IFB_7800_MAS1013_ATT_4_v1.pdf

EXHIBIT A

CITY OF AUSTIN

INSPECTION REPORT FORM

REPORT

OF

INSPECTION

CUSTOMER ________________________________________________

LOCATION ________________________________________________

INSPECTION ________________________________________________

MANUFACTURER ________________________________________________

MODEL NO. ___________________ TYPE ________________

SERIAL NO. ___________________ YR. OF MFG. __________

UNIT NO. ___________________ TEST DATE ___________

CITY OF AUSTIN

ATTACHMENT -- SAMPLE REPORT FORMS

Summary of Test Page 1 of 1

EXHIBIT B

CITY OF AUSTIN

SUMMARY OF TEST

Customer: Unit No.:

Date: Unit Defect Category No.*:

Manufacturer: Model No.:

Serial No.: Year of Manufacture:

Aerial Hours: Wind Velocity: mph

Inspector(s): Temperature:

REASON FOR TEST

Annual Inspection: After Repair:

APPLICABLE NDT METHODS AND INSPECTIONS

Satisfactory See Defect Page N/A

Ultrasonic Test of Pins

Magnetic Particle Test of Welds

Operational Test of Aerial Units

Torque Check of Accessible Bolts

Hardness Test of Aluminum Ladder

Drift Test of Hydraulic Cylinders

Load Test of Aerial Ladder

Stability Test of Aerial Platform

Dye Penetrate Test of Welds

Hydraulic Oil Analysis (to be mailed back)

Eddy Current

Ground Ladder Test

Other

*Category Classifications I. Items Unit shall be taken out of service.

II. Items Will affect the certification of the aerial unit.

III. Items Can be repaired at regular maintenance.

IV. Items For informational purposes.

V. Items No defects noted at the time of Inspection.

DEFECTS NOTED ON DEFECT PAGE

OPERATIONAL TEST/LOAD TEST/DRIFT TEST Page 1 of 1

EXHIBIT C

CITY OF AUSTIN

OPERATIONAL TEST / LOAD TEST / DRIFT TEST

Customer: Unit No.: Date:

Engine R.P.M. Hydraulic Pressure Maximum Reach Maximum Height Drift Test Start Time

Drift Test Stop Time

DRIFT TEST

OUTRIGGERS Hydraulic Oil at Ambient Temperature Front Streetside Front Curbside Rear Streetside Rear Curbside

LIFT CYLINDER

Ladder or Lower Boom Upper Boom Extension Cylinder

OPERATIONAL TESTS

AERIAL LADDERS / ELEVATING PLATFORMS

Seconds Seconds

Set Outriggers Complete Rotation Raise Ladder 60 Fully Extend

Raise Ladder 60, Rotate 90, Fully Extend __________ Seconds _________ Allowed Load Test ___________ at ____________lbs. _____________at ___________lbs.

ARTICULATING BOOM

Seconds Seconds

Set Outriggers Complete Rotation Raise Ladder 60 Fully Extend

Raise Lower Boom 90, Raise Platform to max. Ht., Rotate 90 ______ Seconds ______ Allowed Stability Test ___________ lbs.

Other Specific Test and Inspections Page 1 of 1

EXHIBIT D

AREA OF COVERAGE

Customer: Unit No.: Date:

ULTRASONIC INSPECTION

Kind of UT Machine:

Transducer MHZ.

MAGNETIC PARTICLE TEST

Type of MT Machine:

Amps: DC or

AC:

DYE PENETRANT TEST

Name of Penetrant: Cleaner Batch No.:

Developer Batch No.: Penetrant Batch No.:

Penetrant Dwell Time: Developer Dwell Time Temperature: °F

HARDNESS TEST

Type of Hardness Tester: Lowest Acceptable Rating:

Comments:

Abbreviations:

UT Ultrasonics MT Magnetic Particle PT Dye Penetrant HT Hardness Test ET Eddy Current

DEFECT PAGE Page 1 of 1

EXHIBIT E

CITY OF AUSTIN

DEFECT PAGE

Customer: ___________________________

Unit #: ___________________________

Date: ___________________________

Item # Description Category

Items ___ through ___ and/or Item ___, ___, ___, ___, ___, on Defect Page will affect the certification of aerial unit.

GROUND LADDER TESTING Page 1 of 1

EXHIBIT F

CITY OF AUSTIN

GROUND LADDER TESTING

1. MFR.: 2. MFR.’S Model or Code #:

3.MFR.’S Serial #: 4. AFD ID #:

5. Date Purchased: 6. Date Placed in Service: 7. Unit or Location to which Assigned:

8. Type: Single Roof Extension Pole Folding Combination Pompier

9. Length: 10. Construction Materials:

Wood Metal Fiberglass

11. Beam Type:

Solid Truss

12. Certified as Meeting NFPA Standard 1931: Yes No Edition year:

13. Reason for Test: Annual Inspection Retest after Repair

14. Test Date: 15: Person(s) Performing:

16. Heat Sensor Label Check:

Label Unchanged Label Changed / Heat Exposure Indicated No Label Present

17. Horizontal Bending Test Performed

Weight Used: Passed Failed

Location and Parts Failing:

18. Hardware Test Performed

Weight Used: Passed Failed

Location and Parts Failing:

19. Roof Hook Test Performed

Weight Used: Passed Failed

Location and Parts Failing:

20. Pompier Ladder Test Performed

Weight Used: Passed Failed

Location and Parts Failing:

21. Hardness Test Performed Instrument Calibrated Before Test Instrument Calibration Verification Immediately After Test

Instrument Used: ______________________________ Min. Acceptable Reading for this Instrument: ______________

Passed Failed – Location of Failure: ______________________________ Failure Reading: ______________

22. Eddy Current Test Performed Passed Failed – Location of Failure: _________

Performed By: _______________________________ Firm Name: __________________________________

23. Liquid Penetrant Test Performed Passed Failed – Location of Failure: _________

Performed By: _______________________________ Firm Name: __________________________________

24. Status of Ladder In Service Out of Service for Further Testing Out of Service for Repair Destroyed as result of Test

Other __________________________

25. Repair Notes: (Date and Initial Entries)

Remarks: (Use Section Number):

Signature of Person Responsible for Test:

EXHIBIT_F_Ground_Ladder_Testing_Form