Duffy, Daniel

From: Gregory Mantell [greg@gregorymantell.com ]Sent: Monday, April 22, 2013 10:26 AMTo: Duffy, DanielCc: Office of Inspector GeneralSubject: Re: Freedom of Information Request Reference No. 13755

Correction: Since the foundation work on One World Trade Center began in 2006, the time period Iam interested in is 2006 to present...

From: Gregory Mantell <greg@gregorymantell.com >To: "Duffy, Daniel' <dduffy@panynj.gov >Sent: Monday, April 22, 2013 9:24 AMSubject: Re: Freedom of Information Request Reference No. 13755

However, if you wish more information regarding the timeframe...

1) since construction on One World Trade Center began in 2008, the time period for the inspections Iam requesting would be from 2008 to present2) 1 want copies of any safety inspections or violations issued by the NY Dept of Buildings for theconstructions cranes used on One World Trade Center as well as copies of any other safetyinspections performed by the NY Dept. of Buildings at the One World Trade Center site as well asany other notice of violations issued by the NY Dept of Buildings at the One World Trade Centersite....

Thank you for your time and attention.Greg Mantell

^ I I X1110 1;;1IIIIVOF ICY& NJ

FO/ Adrninistrotor

August 1, 2013

Mr. Gregory MantellThe Gregory Mantell Show1223 Wilshire Blvd. 904Santa Monica, CA 90403-5400

Re: Freedom of Information Reference No. 13755

Dear Mr. Mantell:

This is a response to your April 22, 2013 request, which has been processed under the PortAuthority's Freedom of Information Code (the "Code") for copies of all safety inspections orviolations issued by the New York City Department of Buildings ("NYCDOB") for theconstruction cranes used on One World Trade Center as well as copies of any other inspectionsor violations issued by the NYCDOB from 2006 to the present.

Material responsive to your request and available under the Code can be found on the PortAuthority's website at http://www.panyni.gov/corporate-information/foi/13755-WTC.pdf . Papercopies of the available records are available upon request.

Please refer to the above FOI reference number in any future correspondence relating to yourrequest.

Very truly yours,

Daniel`D- DuffyFOI Administrator

22'> Perk Avemle Soirth, 11th f loo iNew York, IVY 1000 j1 272 4''I ,.E212455, i

REMEDY/REQUIREMENTSOTFiled y' S' . ature) ^,

CA401"

Buildings

LETTER OF DEFICIENCY

THE CITY OF NEW YORKDEPARTMENT OF BUiLDiNGS

MANHATTAN

Cranes & Derricks, 5' h Floor280 Broadway

New York, NY 10007(212)-566-4696

Port Authority of New York and New JerseyAttn: Chief Engineer115 Broadway — 6 th FloorNew York, New York 10006

You are hereby notified that there exists a violating condition in the subject premises as described below, andare ordered to remove this violation immediately. You must notifi the Department of Buildings, Cranes &Derricks Division of the corrective action within 72 hours of this Letter of Deficiency.. All inquiries andreferences to this Letter of Deficiency should be directed to the New York '6y Depa ent uildings,Cranes & Derricks Division.

9.

COMMISSIONER ® I S

Location Boro Violation Number1 ao AQ4aF Date Type Dist. No. Quad.

Co st uctio No. of Stories Block Lot 0/Occupa t Time of Ir^spe5t aas: Complaint No. Docket No.

Section(s) Violated X^6 66? 16 112 4— 6 of the "All I I s, .. r9 it

AFFIDAVIT OF SERVICE BY MAIL— City and ate ofNew ork, County of ) ss: The undersigned being duly swom, deposes and ysthat I am an employee in the New York City De rtment of Buildings, I am over 18 yeast of age, and on I served this Notice of Violation bydepositing a copy thereof, enclosed in a post-paid wrapper, in an official depository under the exclusive care and custody of the U . S. Postal Service within New York City,addressed to the party indicated above and addressed to each of the following persons at the addresses set forth after each name;

I.

2.

Sworn to before me this X \Signature

Day of .20

Print Full NameX

NOTARY PUBLIC/COMMISSIONER OF DEEDS

THE PORTAITHORR9(OF NY& NJ

V\ TC ConstructionBroadway 6 `" Floor

New New York, NY 10006

Phone: 212-435-5612 Jw0Fax: 212-435-5609

April 29, 2009 d tCity of New YorkDepartment of BuildingsCranes & derricks Division280 Broadway - 5 `h FloorNew York, New York 10007

Attn: Mr. Jason Ocharsky, P.E.

- - — - &UBJiJC-T:- -ONE WORLD-TRADE CENTER - -- -North Tower Crane #1- CD # 3743Favelle Favco Model # M760D - Serial # 1166"Weld Repair of Boone Section # 1166-88"

Reference: - Letter of Deficiency, dated 4/24/09 (received 4/27/09)

Dear Mr. Ocharsky:

This office hereby acknowledges the receipt of the above referenced letter (the"Letter") regarding the weld repair of the subject crane boom section, and inaccordance with Paragraph #14 of the Memorandum of Understanding executedon March 5, 2009 between the Port Authority of New York and New Jersey (the"Authority") and The New York City Department of Buildings (the"Department"), offers the following response.

During a scheduled inspection of the subject crane on April 18, 2009, anincomplete weld and hairline crack was discovered at the connection between thediagonal lacing and bottom cord of Boom Section #1166-B8. In response, thesubject crane was removed from service, and a weld repair was performed inaccordance with the manufacturer's requirements and tested on April 25, 2009.Attached for your information in this regard are the following:

1 World Trade Center - Above Grade Steel Contract - New York, NY - Means &Methods- North Tower Crane (CD#3743) - Boom Incomplete Weld Repair, Revision00, dated April 21, 2009

- Eddy-Current Inspection Report, dated April 18 & 25, 2009

- Magnetic Particle Inspection Report, dated April 25, 2009

- Welding Inspection Report, dated April 25, 2009

- Tower Crane Engineer of Record Certification, dated April 29, 2009.

