Vehicle-Mounted Crane 10-Year Inspection Form
Document the results of the formal 10-year inspection of a vehicle-mounted crane. Complete all sections to ensure compliance and safety.
Crane Identification Number
*
Vehicle Registration Number
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Structural Components Assessment
*
Rows
Condition
Main Boom
Good
Satisfactory
Needs Repair
Critical
Outriggers
Good
Satisfactory
Needs Repair
Critical
Mounting Bolts
Good
Satisfactory
Needs Repair
Critical
Chassis Frame
Good
Satisfactory
Needs Repair
Critical
Hydraulic System Assessment
*
Rows
Status
Hydraulic Hoses
No Leaks
Minor Leak
Major Leak
Non-Functional
Cylinders
No Leaks
Minor Leak
Major Leak
Non-Functional
Pump
No Leaks
Minor Leak
Major Leak
Non-Functional
Reservoir
No Leaks
Minor Leak
Major Leak
Non-Functional
Electrical System Assessment
*
Rows
Status
Control Panel
Operational
Intermittent
Non-Operational
Limit Switches
Operational
Intermittent
Non-Operational
Warning Lights
Operational
Intermittent
Non-Operational
Wiring
Operational
Intermittent
Non-Operational
Safety Devices Checklist
*
Load Moment Indicator Functional
Emergency Stop Operational
Anti-Two Block Device Present
Outrigger Interlocks Working
Operational Controls Rating
*
1
2
3
4
5
Overall Inspection Outcome
*
Passed – No Major Defects
Passed with Recommendations
Failed – Major Repairs Required
Submit Inspection
Should be Empty: