INSPECTION CHECK LIST/ ‫ﺹﺣﻔﻟﺍ ﺔﻌﺟﺍﺭﻣ ﺔﻣﺋﺎﻗ‬

MOBILE CRANE / CRAWLER (‫ ﻝﻳﺟﻧﺯ ﻭﺫ (ﺓﺭﺯﻧﺟﻣ) ﺔﻌﻓﺍﺭ )ﺔﻠﻘﻧﺗﻣ‬/ ‫ﺔﻛﺭﺣﺗﻣ ﺔﻌﻓﺍﺭ‬

CRANE

Date / Time:
Equipment Plate No.: :‫ﺓﺩﻌﻣﻟﺍ ﺔﺣﻭﻟ ﻡﻗﺭ‬ Log No.: :‫ﺔﻣﻼﻌﻟﺍ ﻡﻗﺭ‬
Crane Type/ Model:‫ﻝﻳﺩﻭﻣﻟﺍ \ ﺔﻌﻓﺍﺭﻟﺍ ﻉﻭﻧ‬ Subcontractor: ‫ﻱﻭﻧﺎﺛﺍ ﻝﻭﺎﻘﻣﻟﺍ‬
Capacity: :‫ﺔﻌﺳﻟﺍ‬ Lifting Supervisor: : ‫ﻊﻓﺭﻟﺍ ﻑﺭﺷﻣ‬
Manufacturer: ‫ﻊﻧﺎﺻﻟﺍ‬ HSE In-charge: :‫ﻝﻭﺅﺳﻣﻟﺍ ﺔﻣﻼﺳﻟﺍ ﻝﺟﺭ‬
Lifting Item/Type of Lift: ‫ ﺩﺍﻭﻣ ﻊﻓﺭ‬/ ‫ﻊﻓﺭﻟﺍ ﻉﻭﻧ‬: Signalman:‫ﺓﺭﺎﺷﻻﺍ ﻝﺟﺭ‬
Result Column: Acceptable, X: Unacceptable, Not to use, NA: Not applicable ‫ ﺔﻟﻭﺑﻘﻣ‬:‫ﺩﻮﻤﻌﻟﺍ ﺔﺠﻴﺘﻧ‬, ‫ ﺔﻟﻭﺑﻘﻣ ﺭﻳﻏ‬X: ‫ﺔﻣﺩﺧﺗﺳﻣ ﺭﻳﻏ‬, No ‫ ﻕﻳﺑﻁﺗﻠﻟ ﺔﻠﺑﺎﻗ ﺭﻳﻏ‬NA
No.

S/N Check Item / ‫ﺹﺣﻔﻟﺍ ﺩﻭﻧﺑ‬ Result ‫ﺔﺟﻳﺗﻧﻟﺍ‬ Remark

Yes/No
1. Ground Condition/Stable/Compacted with standard outrigger pads.
.‫ ﺽﺭﻷﺍ ﺔﺎﻟﺣ‬/ ‫ ﺔﺗﺑﺎﺛ‬/ ‫ﻲﺳﺎﻳﻘﻟﺍ ﺓﺯﻳﻛﺭﻟﺍ ﻉﺍﺭﺫ ﺕﺎﺻﻧﻣ ﻊﻣ (ﺔﻟﻭﺩﺣﻣ) ﺔﻛﻭﻛﺩﻣﻟﺍ‬
2. Road Block / Area Isolation Needed ‫ﺏﻭﻠﻁﻣ ﺔﻁﻧﻣﻟﺍ ﻝﺯﻋ \ ﻕﻠﻐﻣ ﻕﻳﺭﻁﻟﺍ‬

3. Area Barricaded with Safety Signage ‫ﺔﻣﻼﺳﻟﺍ ﺕﺎﻣﻼﻋ ﻊﺿﻭ ﻊﻣ ﺔﻘﻁﻧﻣﻟﺍ (ﻁﻳﻭﺣﺗ)ﺯﺟﺍﻭﺣﻟﺍ ﻊﺿﻭ‬
4. The warning sign for power line required clearances
‫ﺔﺣﺿﺍﻭ ﻥﻭﻛﺗ ﻥﺍ ﺏﺟﻳ ﺔﻗﺎﻁﻟﺍ ﻁﻭﻁﺧﻟ ﺭﻳﺫﺣﺗﻟﺍ ﺕﺎﻣﻼﻋ‬
5. No of Riggers ~1~2~3~4 > 4~3~2~1~ ‫> ﻝﻣﻌﻠﻟ ﻥﻳﺩﻋﺎﺳﻣﻟﺍ ﺩﺩﻋ‬
6. Assigned Flag man ( ‫ﺔﻳﺍﺭﻟﺍ ﻝﺟﺭ ﻊﺿﻭ ﻭﺍ ﻥﻳﻳﻌﺗ ) ﺓﺭﺎﺷﻻﺍ‬
7. Operator Competency/Certificate ‫ﺓﺩﺎﻬﺷ ﻰﻠﻋ ﻝﺻﺎﺣ \ ﻝﻫﺅﻣ ﻝﻐﺷﻣﻟﺍ‬
8. Lifting Equipment’s & Lifting Tackle TPI Certificates
‫ﺙﻟﺎﺛﻟﺍ ﻑﺭﻁﻟﺍ ﻝﺑﻗ ﻥﻣ ﺹﺣﻔﻠﻟ ﺔﻌﺿﺎﺧ ﺎﻬﺗﺎﻘﺣﻠﻣﻭ & ﻊﻓﺭﻟﺍ ﺕﺍﺩﻌﻣ‬
9. Internal Inspection/Color Coding ‫ﻲﻧﻭﻠﻟﺍ ﺯﻳﻣﺭﺗﻟﺍ‬/‫ﻲﻠﺧﺍﺩﻟﺍ ﺹﺣﻔﻟﺍ‬
10. Dry Run / Pre-Lift Test Accessibility needed ‫ ﻑﺎﺟ ﻝﻳﻐﺷﺗ‬/ ‫ﺔﺑﻭﻠﻁﻣﻟﺍ ﻝﻭﺻﻭﻟﺍ ﺔﻳﻧﺎﻛﻣﺇ ﺭﺎﺑﺗﺧﺇ ﻊﻓﺭﻟﺍ ﻝﺑﻗ‬
11. 75% of tipping for crawler cranes and 85% of tipping for truck crane
...(... ‫ )ﺦﻟﺍ ﺏﺎﻳﻫ‬75٪ ‫ ﻭ (ﺔﻓﺭﺳ) ﺓﺭﺯﻧﺟﻣ ﺕﺎﻌﻓﺍﺭﻟ ﺔﺑﺳﻧﻟﺎﺑ ﻝﻭﺣﺗﻟﺍ ﻥﻣ‬85٪ ‫ﺔﻌﻓﺍﺭ ﺔﻧﺣﺎﺷﻟ ﺢﻳﺟﺭﺗ ﻥﻣ‬
12. The Anti- two –blocking devices (main and auxiliary) ‫ﻥﻳﺯﺎﻬﺟﻠﻟ ﺩﺎﺿﻣ –(ﺓﺩﻋﺎﺳﻣﻟﺍﻭ ﺔﻳﺳﻳﺋﺭﻟﺍ) ﻙﻭﻬﻠﻟ‬
13. Hook weight is marked/ SWL of hook is marked ‫ ﻙﻭﻫ ـﻠﻟ ﻥﺯﻭﻟﺍ ﺔﻣﻼﻋ ﻊﺿﻭ ﻡﺗﻳ‬/ ‫ﻥﻣﻻﺍ ﻝﻳﻣﺣﺗﻟﺍ ﻥﺯﻭ‬
14. Boom shut-off or hydraulic relief is provided ‫ﺔﻳﻛﻳﻟﻭﺭﺩﻳﻬﻟﺍ ﺔﺛﺎﻏﻹﺍ ﻭﺃ ﻑﺎﻘﻳﻺﻟ ﻉﺍﺭﺫ ﺭﻳﻓﻭﺗ ﻡﺗﻳ‬
15. Boom length indicator is fitted for telescoping booms
(‫ﺔﻠﺧﺍﺩﺗﻣﻟﺍ ﻉﺭﺫﻼﻟ ﻉﺍﺭﺫﻟﺍ ﻝﻭﻁ ﺭﺷﺅﻣ ﺏﻳﻛﺭﺗ ﻡﺗﻳ ) ﺕﻳﻼﺳ‬