If you have any questions, or require any additional information regarding theabove repair measures, please either email me at toconnor@panynj.goy, or callme at (917) 697-7046.

Very truly yours,

mas J. O'Connor, P.E.Senior Engineer of ConstructionThe World Trade Center

cc: W. Dougherty, J. Keane, F. Lombardi; -S.-Plate, A.:R-eiss; J—.Schwed,--T. Stickehnan, P. Taylor

'T'gjo N11j; K

n.

y4. ............

M Item SWO

N o, a Inspected Item Code Section #1 Status"

VWER,51I

I Approved Permits & Plans on

site BC3319.4 &.5 1

2 Supporting Soil/Pad/Mal RS 19-2.8.1,1 & 8• 1

3 Cane set-up conformity IRS 19-2.5.0 1

4 CN - 5—nSite Sign-off (OD-4) RS 19-2.8.1 1

5 CD Approved CID (CD-2) BC3319.4 &.5

G.jDaily./Montly Inspection Records 2

71SIgned & Dated —1330.5-2.1.6 2

8 1 Main Frame Member RS 19-2.15.4.1 2

9 see section 1 Ob page 2 Isms 5, 7, 8 & 10 2M _

NAR!,Hi 3 •St' ,al 0m

10 see section 1 of page 2 litems 48 thru 56 1

.11. . ......... ggs ..' .ggg %v.

W520aAE-0 0 It—

see section log page 2 (items 57 thru 60 1RAW

12 see section 1 Qh page 2 Items 6A, 72,77,79,80,82-8A

rf Q170 gzf13 see section 101 psge 2 Items 86 & 88 1

Mobile On-Site and Annual Ins pection Cherkil.0 Paoe I of A

010-00NITHE IN. ^_,Item

N b Inspected Item Code Section #1 Status*SW11

P50§T_ 0 1 10,3"E.,

14 see section 101 page 2 jilems 92-100, 102 & 103

15 Excess Smoke RS 19-2.16.4.7 2

16 see section 10k page 2 Items 105, 105 108 2

10M.-W"Effi l, PIAM

17 Turntable RS 19-2,16.4.4

18 Pumps/MotorsNalves/LinesrrubeE

19 Ring Gear/Pinion Gear/Rollers RS 19-2.15.4.4

20 Hoist and Rope—M ain see sections of & 91

21 Auxiliary Hoist and Rope see sections 9f & 91

22 1 Boom Hoist and Rope see sections 91 & 91

231LUffing 509m Hoist and Rope

8 .011.0 M, '-1,

24 Isee section 1 Do page 3 1 1 1OMS 148,152-154

25 see section 10q page 3 T1t.M5 168,170-172

W

26 see section 1 0s page 3gn!y

27 see section lot page 3 - I items 191)1 3--. & t

F NYC Dept, of Buildings Canes G Derricks Division - 230 Broadway, Room 501, blew York, JNY 10007

Tel: (212) 566-4696 Fax: (212) 566-5571 E-mail: candd@buiidings.nyo.gov

MOBILE ON-SITE AND ANNUAL INSPECTION CHE-CKLIST

1 ERR L--MW-W-WDate of Inspection: d Site Location:

insDectar amILI

a d g e N o.:

^Type of Inspection: Annual e-Inspection On-Site Audit^Patrol Sweep Chief.Special , SWOLI6 Complaint#.

[Inspection Results: No Deficiencies Issue CID Re-inspect SWO)ssued # Number of Violations Issued

•Mi Serial No.:11W, Year: -9.600,

CID: Expiration Date

: &I MaxImax Capacity: q Picture Taken: Y N•

Crane Types: (ST) Boom Truck (CC) Crawler 0, (13)oarrich (MC) Mobile Crane (MMC)MuIll-Staklon Mobile Cruno (NIT) Mobile Truck Tower Grano (F)PIleDriver

CraneU

Owne r

Company •Name: ` _^ ^ Contact Name: ^ ^ Telephone;

Last Name; i I^

Licence No.: Expiration Date: Type: Master Tower SNC)al 1!Lasterh!Lger Special Hanger

Last Name:

Licence No.: Expiration Date:_ On Si Y N NA

^ mm Re =AHRON; I MEF_Last Name:

IfFirs Name: Mil,

LicencAo.: Expiration Date: _?-Typ e: Class A Class B Class C1 Class C2 Class C3

--WMONA•

QMEM N R

"NNW

Company bleml.7-1 ontact blame: elephone:

Licence No,' 7 Expiration Date: General Contractor ' Site fety Manager

v

nn 7 nF AMnhila nn_Rita nnri Ann11m1 ]­­+i- —rtie 4r^+

y^t I a ^'^ ^ ^^^?1: ^-:^?` 1 -S.; cc^yg`a^vG^^^

^.3<.mf

Item

^11'/IsJ

Flo, Inspected Item Code Section #1 Status*

ME-- _EERIER—MA -y

µ

UN

1 Mon ection Records ° 830,5 2.1.5 Z

2 Maintenance Recor RS 19-2.17.1.1 2

3 Repair[Mbdifoation Records 7.3.4 2 .

4 Other

- - '^.S,Lii.^s'^4:=r^-e.Sij:.^^!^."r'.'f^=...1,^,.^^i:^^}=NyY,^-m^..e^t^'I!I.:^N^^-^nTc...k'•l^R«J'^yt.?I

