EN
Inspection Report
Model Number:
Serial Number:
Reason for Inspection: (Check Applicable Box)
1. Scheduled Periodic Inspection ( ___ Quarterly ___ Semiannually ___ Yearly)
2. Discrepancy(s) noted during Frequent Inspection
3. Discrepancy(s) noted during maintenance
4. Other: ___________________________
Refer to the Product Information and Parts Information Manual and "INSPECTION" section for the general inspection criteria. Also, refer to
appropriate National Standards and Codes of Practice. If in doubt about an existing condition, contact the nearest Ingersoll Rand distributor
or the factory for technical assistance.
COMPONENT
Fasteners
Shafts
Bearings
Spool
Wire Rope Guide
Cover
Controls
Hooks
Gate acts as gauge when visually inspecting for stretched, twisted or bent hooks.
Top
Damage
Hook Crack Test Method Used: Dye Penetrant ________ Magnetic Particle ________ Other: ________
Gate acts as gauge when visually inspecting for stretched, twisted or bent hooks.
Bottom
Damage
Hook Crack Test Method Used: Dye Penetrant ________ Magnetic Particle ________ Other: ________
Hook Gate
Wire Rope
Working length(s) maximum wear: ________ inches / ________ mm
Supporting Structure
Rail System
Labels and Tags
Other Components (List in NOTES
section)
This form may be photocopied and used as an inspection record
EN-12
Ingersoll Rand Air Balancer
CONDITION
CORRECTIVE ACTION
Pass
Fail
Repair
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Date:
Inspected by:
Operating Environment:
Normal ___ Heavy ___ Severe ___
Replace
(maximum 10%)
Refer to Rail System Manual
NOTES
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