:

                                                + Maximum floor arrival precision deviation:

- 125% load test:                           + Electromagnetic brake:

                                                + Safety gear:

                                                + Push pull test:

- + Automatic rescue device test:

- Overload prevention device:

- Test of elevator operation upon fire or earthquake (if applicable):

8. Recommendation: (if any)

...

...

...

INSPECTOR
(Sign and append full name)

APPENDIX 02

RECORD OF TECHNICAL SAFETY INSPECTION FOR ELECTRIC ELEVATOR

(Superior organization)
(Name of the inspection organization)

SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom - Happiness

............ ... ..., date ... ... ... ...

...

...

...

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR ELECTRIC ELEVATOR)

No. …

The participants include:

1………Inspector’s number: ………

1………Inspector’s number: ………

Inspection organization: ………

Inspection organization’s registered certificate number: ………

Name of the equipment inspected: ………

Name of the requester:

...

...

...

Address (location) of equipment installation:

Inspection procedure and standards applied: ………

Individuals witnessing and ratifying the record: ………

1...................................................                   Position: ………

2...................................................                   Position: ………

I. PARAMETERS OF THE ELEVATOR

Elevator type:

Year of production:

Rated speed (meter/ minute):

...

...

...

Production number:

Rated load (Kg):

Manufacturer:

Quantity of stops:

Purpose of use:

II. FORM OF INSPECTION

First time □                                                   Periodic □                         Random □

III. DETAILS OF INSPECTION:

1. DOCUMENT INSPECTION:

...

...

...

- Assessment of findings:

No.

ITEM

PASS

FAIL

NOTE

1

2

Profile

...

...

...

2. EXTERNAL INSPECTION:

- Remark: ………

Elevator completeness and synchronization: …

Defects and deformation: …

- Assessment of findings: Pass □                                  Fail □

3. TECHNICAL INSPECTION AND EMPTY LOAD TEST:

...

...

...

- Assessment of findings:

No.

ITEM

PASS

FAIL

NOTE

1

Elevator pit

...

...

...

2

Machine room

3

Motor

...

...

...

4

Gearbox

5

Electromagnetic brake

...

...

...

6

Roller guide

7

Overspeed governor

...

...

...

8

Suspension rope

9

Sheaves

...

...

...

10

Car

11

Counterweight

...

...

...

12

Buffer

13

Safety gear

...

...

...

14

Electrical system

15

Final terminal limit protection

...

...

...

16

Entrance door - door control

17

Distance from the pit’s bottom to car's lowest position:

...

...

...

18

Distance from the car’s roof to the head room’s lowest position

19

Distance from the entrance door’s threshold to car’s doorstep:

...

...

...

4. DYNAMIC TEST OF 100% RATED LOAD:

- Remark: ………

- Assessment of findings:

...

...

...

Result:

Pass

□

Fail

□

+ Electric current in the motor:

Result:

Pass

□

...

...

...

□

+ Maximum floor arrival precision deviation:

Result:

Pass

□

Fail

□

+ Instantaneous safety gear with or without buffered effect:

Result:                                       Pass □                Fail □

...

...

...

- Remark: ………

- Assessment of findings:

+ Electromagnetic brake

Result:

...

...

...

□

Fail

□

+ Progressive safety gear

Result:

Pass

□

Fail

□

...

...

...

Result:

Pass

□

Fail

□

6. RESCUE SYSTEM TEST:

...

...

...

- Remark: ………

- Assessment of findings:

+ Automatic rescue device (if available)    Result:                       Pass □            Fail □

+ Communications system (bell, emergency phone)

                                                            Result:                       Pass □            Fail □

IV. CONCLUSION AND RECOMMENDATION

1. The elevator inspected is:                      Qualified □            Unqualified □

to operate with the maximum load of … (kg)2. Inspection stamp n^o … appended at …

...

...

...

Time limit for implementation of recommendations: …

V. INSPECTION SCHEDULE

The following inspection shall be scheduled for ... [date]

Reason for early inspection schedule (if applicable): …

The record was ratified on … [date]

At: …

The record is made into ... originals. Each party keep ... original(s)

The inspectors conducting the inspection of the elevator assume all liabilities for the accuracy of remarks and assessments in this record./.