51 Sheet Metal 2

6 Guards/Covers j 1926,550(6)(8) & (1o) 2

71 Internal/External Lights 1926.601(2)(1) & (1q 2

8 Housekeeping RS 19-2.26.0 29 SafetyANaming Decals & t•abels I "1S26.s50Ln)(2) 2

10 Hand Signal Chart 1926,550(a),(4) 2

11[Paint Condition/Corrosion Contrg l "Rs 19 .2,15.4.7: 2

1210ther 17 I

Access - Grab Rails/Step s 1926,550(a)(13)(1) & (il l 2 1

14'. ass - 1926.550(x)('12) : , • ..1 '

1.5 Win hield'A/loe' s 2-

16 Door($) estraint(s) ° 133o,5•Le.L(c} 2

17 Mirrors A92s.601(b)(4). 2..'18 IFIre Extinguish Rs i9-2,2e,o 2

19 1 Seat(s) Restraints 1926,601(b)(8) 1 2

2D Seat Belts) 1926,601(b)(9) 2

21 IParking Brake 1926.601(b)(1) 2

22 Air Pressure RS 19-2,15,3.4 2

3) Controls Identified 1926.650(a)(2) 224 instruments/Gauges S 19-2.15,4.8 2

25 Electrical Switches/Functions R 9-2.15,3 226 Horn 1szs,s b)(3) 227 Llaths 1926.550(41 2

I 28 Steering RS 19-2,15,4,10 N, 2

29J Engine Clu tch

30 Accelerator Me3o.5 is.3(b) 2

31 Brake ' Rs 19-2,15.4.10 232 Otherr kikvt p .atPq_. ,l^tq '^}s a,. , r33 Performance Rs 19-2,15,4.7 2 J,C34 Exh System/Guards & Insulators 1926.550(x)(10) 235 Belts/Hoses RS 19-2,15.4 2,36 Guard/Cover/Rotat & Recip Parts 1926.550(,1)(6) 2 7

37 Other

fly._

8 ITransmission I RS 19 .215,4 1 23 rive Line RS 19-2,15 ,4 240 ITITNAIr Pressure/Wheels RS 19.2.15,4.11 2

411 Main ame Members RS 19-2,15,4.1 2

42 1 Hydra uli . oses/Tubing/Fitting 1 830,5.2,1.3(1) 1

43 Hydraulic Flu Level 830,5-2,1.3(h) 1

44 Anti-Skid Surfac 1926.550(a)(13)()II) 2

45 Front Bumper Counkweight RS 19.2.15.4(2&4) 2

.46 Backup Alarm 1926.661(b)(4)(q 247 Other

A /,^ ' 1 ] ^y y . -.-s.^i;,i,;J ,Y:.ici^?^^""S I r i' 10—,u r -••F••a•-• ^^ lt^..-i..

48 Boxes RS 19-2,15.4.1 1'

49 Beams S 19-2,15.4,1 150 Cylinders R 19-2.15.4 151 Floats/Pads "830. .9.3(d) 152 Hydraullc Hoses/Tubes/Fittings RS `19 -2ANQA 153 Holding Valves ^830.5-1,9,3( 134 Position Locks RS 19-2,15,4.4 1i5 Warning Signs 1925.550(a)(2)

6 Blocking/Cribbing 1

lLC d1^^®

X10, Inspected Item bode Section N1 '. Status°j

170 Hydraulic Ho . tubing Fittings B30.5- , 3(I) - i171 Holding- Devices 830.5-2.1.3 n)

172 Boom Section Allgnme RS 19.2.15.4.1'

.173. dear Pads ns 1s-z.;5.asi 7,11, q, E:^E y^3i a.,.,'als i 0il RS 19-2,15A^e

Zfilleabe5 V 19-2.15.4,3 1

j ' 178 Boom Head Section RS 19 .2,15.4,1 Q1

179 Wire Rose Retainer. "830--1.7.4(4)

RS 19-2,15.4.1 I

RS 19-2.15.4.4

186a Sizerc:onstruction: A inch RS 19.2.18.2.3

186b Damage RS 19-2.18.2 1 s186cl Lubrication RS 19-2,18,3.5 1

186d Other

187a Size/Construction: Inch RS 19.2,18,2,3 1

187b Damage RS 19-218,2 1187c Lubrication L RS 19-2,18.3,5 77 1

Mobile OnSlte and Annual Inspection Checklist Page 3 of 4 (Draft) C. k n r -- -- ' ''

;C-Y..-_ ( - ^.1.: y,^ ^^xc '.'.,_ _ _ -.y.Fw :.4r•L' 'r i !/ i^lr':,j,:4 Y:'r r•F r. ^ '=fY'.fc111' '^'ivll`f....^' i^.rM ..niT+^ ,L . ^..ui 7Fr" s _ ,. ^,+.'4'$i4-'s _.^.-- '"'L^" _k..,r,!'.:1, . +'r'7=`1 ^•;'^",.° . ,.0

^. ` 1+ -Y..1f•^ R^' !,^' rlA3^ ^'T:! '^^ ^. ,^<<:v ^."^ ..i:' :{'TCe t r -'. •l,"a ' si:. ^... J P`y'r' P..1cti^L—., ^,TFn^ Kir. iFiSN; "'}+{

Sign ector Date

S' n re Supe g Inspe or Date

rra n-Site and ?annual Inspection Checklist Page 4 of 4 ^'°

NYC Dept. of Buildings Cranes errIcks Division - 280 Broadway, Room 501, New York, NY 10007

Tel: (2 ,12) 566-4696 Fax: (212) 666-5871 E-mail: candd@bwiIdIngs.nyc,qov

PICSILE ON-SITE AND ANNUAL INSPECTION CHECKUST

_T- -11 1571-1 __5^

Inspector Name: Badge No•: C31I

^Tyjpe of Inspection: Annu^ ^R lnspe-Ctjon On-Site Audit . Patrol Sweep Chief Special SWO LIft# Complaint#

Inspection Results Issued # Number of Violations Issued

a-M,

—a-LAN—mg- Serial No.: 3ooMake: 6W)n r - Year. oCD: Expiration Date: Max capacity: (062 01^9 Picture Taken: Y C—N

Crane Typea. (ET) Boom Truck lorrick (MC) Mobile Crane (MMC) Multi Station Mobllu Gran©

IMT) Mobile Truck Tower Crane l?) Pill? Driver

Crane Owner Name: N Telephone:

MR.

Company Name: Contact Name: Telephone:

_ 'aW

lWIN% EW 00 W A 11 ME

Last Name: A First Name: MI:

Licence No.: /T— Expiration Date:' Type: Master Tower Special Master Hanger Special Hangerl

Last Name: First Name: MI:

Licence No.: V Expiration -Date: On Slte.• Y N NA

Last Name: (2:) . First Name: MI:

Licence No.: 144Expiration Date: Type: Class A lass B Class Cl Class C2 Class C31

No. Inspected Item Code SeGUon #1 Status°

2 Supporting Soil/Pad/Mat RS 19-2,8,11 8,4

3 Crane set-up conformity RS ;e2.8.0

4 CN - On-Site Sign-off (CD-4) X I s-za. I

CD - Approved CID (CD-2)—

5 BC3319.4 V5

g81"

6 Daily/Montly Inspection Recpl'ds "930,5-2A.5

7 Signed & Dated7 —B30.6-2,1.5

amwa,, N

8jMain Frame lvlem r RS 19-2,15.4,1 2

91see section 10 page 2 Item. 5, 7, 6 10 2

1-31-PIRWIM-9. MIA

10 see sectio . 10f page 2 jitems 48 thru 56 10

01 4 0— -zl 01 -1 FIR Offill ^ M, Msee

ction I og page 2 items 57 thru 601 1 1

12 ee section 10h page 2 1cams rA, 72,

130 "PS" 0 E 1!DUMB, OREMItem SWN

,0.Inspected Item Code Section #1. Status*

A10ON

14 1 see zection 101 page 2 Items 92-100,102 & 103

15 1 Excess S moke"-., RS'19-2,15.4.7 2

16 see section 10k pa' ,2 Items 105, 106 & 108 2rte` ann" gN ,rg g ,L

17 Turntable RS 19-2,15.4.4 1

18 Pumps/MotorsNalves/LineS L^-, E130,5-2.1,3(1)(m)(n) 1

19 Ring Gear/Pinion Gear/Rollers RS 19-2.15,4,4 1

20 Main Holst and Rope sea sections 9f A 91 1

21 Auxiliary Hoist and Rope see se Ions 9f A 91

22 Boom Hoist and Rope see sertlo'er"Of & 91

23 Luf6q Boom Hoist and Rope I

24 see section 10o page 3 j items W, 152-154X

251 see section 10q page 3 I!tams 16B, 170-172

?R spi; _,;i-.r.Hr)n I ns mane 3 Hp.mq i A& i cm

!1C^SS - r^^991^. eps 9326,550(9-)(13))1) ^ (11; r ^

14 Glass 1926,550(a)(12) 115 Windshield Wlpei(s) 1926.601(b)(2)(1) & (11) 216 Door(s) Restralnt(s) °re3o,s 1,6.1,(0) 217 Mirrors 1928.601(b)(4) 2

18 Fire Extinguisher RS 19.2.28.0 2

19 Seat(s) Restraint(s) 1926,601(b)(8) 2

20 Seat Belt(s) 1926,601(b)(9) 221 Parking Brake 1926.601(b)(1) 2

22 Air Pressure 125 19-2,15,3,4 223 Controld Identified 1926.550(0)(2) 224 Instruments/Gauges RS 19-215,4.6 2

251 Electrical Switches/Functions RS 19.2 15.3 226 1 Hom 1926,601(b)(3) 2

27 Ligttl^ 1 1^25,550(a)(1) 1 e

28 Steering RS 19-2.15,4.10 2

29 Engine Clutch -8305-1.6,a 230 Accelerator 630.51,s,3(b) 2311 Brake RS 19-2,15,4,10 2

32 OtherC^F

c33 1 Performance I RS 19-2.15,43 2

341 Exh System/Guards & InsulatorsI 192131.550(a)(10) 235 Belts/Hoses I RS 19-2,15,4 236 1 Guard/Cover/Rotat 3 Recip Parts 1926.550(9- ) 1 2371 Other

Y ^^p3R

38 Transmission I RS 9-2.15,4 1 2391 Drive Line I PA I9.2,15,4 240 Tire/Air Pressure/Wheels s 19-2,15,4.11 241 Main Frame Members RS 19-2,15,4,1 242 Hydraulic Hoses/T'ubing/Fitting s30.5-2,1.3(I) 143 Hydraulic Fluid Level 830,5-2.1.3(h) 144 Anti-Skid Surface 1926,550(6)(13)(111) 245 Front Bumper Caunterw ' ht RS 19-2,15.4(2&4) 246 Backup Alarm lszssol@}(4)(I) 2 J4 -7j Other

48 Boxes RS 19-2,15.4,1 149 Beams RS 19-2.15.4.1 150 Cylinders RS 19-2.15,4 151 Floats/Pads "830.5-1.9.3(d) 152 Hydraulic Hoses/Tubes/Fittings RS 19.2.15.3 ,4 153 Holding Valves ^830,5-1,8,3(b) 154 Ppsilion Locks RS 19.2,15,4.4 i55 Warning Signs 1926,550(a)(2) 1FR RI^n4in,.lf'rfhF,lnn a