16. Outrigger extensions and operations ‫ﺓﺩﻳﺟ ﺓﺭﻭﺻﺑ ﺔﻟﺎﻌﻓﻭ ﺓﺩﺗﻣﻣ ﺔﻳﺟﺭﺎﺧﻟﺍ ﺯﺋﺎﻛﺭﻟﺍ‬
17. Boom / Outriggers for oil leaks on Hydraulic
‫ﺔﻳﻛﻳﻟﻭﺭﺩﻳﻬﻟﺍ ﻰﻠﻋ ﺕﻳﺯﻟﺍ ﺏﺭﺳﺗ ﻥﻣ ﺔﻳﻟﺎﺧ ﺯﺋﺎﻛﺭ \ ﺔﻌﻓﺍﺭﻟﺍ ﻉﺍﺭﺫ‬
18. All hydraulic hoses for cracks, wear and blistering
‫ﻕﻭﻘﺷﻟﺍ ﻥﻣ ﺔﻳﻟﺎﺧ ﻡﻳﻁﺍﺭﺧﻝﺍ ﻊﻳﻣﺟ‬، ‫ﺕﺎﺣﺭﻘﺗ ﺭـﻪﻅﺗﻻ ﺙﻳﺣﺑ ﺔﻔﻠﻐﻣﻭ‬
19. Main hoist rope / Auxiliary hoist rope ‫ ﺓﺩﻋﺎﺳﻣﻟﺍ ﺔﻌﻓﺍﺭﻟﺍ ﻝﺑﺣ‬/ ‫ﺔﻳﺳﺍﺭﻟﺍ ﺔﻌﻓﺍﺭﻟﺍ ﻝﺑﺣ‬
20. Crane level indicator/ Engine gauges and indicator ‫ ﺔﻌﻓﺍﺭ ﻯﻭﺗﺳﻣ ﺭﺷﺅﻣ‬/ ‫ﺭﺷﺅﻣﻟﺍﻭ ﻙﺭﺣﻣﻟﺍ ﺱﻳﻳﺎﻘﻣ‬
21. Reverse Alarm/Operational Alarm functioning ‫ ﻲﺳﻛﻌﻟﺍ ﺭﺍﺫﻧﻹﺍ‬/ ‫ﺭﺍﺫﻧﺇ ﺓﺯﻬﺟﺃ ءﺍﺩﺃ ﻝﻳﻐﺷﺗ‬
22. Web Sling /Shackles -SWL-Fit to use
‫ ﻱﺓـﻙﺑﺷ‬/ ‫ (ـﺕﻼﻛﺎﺷﻟﺍ)ﻝﻼﻏﻷﺍ‬- ‫ـﺔﻧﻣﻵﺍ ﻝﻣﻌﻟﺍ ﻝﻳﻣﺣﺗ‬- ‫ﻡﺍﺩﺧﺗﺳﻼﻟ ﺢﻟﺎﺻ‬
23. Wire Rope Sling/ Hooks / Shackles ‫ ﻝﺎﺑﺣ‬-SWL - Fit to use
.‫ (ﻲﻧﺩﻌﻣ) ﻲﻛﻠﺳ ﻝﺑﺣ‬/ ‫ ﻑﺎﻁﺧ‬/ ‫ﻥﻣﻻﺍ ﻝﻣﻌﻟﺍ ﻝﻳﻣﺣﺗ –ﻝﻼﻏﻷﺍ‬- ‫ﻡﺍﺩﺧﺗﺳﻼﻟ ﺢﻟﺎﺻ‬
24. Chain Sling / Hooks /Shackles -SWL - Fit to use
‫ ﻝﺎﺑﺣ ﺔﻠﺳﻠﺳ‬/ ‫ ﻑﺎﻁﺧ‬/ ‫ ﻥﻣﻻﺍ ﻝﻣﻌﻟﺍ ﻝﻳﻣﺣﺗ –ﻝﻼﻏﻷﺍ‬- ‫ﻡﺍﺩﺧﺗﺳﻼﻟ ﺢﻟﺎﺻ‬
25. Spreader Bar/Beam/Tackles -SWL – Fit to use
‫ ﻲﻧﺩﻌﻣﻟﺍ ﻲﺿﺭﻌﻟﺍ‬/ ‫ (ـﺕﻔﺷﻟﺍ) ﺱﻭﺭﺑ‬/ ‫ ﻥﻣﻻﺍ ﻝﻣﻌﻟﺍ ﻝﻳﻣﺣﺗ –ﻊﻓﺭﻝﺍ ﺓﺭﻙﺑ‬- ‫ﻡﺍﺩﺧﺗﺳﻼﻟ ﺢﻟﺎﺻ‬
‫ﺕﻔﺷﻟﺍ‬

Reviewed / Inspected By:

Operator Name & Signature: . Subcontractor HSE Name & Signature:
Samsung HSE Supervisor Name & Signature: Remarks: _