...

...

...

WITNESS
(Sign and append full name)

INSPECTOR
(Sign and append full name)

Inspection procedure 08

APPENDIX 1

FIELD DATA ACQUISITION FORM (TECHNICAL SAFETY INSPECTION FOR INDUSTRIAL GAS CYLINDERS)

......, …, date: ... ... ...

FIELD DATA ACQUISITION FORM

...

...

...

Inspection schedule: First time □;          Periodic □;                   Random □

User

Production number, batch number:                                                         (1)

Month and year of production:                                                                (2)

Type of cylinder (by volume):                                            Hydraulic test pressure (Bar):

                                                                                    Tightness test pressure (Bar):

Inspector

Signature

Performer of visual inspection

...

...

...

Performer of hydraulic test

Signature

Performer of tightness test

Signature

Weight (kg)                                                                                       Result of inspection

Code

Production number

Month and year of production

...

...

...

Weight (kg)

Result of inspection

On label

Actual

Pass

Early inspection schedule (specify reasons)

Fail (specify reasons)

1

...

...

...

(3)

2

...

...

...

(4)

3

...

...

...

4

...

...

...

5

...

...

...

· (1), (2) for cylinders inspected for the first time.

· (3) for example: 02 years due to cylinders’ containment of gases corroding metal or posing hazards

...

...

...

INSPECTOR
(Sign and append full name)

APPENDIX 2

RECORD OF TECHNICAL SAFETY INSPECTION FOR INDUSTRIAL GAS CYLINDERS

(Superior organization)
(Name of the inspection organization)

SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom - Happiness

...

...

...

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR INDUSTRIAL GAS CYLINDERS)

The participants include:

1………Inspector’s number: ………

2………Inspector’s number: ………

Inspection organization: …

Inspection organization’s registered certificate number: ………

Having inspected: …

Under ownership of (name of the organization):

...

...

...

Location of inspection: …

Inspection procedures applied: ………

Individuals witnessing and ratifying the record: ………

1.......................................................... Position:................................................

2.......................................................... Position:................................................

I. BASIC PARAMETERS OF CYLINDERS

Name and address of the manufacturer: …

Month and year of production: …

Batch number: …

...

...

...

The brand name embossed on cylinders: …

Intended pressure:........................... bar          Test pressure:.........................................bar

Volume: … liters                               Tare weight: … kg

Function: …

Previous date of inspection: … By: …

II. FORM OF INSPECTION

First time □;                             Periodic □;                         Random □

III. DETAILS OF INSPECTION:

1. Inspection of documents and profile:

...

...

...

Pass

Fail

Item

Pass

Fail

Cylinder batch list

Result of cylinder batch inspection

...

...

...

Result of strength and tightness tests:

Result of volumetric expansion test

Result of tests on materials’ mechanical properties and welds

...

...

...

Record of explosion test

Result of thickness test

Result of ultrasonic test of welds

...

...

...

Cylinder batch’s profile

Documents on usage, inspection and other details of the cylinders

Other papers

...

...

...

Assessment of findings:

- Remark: ………

- Result: Pass □                                  Fail □

2. External and internal inspection:

Item

Pass

Fail:

Item

...

...

...

Fail

Conditions of cylinder shroud

Conditions of external metal surface

Conditions of cylinder foot

...

...

...

Conditions of internal metal surface

Cylinder valve:

Weld surface conditions

...

...

...

- Result:                                    Pass □                          Fail □

3. Test:

Entry

Reagent

Test pressure (bar):

Duration (minute)

Strength test

...

...

...

Volumetric expansion test

Tightness test

- Remark: ………

...

...

...

IV. CONCLUSION AND RECOMMENDATION

1. The batch (specify the quantity of cylinders) inspected is:   Qualified □                     Unqualified □

2. Inspection mark has been appended on: …

3. Operational pressure: … bar

4. Recommendation:

5. Time limit for implementation of recommendations: …

V. INSPECTION SCHEDULE

Periodic inspection shall be scheduled for ... [date]

The record was made on … [date]

...

...

...

The inspectors conducting the inspection assume all liabilities for the accuracy of remarks and assessments in this record./.