711 Seat Restralpt 1926.601(b)(9) 2 I I72, ^$atltfi ; quired. 1^2s,so1.(b)(s) 273 1 Operator,9 Manual 1926.551)(0)(1) 174 Operat g Instructions/Decals 1926.550(a)(2) 275 1121actmAlian Warning Sign -Inside 1B26,550(a)(2) 276 Ha Signal Chart 162.6,550(9-)(4) 177 S^ 1n4 Brake/House Lock I ^1330.5-1.4.21avrbl 178 1 ^'osltive Swing Lock 1 ^830.5 .1,4.2(b) 1701 Controls - Forces/Movements 1 ^1330,5-1,6,2 1

I Jtia _t^trt,,?l ta rte:tam - - - - -

Flo. Inspected Itarn Code Section 41 Status°i

57 Gar Body/Side Frames I"a30,s•t.e 158 1 Chain - Condition/Adiustment 1 RS49-2.15.4.8 I 1 1

699 6prockais%idieraiRoiier5 /RS 19-2,15,4 1

60 Track Pads/Pins RS 19-2.15.4 961 ITravel Locks "830.5-1,5,3(8) 162 Steering Clutches °°830,5-1.5.2(b) 183

i--,^

64

Other^,'z'3-i'^ a: •`•may'*' ^, Y

Grab Rails/Steps/Platfo

y^^^^'¢ S^^.c,' ..

1926450(a)(13)(i & m)

-s'ifv; T:zK.-,._ri-. ^:5

2 .65 Anti-Sk1d Surface 1925.550(9-)(13){411) 266 Glass 1928,550(a)(12) I67 Windshield Wiper(s)Z 1926,601(2)(1) 8 (11) 168 Door R straint 269 Fire Extinguisher Rs 19-2.28,0 2 _701 itJ}1n®r'9- ! 1 1 926.0'0'1(b)(4) ^ i

'-----

em Item'

No. Inspected Item Code Section Watus*, N 0, Inspected Item Code Section

#1 ^Status`

114 N draulle Pressure 171 Holding Devices B30 5_31n21.,

'7Z "Boo-in Seation Aiio

11 7^ Main HeiRt - Wrapping On Drum I RS 19-2.15.3.8 enslon RS 19-2.15,4

120 Auxlllarj Hoist - rap Drum RS 19-2.15.3.6 1 1771Boom Hinge Pin R8 19-2.15,4.4

;RS19-2.15.4121 Auxiliary Hoist - Alli op raps ^-B3 178*om Head Section I

122 Boom Hoist - Clutch /Brakes I_j 1791WIre Rope Retainer

i

181 10ther

127 Hydraulic Motor/Valve^/LlneletC

_^

:128 Drums/Flanges RS 19-2.15.4.3

1 ;24 j Clutch/Brake Protection

130ITorque Converter -B30.5-1.6.4

131 Anti-Skid Surface 2

133 Access to Cab and Roof 56b Damage RS 19-2.18.2

134 Air System. CompressodUnelate— RS 19-2.15.3.4 186c Lubrication RS 1--2.18.3.5

136 Counterweight lv'Varn)ng Signs

137 Ele&acullcin waming Sign OtAside 187a Size/Construction: Inch RS

1 13810ther 187b Damage RS 19-?_18,2

m^wwwna^wmffa 187c Lubrication RS ig-2.18.3,5

om Stops Rs 19-2

142 Outer Ball/Equalizer 88b Damage RS 19-2.18.2

143ISheaves RS 19-2,15.4.3 184c Lubrication

144 1 Boom Hoist Reevirig 19.38 188d Other

189a S*Constructlon: -Inch RS 19-2,1823

LI 189b Damaqs RS 19-2.18.2

189c Lubdcatlon RS

189d Dther

151f aves RS 192.15.4.3 1 190b Damage RS 19-Zli

152] Hoist Llne.Dead End 190c Lubrication R3 19-2,18.3.5

153 [Wire Rope Retainer(s) 830.S-1.7.4(b) 190d Other

154 ^ Boom Foot Pins/Keepers RS 19-2,16,4.4

155 1 Boom Head Section RS 19.2,15.4.1 1 F W10156JAuxiliary Boom Head RS 19-2,16A.1 1 191a Weight Capacity Label S30.5.1.7.6

15711-attice Member RS 19-2.15.4.1 T 191b Sheaves ig-2.15.4.3

158 Cord Members RS 19-Z15.4.1 19 1 c Safety Latches 1330.5-1.7,6_ 1

160 Other 191e Bearing/Swivel 0.5-2,U(a)(4)

191f Wedge Socket End Fitting I'S .5-1.7;3,(c)

161 Positive Stops 1926.550(b)(1) 191g Non-Destructive T RS I

162 Sheave(s) RS 19-2J5.4.3 191h Other

164 Lattice Member RS 19-Z15,4.1 192a Weight & Capacity Label 13305-1,7.6

165 rd Members RS 19-Z 1 6.4.1 192b Safety Latches 1330.5-1.7.6

166 End Connectlons/Pins RS 19-2.154,(j & 41 1 192c. Wear, Twist & Throat Opening B30.J0-1.2.1.3

167 Other 192d Beadng/Swivel —830,5_2.1,3(a)(4)

192e Wedge Socket End Fitting -B30.5-1.7.3.(c) 1

168 Lift Cyllnder(s) 192f Non-Destructive Test Results RS 19-2.15.4.9

1:.1("i-^'":^TC:'-.^';;tiiL4iary"i.-._ _ __ :,F=a='i- 5'=_.inv;l:.!'^.?=^;,c.S:T%r^T^L'^.Y'::LS"SSIJ.1fr=^J?iv1=>'t^_

Boom I.C. No. Length Jib I.D. No.le: r.^a:^=.cc.tisn -___J.:.i.vC^Y.^=.iac;mS,ut^•rt5Y5!,^ii`Y7rw.:::.;nr^^:-

Length Mast 1.1). No.t.:i==- _

Length I

1^

I

' l !s ^/ gi l ^a^

TAC

!

