Form No.

PNMI-QHSE-P-10-02-02

Daily Crane Checklist

Daftar Periksa Harian Derek
Barge Name Crane Manufacture
Nama Kapal Pabrikan Derek
Location Crane Capacity
Lokasi Kapasitas Derek
Inspection Date Main Hoist Load Capacity
Tanggal Inspeksi Kapasitas Angkat Kerekan Utama
Crane Type/Model Auxiliary Hoist Load Capacity
Jenis/Model Kapasitas Angkat Kerekan Bantu
Boom Type/Model Total Running Hours
Jenis/Model Boom Total Jam Kerja
Check on appropriate box: Satisfactory (S) UnSatisfactory (U) Not Applicable (NA)

Conditions Additional Remarks

A. Crane In Boom Rest Mode
S U NA (Please Explain The Result Of Inspection)
A.1. Anti Two-Blocking System
Sistem Anti Dua Blok
1. Sling/Chain
Tali Baja/Rantai
2. Supender Ring
Cincin Bandulan
3. Shackle(s)/Pin(s)/Bolt(s)
Pemasung/Pencocok/Baut
4. Electric Cable(s)
Kabel Kelistrikan
5. Electric Limit/Switch
Pembatas/Saklar Kelistrikan
A.2. Other Devices
Peralatan Lainnya
6. Buzzer/Bell/Alarm
Lonceng/Alarm
7. Load Block/Hook(s)
Blok/Pengait Beban
8. Wire Rope(s)
Tali Tambang Baja
9. Safety Latches
Palang Pengaman
10. Boom Back-Stop Auto-Shut Off
Penghenti Otomat Backstop Boom
11. Indicator(s), Level(Rolling/Pitching)
Petunjuk Gulingan/Anggukan
12. Window Glass/Visibility
Kaca Jendela/Jarak Pandangan
13. Fire Extinguisher(s)
Pemadam Kebakaran
14. Proper & Adequate Access
Akses yang baik & memadai
A.3. Certificates & Safety Signs
Sertifikat & Petunjuk Keselamatan
15. Warning Signs/Posters
Rambu/Poster Keselamatan
16. Posted Valid Operator Certificate
Sertifikat Operator yang Berlaku Terpampang
17. Posted Valid Crane Certificate
Sertifikat Derek yang Berlaku Terpampang
18. Appropriate Load Charts
Diagram Beban yang Sesuai
19. Daily Crane Log Book
Buku Catatan Harian Derek
20. General Housekeeping/Cleanness
Kebersihan & Kerapian Secara Menyeluruh
A.4. Greasing, Lubricating, & Other Fluid
Pelumasan & Cairan Lainnya
21. Greasing on All Wire Ropes/Slings
Pelumasan pada semua Tali Baja
22. Greasing on All Sheaves/Rollers
Pelumasan pada semua Peluncur/Roda
23. Greasing on All Chain & Sprocket
Pelumasan pada semua Rantai & Roda Gigi
24. Greasing on All Shafts & Swivels
Pelumasan pada semua Sumbu/As & As Putar
25. Coolant Fluid/Water for Radiator
Cairan Pendingin/Air untuk Radiator

Pelangi Niaga Mitra Internasional, PT.

Jl. Wijaya IX No. 15 - Melawai
Jakarta 12160
 Form No. PNMI-QHSE-P-10-02-02

26. Lube Oil for Engine

Minyak Pelumas untuk Mesin
27. Hydraulic Fluid
Cairan Hidrolik
Conditions Additional Remarks
B. Crane In Operating Mode
S U NA (Please Explain The Result Of Inspection)
1. Electrical Switches/Buttons
Saklar/Tombol Kelistrikan
2. Securely Attached Bolts/Pins
Baut/Pencocok Terpasang Dengan Benar
3. Machinery Safety Guard
Pelindung Pengaman Mesin
4. Turntable/Swing Desk
Meja Putaran
5. Brakes & Clutches
Rem & Kopling
6. Swing Brake
Rem Putaran Kiri/Kanan
7. Hoist Drum System
Sistem Penggulung/Kerekan
8. Rope Spooling/Wrapping
Gulungan Tali Tambang Baja
9. Leakages
Kebocoran - Kebocoran
10. Travelling
Berjalan Maju/Mundur
11. Steering
Kemudi
12. Swing Right/Left
Putar Kanan/Kiri
13. Boom Up/Down
Boom Naik/Turun
14. Hoist Up/Down
Kerekan Naik/Turun
15. Load Weight Indicator
Petunjuk Beban Angkat
16. Boom Angle Indicator
Petunjuk Derajat Sudut Kemiringan Boom
17. Buzzer/Bell/Alarm/Horn
Lonceng/Alarm/Klackson
18. Warning Lights
Lampu Tanda Bahaya
19. Working Lights/Lightings
Lampu Penerangan/Pencahayaan
20. Emergency Engine Shut Off System
Sistem Mematikan Mesin Darurat

RECOMMENDATIONS & CONCLUSIONS

REKOMENDASI & KESIMPULAN
Chief Engineer:

Chief Elcetrician:

Crane Operator:

Leader-man:

Safety Officer:

Barge Master:

Pelangi Niaga Mitra Internasional, PT.

Jl. Wijaya IX No. 15 - Melawai
Jakarta 12160
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