1. For the inspection done at the inspection organization’s station:

HEAD OF THE STATION
(sign and append full name)

INSPECTOR
(Sign and append full name)

TECHNICIAN
(Sign and append full name)

2. For the inspection done at the concerned organization’s premises:

HEAD OF THE ORGANIZATION
(sign and seal)

WITNESS
(Sign and append full name)

...

...

...

APPENDIX 3

LIST OF SAMPLE CYLINDERS INSPECTED

Cylinder batch:

Quantity of cylinders:

Production number: from … to…

User (manager):

(Enclosed with the record or certificate of registration n^o …dated …),

No.

...

...

...

Month and year of production

Manufacturer

Weight (kg)

Result:

Pass

Fail (specify reasons)

1

...

...

...

2

...

...

...

...

LIST OF CYLINDERS EXCLUDED (OR LIST OF CYLINDER BATCHES)

...

...

...

Quantity of cylinders excluded:

User (manager):

No.

Production number

No.

Production number

No.

Production number

No.

...

...

...

1

2

...

...

...

...

...

...

...

Note:

+ Draw up the “LIST OF CYLINDERS EXCLUDED” for the cylinder batch with continuous production numbers or with few cylinders excluded (for the manufacturer’s test of mechanical properties, destructive test, etc.) or draw up the “LIST OF CYLINDER BATCHES” and specify the full amount of cylinders in the batch for the cylinder batch with interrupted production numbers. + This list may not be required if there are only a few cylinders to be directly enumerated in the record.

Notice: This list must not be modified. The list must be stamped on its corner or fan stamped.

LIST OF CYLINDER BATCHES INSPECTED

...

...

...

Quantity of cylinders:

Production number: from … to …

User (manager):

(Enclosed with the record or certificate of registration n^o … dated …)

No.

Production number

Month and year of production

Manufacturer

Weight (kg)

...

...

...

Pass

Fail (specify reasons)

1

...

...

...

...

...

...

...

Inspection procedure 19

APPENDIX 1

FIELD DATA ACQUISITION FORM (FOR MOBILE CRANE)

......, …, date: ... ... ...

...

...

...

(Record of full parameters for inspection and test as per the inspection procedure)

1. General information

Name of the equipment:

Name of the requester: …

Address (head office): …

Address (location) of equipment installation:

Details of the work session:

- Participants: (details)

- Witness:

...

...

...

- Code: …

- Rotary speed: … rotation/ minute

- Production number: …

- Travelling speed (for self-propelled ones): … meter/ minute

- Year of production: …

- Working radius (max): … meter

- Manufacturer: …

- Lifting height (main and auxiliary hooks): … meter

- Intended load (max): … ton

...

...

...

- Lifting speed: … m/ minute

- Function: …

3. Inspection of documents:

- Profile of the equipment:

- Technical documents:

4. Measurement device identification code:

5. Inspection of the equipment:

a) External inspection:

- Metal structure:

...

...

...

- + Rope and rope fixation: …

- Hydraulic system, piston, cylinder:

- Brake:

- Counterweight: …

- Safety devices:

b) Technical inspection:

- Test at 125% rated load (10-minute hold):

- Brake:

- + Metal structure:

...

...

...

- + Brake (load holding)

- Constituents or parts:

- Metal structure:

6. Inspection of limiters, load indicator, overload indicator.

7. Processing and assessment of findings of the inspection.

8. Recommendation: (if any)

INSPECTOR
(Sign and append full name)

...

...

...

APPENDIX 2

RECORD OF TECHNICAL SAFETY INSPECTION

(FOR MOBILE CRANE)

(Superior organization)
(Name of the inspection organization)

SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom - Happiness

................. ... ..., date ... ... ... ...

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR MOBILE CRANE)

...

...

...

The participants include:

1. Inspector’s number:

2. Inspector’s number:

Inspection organization: ………

Inspection organization’s registered certificate number: ………

Name of the equipment inspected: ………

Name of the requester:

Address (head office): …

Address (location) of equipment installation:

...

...

...

Individuals witnessing and ratifying the record: ………

1. ...................................... Position:..................................

2. ...................................... Position:..................................