! 1

1 9^i„ fT Total Length

words: Tubular angular ldords: Tubular Angular :ords: Tubular AngularLacings; Tubular Angular Lacings: Tubular Angular Lacings: Tubular Angular'

Assembled Notes:Unassembled Notes;

*Status: (S) Satlsfactori (U) Deficiencies (13) Parts hidden h6wever functional (_) Not Applicable (SWJO) Stop "J'3ork OrderReferences: OSHA 29CFR 9925.560 8, 9990.980; "ASMS 530.5 (9968); ASMS 530.5 (2000; 3008 RIYC Building Code & RS 99-2 (2006); RCNY***Consult operator's manual for kick-out angle for boom

^'^$ewm''",ha ^R8i1Ir^'91,z 17 ^i ` rt 4@ rQ^1 N...a4)J-.,^l,^e^7^e.^ 9i^8^! I ^^'eoa'^+^_^ !+^ a s ''^u9 ir}9p^1^ sp ^^ n

Item Numbers Deficiencies j oath

n

Corrected

f

ippgq.''^s1f ^. ,^,ur' •- as_^,.r 7 ,^, a ^M1^:.LP;'Y•-9_3YC• ...^.R^1^'.ri[^^51u'ic^ "^.^. c c{r'r,,^ t.J'a,^ ^^- ^7^`.'.a_-^^v ^"• 5^'+-r.^:e, u'.^^''}'` a_- _t^^,^^a.-..9C'.^^^1 =k .Y"-e.^'^xr^v'^'I.o-,:...^ e'^ eL_^t ,Jl ^• .^- 1Q E ^r_.^u`^L

Y (lam

0(?(O&tT OP 2®^ P5 1 Ala ,

i C !C q `( ^^ )k^ uS1'^ Jl ^t 0

3y 1

aa'u-^

Na

^},j}''^^!` 7 - iN . pt^J:.tls ^'{'

"7Ea('j^j,_l^r ^'IIIi'J ' f i'_ d. , MAJ._.lr'1u`,'1 n^3"^fy4""'4^-'^^^•ti _lC^itY^ w^ , ^':`a 4:' irp! ...: i^ _ ^a

r of s c a

Na Sionature of Suoervisina Inspector D to

^r V

IM

5

r. F1^ >3°.7a•('•fs"-.iin:^$:'c7c 4°^:vn n1,^^G'nQ-_•,:t}w-ir1+t%.:P;+—a:".i4-:L'^—,^k24'^i?,al'?x... 1 ?-^ek2SY.4Ci'iY`.^^kiJ'.'3^ ..=.ie:;iEi 7::hi^^z^ird•.^:^i-f^;-,"G Sa, 'ci

Ib3Al' RATTANCranes E Derricks, S' h loon

200 Broadway`- Ne"y York, NY 1 0007

M Ddings (212)-56611696

LETTER OF DEFI°CHENI CY

Tom. C_IT Y OF NEW Y' 1)R2r

.fort Authority of New York and New JerseyAttn: Chief Engineer7 ] ^ ^zoadw^y — ^tlt Fipa^^ -

New York, New York 10005

You arc horaby notiled that there exists a violating' condition in the subject premises as described below, and

s;v Goa ? d 2^ :Wino-ie the violation i-nmediatai.y, You trust notify the Depar=tment of Buildings_, Cranes ^Z -

iiGars Uf [ l i:^ i^c^i i_i ^lr^'ia;^.^J, e'n'd:: ^vlia l°yS r^,010.d,d.I i7references to this Letter of Deficiency should be directed to the New York City Department of Buildings,

Cranes & Derricks Division.

COMMISSIONER OF BUILDINGS

e

44 LIj Nc. Gf v'svidtwS ^ ' t j.,^°

of the

a ?4 5 00.

Violation idumberDate T}^e Dist, No,

^p/So

p laint No. Docke

__5Reinspecdon Date I Priority

Section(s) Violated

CRIPTION OF VIOLA

No,

0

/REQUIREMENTS:

Fil^d y gnatur PrinrN f Badg ulb r

A IDAVIT FSERVICE BY MAIL— City and Stateof New Yonty of ; ss: The undersigned being duly sworn, deposes and saysthat I am an ployee in the New York City Department of Buildings, I am over 18 yeast of age, and on I served this Notice of Violation bydepositing a copy thereof, enclosed in a post-paid wrapper, in an official depository under the exclusive care and custody of the U.S. Postal Service within New York City,addressed to the party indicated above and addressed to each of the following persons at the addresses set forth after each name:

2.

Sworn to before me thisSignature

Da y of , 20

Full NameX

NOTARY PUBLIC/COMMISSIONER OF DEEDS

1^^ ^... ffi%0%nV r' Phone: 212-435-5115

Fax: 212-435-5899

Engineering DepartmentConstruction Management Division115 Broadway 8'" RNew York City, NY, 10006

City of New YorkDepartment of BuildingsCranes & Derricks Division280 Broadway-0 Fl.New York, New York 10007

October 14, 2009

(:Iii)Attn: Mr. Jason Ocharsky, P.E.

SUBJECT-; TIHERNk ORLD. TRADE CENTER=T7ANls O­WOC 15000 CRANE, SERIAL # 1800-1054

Reference: -Letter of Deficiency, received 10. 13.09

Dear Mr. Ocharsky:

This office hereby acknowledges the receipt of the above referenced letter (the "Letter")regarding the non-prototyped assembly of the subject crane at the WTC Site, and in accordancewith Paragraph #14 of the Memorandum of Understanding executed on March 5, 2009 betweenthe Port Authority of New York and New Jersey (the "Authority") and the New York CityDepartment of Buildings (the "Department"), offers the following response.

