Initial Date: January 2015

Revision Date: January 2017 Safety, Health and Environment

Standards
Revision No: 01
Document No:

CHAIN BLOCK CHECKLIST: MONTHLY

DEPARTMENT: WET GRAVITY EXTENSION PROJECT EQUIPMENT NO: 275428
APPOINTED PERSON TO INSPECT: NICO VAN DER WESTHUIZEN
MONTHS
POINTS TO BE CHECKED
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Correct colour tag
No physical damage
Casings not damaged or cracked
Chain not kinked or damaged
Hand chain not damaged or kinked
Smooth action, no binding when operated
All bolts tight
No cracks in hook
No damage to hook latch
Hook not bent or distorted.
Other (describe):

Appointed person checked:

Appointed Contractor Supervisor certified:
Safety Officer checked on date:
Contractor Site Manager to sign:
To Standard.
OK
REMARKS: May be Used
Physical Damage
PD
Do Not Use