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Department of Labor and Training - Division of Occupational Safety - Elevator Unit Date: Location of Elevator:

DLT - L - 130 (11/04)

HYDRAULIC ELEVATOR INSPECTION CHECK LIST


State I.D. Number: Phone Number: Last Inspected Signature:

Passenger Freight Capacity Speed Inspected By: RI License No.: Signature of person interviewed Key Code: No Deficiencies - OK
INSIDE OF CAR
Door reopening device Stop switch Operating control devices Car floor and landing sill Car lighting Car emergency signal Car door or gate Door closing force Power closing of doors or gates Power opening of doors or gates Car vision panel & glass car doors Car enclosures Emergency exits Ventilation Signs & operating devices symbols, A/V
Rated load, platform area & data plate

Elevator Co

Safety Test Information: Annual________Annual Relief Valve______3 Year Governor Calibration_____ Needs Repair - NR Not Applicable - NA
HOISTWAY (cont.)
Car frame and stiles Guide rails, fastening, equipment Governors, safeties, ropes and counterweights Railing on top of car

MACHINE ROOM (cont.)


Controller wiring, fuses, grounding Hydraulic power unit Relief valves Control valves Tanks Flexible hydraulic hose & fitting assemblies Supply line & shutoff valve Hydraulic cylinder Pressure switch TOP OF CAR Top of car stop switch Car top light and outlet Top of car operating device Top of car clearance & refuse space Normal terminal stopping device Emergency terminal speed limited devices Anti-creep leveling device Crosshead data plate Top emergency exit Floor & emergency ID numbers Hoistway construction HOISTWAY Pipes, wiring and ducts Hoistway construction Hoistway smoke control Windows, projection, recess and setbacks Hoistway clearances Multiple hoistway Traveling cables, junction boxes Door and gate equipment

INSIDE HOISTWAY
Car platform guard Hoistway doors Vision panels Hoistway door locking device Access to hoistway Power closing of hoistway doors Sequence operation Hoistway enclosure Elevator parking device Emergency doors in blind hoistways Standby power selection switch PIT Pit access, light and stop switch and condition Bottom clearance and run by Plunger and cylinder Car buffer Normal terminal stopping devices Traveling cables Car frame and platform Guiding members Supply piping Registration number, stamped / marked Certificate posted MISCELLANEOUS CHECKS Firefighters Service (Phase 1 & 2)

Standby power operation Restricted opening of car or hoistway doors Car ride MACHINE ROOM Access to machine space Headroom Lighting and receptacles Enclosure of machinery space Housekeeping Ventilation Fire extinguisher Pipes, wiring and ducts Guarding of exposed equipment Numbering of elevators, machines and disconnect switches Disconnecting means & control

CODE VIOLATIONS: -

*Per R.I.G.L. 23-33-24, violations must be abated within 30 days from the above inspection date.

Please Print FOUR COPIES: DLT - 1, Elevator Co - 1, Customer - 1 and Machine Room - 1

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