As always, the Department's recommendations regarding the assembly of the Manitowoc 18000at the WTC Site are greatly appreciated. In response, the Authority has removed the fall from themain boom completing the assembly in accordance with the manufacturer's recommendation,load charts and computer limits. A second inspection was held on 10.7.09. The crane wasapproved for use with an audit item requiring the anemometer installation by 10.14.09. Theanemometer will be installed on 10. 14.09 at 3:30PM. The Department will reinspect the on10.15.09.

If you have any questions, or require any additional information regarding the above correctivemeasures, please email Ms. Maureen Lynch-Jacobs, Senior Engineer at mjacobs@,panynj.gov .

Very ^:l-uly` Yours,^^

Jams Starace, P.E.Deputy Director-ConstructionEngineering Department

Cc: F. Lombardi, T. O'Connor, S. Plate, A.Reiss, T. Stickelman, M. Lynch-Jacobs

COMPLAINT NO: Accident Occurance C&D Notified I C&D Respondedii Date

4a/

Time

Location or

ough

• r^^Specifics%

Accident Classificatior 1 ,>qCrane. Derrick Rigging Scaffold. Wor Other:

Injuries Last Name First Name Address Sex Age

Fa' lally Injured? "Y 'n,

Fatally InjuredT y n

1A.

'Fa& ly Injured? y n

I Rigger A.ddrdss:

Phone: License No-:

Hoist Machine operator.

....... _WYPhone; LIPh _peDse No.

Foreman on-site4-

7.6h Fax No.:e:

Contractor Add.^ess:

Phone: Fax No.:

Probable Accident 6^^uw s e. .Crane'Hitt i ng:

I. 'eBreakage/ e =Fail.re

Design/Sef0^'ErroF­

Vind /Weather Related ,

Human Error Fou6datidn Colla se

Other:

Crane / Derrick Ark Platform"

,Manufacturer. ,

CN No,: 44 1pr

Model-

CD#-

Curreni Tiowei Height: ft, Platform WicIft - ft, Boom Length: ft, Jib Length It

Describe load Pick: i^ Weight: lbs, Radius

of pick: k^l 0Z

I Mata/Fou r1dations used? q yes , ' E],' no . _ . if yes, indicate mat erial: Dim . enslon: Condition:

tOut(Igger Position? q Futly . extended . Partially or fully withdrawn TCAO-on-site? yes q no Approved load chart on site? Aryesq

no

Approved CN/on-site? ff_yes _ o. Machine set' yes q no Is form.CD-8 / TR1 on-site? q yes [] no

Scaffold / Hoist

Was this job filed with the Cranes and Derricks division? q yes El no Machine set up according to plans? qyes El no

J66 No..

Scaffold elevation: ft. Rope type: [I Manilla q Wire- * E] Nylon size: Condition:

Scaffold anchor and Suppo,—L: Parapet Clamp / C Hook Staging Outrigger Beam Tiebacks Safety bells

Counterweight: lb, Counterweight makeup: OuViocer beam size: Te down:

Material on Scaffold:,.. .......... .

. .. ...... ....... . .. Number of pqrsons . pT.i scaffold:.,

CD-15 Revised 02-(

Page . 1 of

2,

ACCIDENT INVES T IGAT !ON FORM (CON70)Accident Description:

} Describe work being performed:

Existing Unsafe field / cperaiino conditions:

tom"s--

1

Equipment 15amage:- 6

Property Damage:/

nActions taken:

Ccmments: r

E Witness Statement{s) {In6lude ^rritten statementby'.vritness If available)

Name-. Title:

Com pany Name: Phone No.:Ci State° -_..:..:..ZiAddress; tY p:"

Name: Title:

I Company Name:

I Address:

i Other Agencies Present At Accident Site ._'...

Police: Name:

Address:

OSHA: Name:

;._- •^ ^ P h o ne No.:City: . ... ,........ __,...- Sfale:.....;

ZiP.. ,._...

Title:'.... RrecincL.No::

Phone No.::. ..

Title:

Address: Phone No.:

Other: Name: Tdle: - - Agericy:'..,..

^ Address: _ _Phona No.: , ; '

Cranes and Derricks Division RepresentativeRepresentative,On-Site.._.,

1

2: : Title;:

Accident Investigated by:

Name:

Title:

Signature Date

if Supervisor

Signature Date

CD-15 RevisedPace 2 of

_- -

[[,, ((^^- ^ - - _ ^^=w-.,ter.., a i'•^-`.#!ui ".,`4 -z_

^^:9_i^,S1 .-^^:^w..:p:^_.;11.4i^_ ^^?^lT1NU_^_D_ ^_..r:-^•,_,_ .:^._^. ^^^_..._.Ite SWONo. Inspected Item Code Section #1 Status*

^r,_ °^•;:^„ .'af, .Devil I,Q:''era Ion s.. ,;>. -,>:%:s_

-u14 see ?ection 10j page 2 Items 92-1o0,'to2,g`to3

15 Excess Sr )qke RS 19-'2:15.4.7 216 see section 1 -Okpage 2 I10mA05, 106 & 108 2

^._9`: -^R;o,`a^'` :U -• e.r-.S°u e:^'-Eruc^ii^^.a^_z - ^_,^`^_ -ur a e17 T nt bl R S 1 9-2.15,4.4 1

