Attachment VA Form 10 6166 Report of Inspection of Elevators.pdf

REPORT OF INSPECTION OF ELEVATORS

DATE OF INSPECTION

TO

Director Field Operations

Region No._________(138)

Veterans Administration Central office

Washington, D.C. 20420

Name and Location of Station

Building Name and Number

No. of stops

No. of Openings

Elevator number and type

Rated Capacity

LBS: PERSONS

Manufacturer Serial No. and year installed

Rated Speed (fpm)

Actual Speed (fpm-tach)

1. CONDITION OF EQUIPMENT (Check)

ITEM GOOD FAIR POOR ITEM GOOD FAIR POOR

MACHINE

ELECTRONIC TUBES & TRANSISTORS

WORM AND GEAR

RESISTANCES

WORM AND GEAR THRUST BEARING

RECTIFIERS

SHEAVE SHAFT BEARINGS

CONTACT INSULATORS

WORM SHAFT PACKING AND SEALS

CONTACT HOLDERS

BEDPLATE

CONTACT SPRINGS

MAIN MOTOR

BRAIDED & WIRE CONNECTORS

MOTOR FIELDS, BRUSHES & HOLDERS

MACHINE ROOM VENTILATION

COMMUTATOR AND SLIP RINGS

ELECTRIC WIRING

MOTOR GENERATOR

LIGHTING IN MACHINE ROOM

EXCITER

HEATING IN MACHINE ROOM

MOTOR GENERATORS FIELD,

BRUSHES AND HOLDERS

CLEARANCE AROUND MACHINE ROOM

EQUIPMENT

BRAKE, PINS, LINING, DRUM

MAIN LINE SWITCH LOCATION

GOVERNOR AND RELEASING CARRIER

CONDITION OF MACHING ROOM FLOOR

SELECTOR, CABLE, SWITCH AND TAPE

GUARDING OF EXPOSED EQUIPMENT

CONTROLLER

PROJECTIONS, RECESSES

RELAY PANELS

HOISTWAY VENTING

RELAYS AND CONTACTS

PITT LADDER

OVERLOADS

GROUNDING OF EQUIPMENT

FUSES AND FUSE LINKS

ELECTRICAL PROTECTIVE DEVICES

MAGNET COILS

CYLINDER AND PLUNGER

CAPACITORS

PUMPS, VALVES, PIPING AND TANKS

VAFORM 10-6166 SUPERSEDES VA FORM 10-6166, MAY 1972, WHICH WILL NOT BE USED.

MAY 1974

1. CONDITION OF EQUIPMENT (CONTINUED)

ITEM GOOD FAIR POOR ITEM GOOD FAIR POOR

CROSSHEAD, SHOES, CARTOP

CAR ENCLOSURE

CAR DOORS, OPERATOR

CAR OPERATING PANEL

GUIDE RAILS AND SUPPORTS

CAR CANOPY

OVERHEAD BEAMS

CAR EMERGENCY EXIT CONTACTS

SHEAVES AND BEARINGS

CAR FLOORING

HANGERS AND DOOR GIBS

CAR LIGHTING

INTERLOCKS AND CLOSERS

CAR VENTILATIONS

LEVELING SWITCHES AND VANES

CAR CAPACTIY PLATE

TOP CAR OPERATING DEVICE

CAR TELEPHONE BOX

TRAVELING CABLE

CAR CERTIFICATE FRAME

LIMIT SWITCHES

HOISTWAY DOOR PANELS AND FRAMES

CWT, TIE RODS, AND COTTER PINS

HANGER COVERS

BUFFERS (CAR AND CWT)

FASCIA PLATES

GUARD FOR CONTERWIGHT

TOE GUARDS

GOVERNOR TENSION SHEAVE & GAURD

HEADERS

GOVERNOR TENSION SHEAVE WEIGHT

HOISTWAY SILLS

SAFETY

FIREPROOFING UNDER PLATFORM

PIT ACCESS DOOR

NUMERAL ON EQUIPMENT

CAR PHOTO-ELECTRIC RAYS

HALL LANTERNS

CAR DOORS CONTACTS

HALL PUSH BUTTONS

CAR SAFETY EDGE

DISPATCHING PANEL

FACEPLATES AT STATIONS

HOISTWAY ACCESS SWITCH

CAR POSITION INDICATOR

PAINTING OF EQUIPMENT

HALL POSITION INDICATOR

EMERGENCY ELECTRIC POWER EQUIPMENT

ARE MANUAL AND PARTS LIST AVAILABLE?

[ ] Yes [ ] No

ARE TOOLS AVAILABLE?

[ ]Yes [ ] No

2. CONDITION OF ROPES

LOCATION MATERIALS NUMBER SIZE AND

CONSRUCTION

USED LIFE

(in months)

EST. ADD. LIFE

(in months)

NO. OF BROKEN WIRES (Per

Rope Lay)

HOISTING

DRUM COUNTERWEIGHT

CAR COUNTERWEIGHT

GOVERNOR – CAR

GOVERNOR – CWT

COMPENSATING

SAFETY

CONTRACT NO. NAME OF CONTRACT COMPANY

SIGNATURE OF INSPECTING OFFICER

WE CERTIFY That the contractor has complied with all requirements of the contract and specifications.

DATE SIGNATURE OF ENGINEER OFFICER SIGNATURE OF DIRECTOR

Use blank sheet for any remarks and/or recommendations and attach to this report.