I. BASIC PARAMETERS OF THE EQUIPMENT

- Code: …

- Rotary speed: … rotation/ minute

- Production number: …

- Travelling speed (for self-propelled ones): … meters/ minute

- Production number: …

...

...

...

- Manufacturer: …

- Actual / intended lifting height (main and auxiliary hooks): … meter

- Intended load (max): … ton

- Load at maximum actual / intended radius: … ton

- Lifting speed: … meter/ minute

- Function: …

II. FORM OF INSPECTION

First time □,                             periodic □,                   random □

III. DETAILS OF INSPECTION:

...

...

...

No.

Entry

Pass

Fail

Note

No.

Entry

1

...

...

...

2

Number plate

………….

B. External inspection and no-load test:

No.

...

...

...

Pass

Fail

Note

1

Main and auxiliary hooks

2

...

...

...

3

Main lifting rope

4

...

...

...

5

Boom bearing

6

...

...

...

7

Main lifting part

8

...

...

...

9

Height limiter

10

...

...

...

11

Counterweight

12

...

...

...

13

Main lift brake

14

...

...

...

15

Auxiliary lifting part

16

...

...

...

17

Boom extension part

18

...

...

...

19

Siren and buzzer

20

...

...

...

21

Hoist motor frame

22

...

...

...

23

Boom lift brake

24

...

...

...

25

Control system

26

...

...

...

27

Rotating part

28

...

...

...

C. Load test

No.

Load positions and findings

Pass

Fail

Radius (m)

...

...

...

Equivalent load (ton)

Static load test (ton)

Dynamic load test (ton)

1

Minimum radius

R =

...

...

...

2

Maximum radius

R =

...

...

...

3

Auxiliary hook

...

...

...

4

Main boom length

...

...

...

Stability

...

...

...

Assessment of findings

Pass

Fail

Note

1

Metal structure:

...

...

...

Load lift brake

3

Boom lift brake

...

...

...

Overload prevention device (if available)

5

Lift rope

...

...

...

Brake for rotating part

7

Travel brake

...

...

...

Outrigger (chain)

9

Hydraulic system

...

...

...

Control system

IV. CONCLUSION AND RECOMMENDATION

1. The equipment inspected is: Qualified □                                   Unqualified □

2. Inspection stamp n^o … affixed at …

3. The equipment is functionally qualified for the maximum load of … ton at an equivalent radius of … meter

4. Recommendations:

...

...

...

V. INSPECTION SCHEDULE

Periodic inspection:           …. [date]

Reason for early inspection schedule (if applicable): …

The record was ratified on … [date]

At: …

The record is made into ... originals. Each party keep ... original(s)

The inspectors conducting the inspection assume all liabilities for the accuracy of remarks and assessments in this record./.

HEAD OF THE CONCERNED PARTY
Undertakes to fulfill recommendations promptly
(Sign and seal)

...

...

...

INSPECTOR
(Sign and affix full name)

Inspection procedure 21

APPENDIX 1

FIELD DATA ACQUISITION FORM
(FOR FORKLIFT)

......, ... ... ..., date ... ... ... ...

FIELD DATA ACQUISITION FORM

(Record of full parameters for inspection and test as per the inspection procedure)

...

...

...

Name of the equipment:

Name of the requester:

Address (head office): …

Address (location) of equipment installation:

Details of the work session:

- Participants: (details)

- Witness:

2. Basic parameters of the equipment:

- Code: …………                                   - Fork size: … mm

...

...

...

- Year of production: …                         - Lift speed: … meter/ minute

- Manufacturer: ...                                  - Travel speed: … kilometer/ hour

- Power source: …                                 - Load center distance at maximum load: … mm

- Working / intended load: … / … kg                   - Function: …

3. Inspection of documents:

- Profile of the equipment:

- Technical documents:

4. Measurement device identification code:

5. Inspection of the equipment:

...

...

...

- Fork: …

- Carriage: …

- Lift cylinder: …

- Tilt cylinder: …

- Load bearing cylinder: …

- Counterweight: …

- Overhead guard: …

- Signs that indicate radius and equivalent load: …

- System for signaling, observation, lighting: …

...

...

...

