Page 29
2669-RT / 3369-RT / 4069RT
Annual Inspection Report
Key: "Y" Yes/Acceptable
"N" No/Unacceptable
"R" Repaired
"U" Unnecessary/Not Applicable
Comments:
Signature/Mechanic:
Signature/Owner-User:
Date:
Date:
• Check each item listed below.
• Use proper Operator's, Service and Parts manual for specific information and settings.
• If an item is found to be "Unacceptable" make the necessary repairs and check the
"Repaired" box.
• When all items are "Acceptable", the unit is ready for service.
Dealer
Street
City/State/Zip
Phone Number
Contact
Date
Serial Number
Model Number
Date Of Last Inspection
Date Placed In Service
Customer
Street
City/State/Zip
Phone Number
Contact
Y N R U
Y N R U
Y N R U
Decals:
Proper Placement/Quantity
Legibility
Correct Capacity Noted
Rails:
All Rail Fasteners Secure
Entry Gate/Chain Closes Properly
Manual/Safety Data In Box
Rear Rail Pad In Place
Extending Platform:
Slides Freely
Latches In Stowed Position
Latches In Extended Position
Rail Latches Work Properly
Cable Secure
Platform:
Platform Bolts Tight
Platform Structure
Platform Overload System:
Functional
Calibrated
Wire Harnesses:
Mounted Correctly
Physical Appearance
110/220V Outlet Safe/Working
Elevating Assembly:
Beam Structures
Welds
Retaining Rings
Upper Cylinder Pins Secure
Lower Cylinder Pins Secure
Lower Beam Mounts tight
Rollers Turn Freely
Maintenance Locks:
Secure
Operational
Base:
Cover Panels Secure
Base Fasteners Tight
Bolts Tight
Front Axle Mounting (4WD)
Rear Axle Mounting (4WD)
Front Axle/Front Wheel Assemblies:
Wheel Motors-Mounting Secure
Wheel Motors-Leaks
Lug Nuts Torqued Properly
Steering Cylinder Pins Secure
Pivot Points Lubed
Rear Axle/Rear Wheel Assemblies:
Brakes Operational
Wheel Motors-Mounting Secure
Wheel Motors-Leaks
Lug Nuts Torqued Properly
Component Area:
Valve Manifold(s) Secure
Hoses Tight/No Leaks
D/C Mtr(s) Secure/Operational
Contactors Secure
Pump Secure
Batteries:
Secure
Fully Charged
Battery Charger:
Secure
Operational
Emergency Stop:
Breaks All Circuits
Operation:
Wires Tight
Switches Secure
All Functions Operational
Emergency Down:
Operational
Slow Speed Limit Switch:
Set Properly
Pressures & Hydraulics:
Oil Filter Secure/Chg
Oil Level Correct/Chg
Steering Pressure Set
Drive Pressure Set
Lift Pressure Set
Engine:
Engine Mounts Tight
Fuel Lines Secure
Fuel Lines Free Of Leaks
Fuel Tanks Secure
Fuel Shut Off Valves Func.
All Shields/Guards In Place
Oil Level
Oil Filter
Air Filter
Options Operational:
Hour Meter
Battery Indicator
Warning Light
Warning Horn
Generator
Converter
Annual Inspection Report
GMG
(Global Machinery Group, Inc.)
3428 Bullock Lane
•
San Luis Obispo
, CA 9
3
401
U
S
A
800-
3
01
-
0499
•
805
-
303
-
2066
• F
a
x:
805
-
293
-
6211
P/N 90728 Rev. 3
1
OP69
– January 2018
Machine Inspections