**A-FRAME PREUSE INSPECTION CHECKSHEET SAMPLE**

> A-Frame Identification: Date: / /
>
> The user shall perform the following checklist prior to performing
> hoisting and rigging operations with this A-Frame. Correct Unsat items
> found during this inspection before using this equipment. If Unsat
> items can not be corrected, tag the equipment out of use. Mark not
> applicable (N/A) for items not contained or applicable to this
> A-Frame.

+------------------------------------------------------+----+---+-----+
| > **A-Frame Inspection Areas**                       | >  | > | >   |
|                                                      |  * |   | **U |
|                                                      | *N | * | NSA |
|                                                      | /A | * | T** |
|                                                      | ** | S |     |
|                                                      |    | A |     |
|                                                      |    | T |     |
|                                                      |    | * |     |
|                                                      |    | * |     |
+------------------------------------------------------+----+---+-----+
| > Manufacturers' instructions for use are posted in  |    |   |     |
| > the area of use or on the portable                 |    |   |     |
| >                                                    |    |   |     |
| > A-Frame.                                           |    |   |     |
+------------------------------------------------------+----+---+-----+
| > Look for bent, broken, damaged, corroded, cracked, |    |   |     |
| > or missing parts.                                  |    |   |     |
+------------------------------------------------------+----+---+-----+
| > Verify required markings are installed and         |    |   |     |
| > legible: Rated capacity legibly marked             |    |   |     |
| >                                                    |    |   |     |
| > on the structure on each side of the primary beam, |    |   |     |
| > and a tag indicating the due date                  |    |   |     |
| >                                                    |    |   |     |
| > of the next inspection is attached to the trolley, |    |   |     |
| > A-Frame, and any attached hoist.                   |    |   |     |
+------------------------------------------------------+----+---+-----+
| > Ensure the trolley, beam clamp, or hoist working   |    |   |     |
| > load limits do not exceed the                      |    |   |     |
| >                                                    |    |   |     |
| > capacity rating of the A-Frame.                    |    |   |     |
+------------------------------------------------------+----+---+-----+
| > Perform a function test of the trolley and hoist   |    |   |     |
| > to ensure proper operation.                        |    |   |     |
+------------------------------------------------------+----+---+-----+
| > If adjustments or repairs are necessary or any     |    |   |     |
| > defects are found that affect safe                 |    |   |     |
| >                                                    |    |   |     |
| > operation, stop work and report deficiencies to    |    |   |     |
| > the equipment custodian.                           |    |   |     |
+------------------------------------------------------+----+---+-----+
| > Operator is qualified in accordance with the       |    |   |     |
| > Hanford Site Hoisting and Rigging                  |    |   |     |
| >                                                    |    |   |     |
| > manual to perform H& R operational activities.     |    |   |     |
+------------------------------------------------------+----+---+-----+

> Type of hoist used on the A-Frame: None Air Manual Electric
> [\_\_\_]{.underline}

+------------------------------------------------------+----+---+------+
| > **Hoist Inspection Areas**                         | >  | > | > *  |
|                                                      |  * |   | *UNS |
|                                                      | *N | * | AT** |
|                                                      | /A | * |      |
|                                                      | ** | S |      |
|                                                      |    | A |      |
|                                                      |    | T |      |
|                                                      |    | * |      |
|                                                      |    | * |      |
+------------------------------------------------------+----+---+------+
| > Unusual sounds.                                    |    |   |      |
+------------------------------------------------------+----+---+------+
| > Brakes working properly.                           |    |   |      |
+------------------------------------------------------+----+---+------+
| > Hooks inspected in accordance with H&R Manual      |    |   |      |
| > "Hooks" Section.                                   |    |   |      |
+------------------------------------------------------+----+---+------+
| > Housing integrity intact.                          |    |   |      |
+------------------------------------------------------+----+---+------+
| > Supporting structure sound.                        |    |   |      |
+------------------------------------------------------+----+---+------+
| > Load bearing parts (Yoke, Clevis).                 |    |   |      |
+------------------------------------------------------+----+---+------+
| > Cable/Chain in operating condition.                |    |   |      |
+------------------------------------------------------+----+---+------+
| > Operating controls respond properly.               |    |   |      |
+------------------------------------------------------+----+---+------+
| > Load limiting devices functional.                  |    |   |      |
+------------------------------------------------------+----+---+------+
| > Limit switches work properly.                      |    |   |      |
+------------------------------------------------------+----+---+------+
| > Warning labels installed in accordance with H&R    |    |   |      |
| > Manual "Hoists, Jib Cranes, and Monorails"         |    |   |      |
| > Maintenance section.                               |    |   |      |
+------------------------------------------------------+----+---+------+
| > Sheaves and Drums inspected for damage/wear.       |    |   |      |
+------------------------------------------------------+----+---+------+
| > Lubrication in accordance with manufacturers'      |    |   |      |
| > instruction manual.                                |    |   |      |
+------------------------------------------------------+----+---+------+
| > Collectors/Load chain buckets properly affixed.    |    |   |      |
+------------------------------------------------------+----+---+------+
| > Evidence of wiring wear or damage.                 |    |   |      |
+------------------------------------------------------+----+---+------+
| > Supply air system at rated air pressure.           |    |   |      |
+------------------------------------------------------+----+---+------+

> **[COMMENTS:]{.underline}**