- Brake system: …

- Safety devices: …

b) Technical inspection:

- Test at 125% rated load (10-minute hold):

+ Brake: …

+ Metal structure: …

- Dynamic test at 110% rated load:

+ Brake (load holding)

+ Constituents and parts:

...

...

...

7. Processing and assessment of findings of the inspection.

8. Recommendation: (if any)

INSPECTOR
(Sign and affix full name)

APPENDIX 2

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR FORKLIFT)

(Superior organization)
(Name of the inspection organization)

...

...

...

..............…, date … … …

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR FORKLIFT)

No. …

The participants include:

1. Inspector’s number: …

2. Inspector’s number: …

Inspection organization: ………

...

...

...

Name of the equipment inspected: ………

Name of the requester:

Address (head office): …

Address (location) of equipment installation:

Inspection procedure and standards applied: ………

Individuals witnessing and ratifying the record: ………

1. ...................................... Position:..................................

2. ...................................... Position:..................................

I. BASIC PARAMETERS OF THE EQUIPMENT

...

...

...

- Production number: …                         - Lift height: … mm

- Year of production: …                         - Lift speed: … meter/ minute

- Manufacturer: ...                                  - Travel speed: … kilometer/ hour

- Power source: …                                 - Load center distance at maximum load: … mm

- Working / intended load: … /… kg- Function: …

II. FORM OF INSPECTION

First time □,                             periodic □,                   random □

III. DETAILS OF INSPECTION:

A. Inspection of technical documents:

...

...

...

Entry

Pass

Fail

Note

1

Profile of the equipment:

...

...

...

B. External inspection and no-load test:

No.

Constituents and parts

Pass

Fail

...

...

...

1

Load bearing

2

Carriage

...

...

...

3

Lift cylinder

4

Tilt cylinder

...

...

...

5

Load bearing cylinder

6

Counterweight

...

...

...

7

Overhead guard

8

Indicators of radius and equivalent load

...

...

...

9

Overload prevention device

10

Hydraulic system

...

...

...

11

Control system

12

System for signaling, observation, lighting: …

...

...

...

13

Motion-driving system

14

Travel system: …

...

...

...

15

Brake system

16

Lift height limiter

...

...

...

17

Tilting angle limiter

C. Load test

No.

Load positions and findings

Pass

...

...

...

Static load test (ton)

Dynamic load test (ton)

1

On the fork

...

...

...

2

Stability

No.

Assessment of findings

Pass

...

...

...

Note

1

Load bearing and carriage

2

System for signaling, observation and lighting

...

...

...

3

Overload prevention device

4

Travel system

...

...

...

5

Hydraulic system

6

Brake system

...

...

...

7

Motion-driving system

IV. CONCLUSION AND RECOMMENDATION

1. The equipment inspected is:  Qualified □                   Unqualified □

to operate at the maximum load of … ton, with the equivalent load center distance of … mm

...

...

...

Time limit for implementation of recommendations: …

V. INSPECTION SCHEDULE

The following inspection shall be scheduled for … [date]

Reason for early inspection schedule (if applicable): …

The record was ratified on … [date] at: …

The record is made into ... originals. Each party keep ... original(s)

The inspectors conducting the inspection assume all liabilities for the accuracy of remarks and assessments in this record./.

HEAD OF THE CONCERNED PARTY
Undertakes to fulfill recommendations promptly
(Sign and seal)

...

...

...

INSPECTOR
(Sign and affix full name)

Inspection procedure 23

APPENDIX 1

FIELD DATA ACQUISITION FORM
(FOR GOODS LIFT WITH ATTENDANTS)

......, …,date ... ... ...

FIELD DATA ACQUISITION FORM

(Record of full parameters for inspection and test as per the inspection procedure)

...

...

...

Name of the equipment:

Name of the requester:

Address (head office): …

Address (location) of equipment installation:

Details of the work session:

- Participants: (details)

- Witness:

2. Basic parameters of the equipment:

- Type and code:

...

...

...

- Intended load:

.........… ton

- Production number:

................

- Lift speed:

.........… meter / minute

- Year of production:

...

...

...

- Lift height:

........................

meter

- Manufacturer:

................

- Function:

..............................

3. Inspection of documents:

...

...

...

- Technical documents:

- Inspection of design documents and foundation completion papers

- Data from the measurement of anti-lightning and ground wiring systems: …

4. Measurement device identification code:

5. Inspection of the equipment:

a) External inspection:

+ Inspection of the equipment’s location, electrical system, internal written guidelines on usage, protective fences, ground area, distance and safety measures.

+ Pillar platform structure:

+ Car buffer must be fully and firmly installed (according to design documents).

...

...

...

+ Entrance doors that the lift reaches:

+ Pillar body:

+ Car (cage):

+ Motion-driving part for the cage:

+ Fall protection unit:

+ Counterweight

+ Ground wiring unit:

+ Inspection of anti-lightning system:

+ Safety devices:

...

...

...

b) Technical inspection:

- Test at 125% rated load (10-minute hold):

+ Brake:

+ Metal structure: …

- Dynamic test at 110% rated load:

+ Brake (load holding)

+ Constituents and parts:

+ Metal structure:

c) Inspection of fall protection unit:

...

...

...

7. Processing and assessment of findings of the inspection.

8. Recommendation (if any):

INSPECTOR
(Sign and affix full name)

APPENDIX 2

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR GOODS LIFT WITH ATTENDANTS)

(Superior organization)
(Name of the inspection organization)

...

...

...

..............…, date … … …

RECORD OF TECHNICAL SAFETY INSPECTION
(FOR GOODS LIFT WITH ATTENDANTS)

No. …

The participants include:

1. … Inspector’s number: ….

2. … Inspector’s number: ….

Inspection organization: ………

...

...

...

Name of the equipment inspected: ………

Name of the requester:

Address (head office): …

Address (location) of equipment installation:

Inspection procedure and standards applied: ………

Individuals witnessing and ratifying the record: ………

1. ...................................... Position:..................................

2. ...................................... Position:..................................

I. BASIC PARAMETERS OF THE EQUIPMENT

...

...

...

....................

- Intended load:

.....................

ton

- Production number:

....................

- Lift speed:

......................

meter/minute

...

...

...

....................

- Lift height:

......................

meter

- Manufacturer:

....................

- Function:

...........................

...

...

...

First time □,     Periodic □,      Random □

III. DETAILS OF INSPECTION:

A. Inspection of technical documents:

No.

Item

Pass

Fail

Note

1

...

...

...

Ground foundation papers

...

...

...

B. External inspection and no-load test

No.

Constituents and parts

Pass

Fail

Note

...

...

...

Car

2

Gear box

...

...

...

Rack and pinion

4

Pillar’s metal structure

...

...

...

Anchored tie

6

Final terminal limit protection

...

...

...

Erection part

8

Load lifting part

...

...

...

Lift brake

10

Fall protection brake

...

...

...

Platform frame (buffer)

12

Siren and buzzer

...

...

...

Ground wiring

14

Anti-lightning

...

...

...

Safety barrier

16

Control system

...

...

...

Load positions and equivalent load test

No.

Load position

Pass

Fail

Equivalent load (ton)

Static load test (ton)

Dynamic load test (ton)

1

...

...

...

2

Stability

...

...

...

No.

Load test result

Pass

Fail

Note

1

Pillar’s metal structure

...

...

...

2

Car structure

3

Lift brake

...

...

...

4

Gear box

5

Rack and pinion

...

...

...

6

Control system

7

Fall protection brake

...

...

...

8

Anchored tie

9

Overload indicator

...

...

...

IV. CONCLUSION AND RECOMMENDATION

1. The equipment inspected is: Qualified □       Unqualified □ to operate at the maximum load of … kg.

2. Inspection stamp n^o …was affixed at … 3. Recommendations:

Time limit for implementation of recommendations: …

V. INSPECTION SCHEDULE

The following inspection shall be scheduled for … [date]

Reason for early inspection schedule (if applicable): …

The record was ratified on … [date]

...

...

...

The record is made into ... originals. Each party keep ... original(s)

The inspectors conducting the inspection assume all liabilities for the accuracy of remarks and assessments in this record./.

HEAD OF THE CONCERNED PARTY
Undertakes to fulfill recommendations promptly
(Sign and seal)

WITNESS
(Sign and affix full name)

INSPECTOR
(Sign and affix full name)