181 Pumps/MotorsNalves/Lin [.Tribe 830,5-2,1.3(q(m)(n) 119 Ring Gear/Pinion Gear/R^l e RS 19-2,15.4,4 120 Main Hoist and Rope see secflons 91 & 91 121 Auxiliary Hoist and JRope 'No sections 9( & 91 122 Boom Hoist and Rope see~sacUons 91 & 91 123 Luffin Boom )ipist and Ro pe

'-n<g _•'-r:5-- :yss

1

^a!_ — - Etla_eH-o^';;'^^^^_^- _ .:;y,;: ; °sue •" — _7?I

^q_sv24 see sect d 100 pagen 3P9 le s 8 152 -154 11 m 14 ^

AR @t ^' r 7 : s..., _ Telescopic Boom; ^__ ". _ Y.1 ....+ ^..': .25 see,6ection 10q page 3 I llarn, 168, 170 . 172 1

°c , =z.1:_,,U1r.$ RRPe }1_bo'k,.8lnek 8°atJ^„i`_^`^, ,:< r26 be section Inc e z ^- "

:^:;t^4,O^1 ^SIT^ IV^SP;E';^771:CJP1 -- -- _ - - -^_ -- - - -Item SWO

No, \^ Inspected, Item Code Section #1 Status*

& ,Plan ^afaz

SIM gpP,l ldation aal

1 Approved-Permits & Plans on site Bc3319.4 &.5

2 Supporting )/Pad/Mat RS 19-2,8,1.1 & 8.y 1

3 Crane set-up cord rmity RS 19-2.8 :P/ 1

4 CN - On-Site Sign-oo CD-4) RS 19,-^.'8,1 15 CD - Approved CD (CD- KX6,4 &.5 1

—-?=u9b—

sDaily6 /Montfy Inspection Recor ~aao.s•z.ts 2

7 Signed & Dated ^030.5.2.1,5 2

8 Main Frame Member T RS 1 .15.4,1 29 see section 10b page 2•/ Items 5, 7,'a.& 10 2

_=9Ct ,4.R _ _ rl ":' a' i`:d U f f{g 9.0PS _ _'_ ^i -

- 10 see section 10f pag6 2 litems 48 thru 56 1°:^" g:_,:^F;:^:;_;^;r-_^^:^ - - --

11 see section 10g page 2 items 67 thru 60 191 Operators Bali;?:& M-1 2 I a s 64 2 77 79 80 82-64seesection 10 a e lm 7h 2P9

-<.9. ^- - -^^;;•^-^_:-, L,t ^?•^,.Loa.d:^.harts. _:-:^=^=^: ^^.,:_;..... _..-_:

- NYC Dept, of Buildings Cranes & Derricks Division - 280 Broadway, Room 501, New York, NY 10007

s^oo^ov^^s Tel: (212) 566-4696 Fax: (212) 566-5871 E-mail: candd@buildings.m/c.gov

MOBILE ON-SITE AND ANNUAL INSPECTION CHECKLIST

•^i;-lnspgct'to:n;.lnTOrmafio.n,-_ > :-- -- -_ : -- = -- - = - --- __ ---- _ - - --

r ! Siie Location. ( / tDate of !nspec`lcnc : • i ^: (^' ° j L i ,^ )i

Borate! ^, 1r 1.. CN:„

Inspector Namezf 7% ^'T%i^7:1{',',: f i J;."7 ` Badge No.:,^ <'^ >

Type of Inspection:Ann^i ll Re-inspection On-Site Audit Patrol Sweep Chief Special SWO I_Ift# Complaint#/

Inspection Results: No Deficiencies Issue CD Re-Inspect SWO Issued # Number of Violations Issued

rave.-Da •" ^- - - -

Make.` Model: / ) lam' ^ ^° .•^

Serial No.: p - • r Ij r

Year: L.

CD:." : _:"^q V

r

Expiration Date: c^^ rCy Max Capacity: Picture Taken: Y^(

Crane Types;^(BT) Boom Truck (cc) Crawler Crane (D) DerrickMCpobile Crane (MMC) Multi-Slallon Mobile Crane IMT) Mobile Truck Tower Crane (P) Pile Dr vier

Crane Owner N ame : j^' -/ `^ ,I

^/4 ^,/ t t Contact Name' p 1 , j' l

'{l , _

d,C`) Telephone

r t` ame { l . ^ ft f' , r_ L 1..^ (='> l i P

Company Name: Telephone:

-1 -r

Last Name:- - ---,- - ---- -- - - - --- - ~tFirste.^'=-• - - - -- -

ML'- - -- - - --- - -

Licence No.: Expiration Date: GIB 1^Type: ,^ Master Tower Special Master Hanger Special Hanger

Last Name: Ao } ^-) t a First Name: ~ nn

Licence No,_ , r,^^ ^' Expiration Iate: I jia (j I Type: Clas A; Class B Class C1 Class C2 Class C3

-_ 1S r iener^t'G'onxr:'aGt_o I,Slte aafp <^/{an^ger lnforrl tints _ .'_i, t .u K:. r_ L „,:.a ;'

Company Name: "tact Name: Telephone:

Licence No,: Expiration Date: ^`^ ^s General Contractor Site Safety Manager

4Other

°': LOb 1enerei5 Sheet Metal ..B30.5-1.2.1 (a) 2

6 Guards/Covers 1926,550(8)(8) & (10) 27 Internal/External Lights 1926.601(2)(1) & (i) 2

1 8 Housekeeping Rs 19-2.26.0 2 i9 Safety/Waming Decals & Labels 1926.550(6)(2) 2

10 an Signal Chart 1926.550(a)(4) 211 Paint Condition/Corrosion Control RS 19-2.15.4.1 2

12 Otheri'1 ^G `+ t -'' r .^ _ ^-b@Ib9P ^{_Ci_ l7 _u1 _^LaGtLll 2 ti t , r-1

(

^:

13 Access - Grab Pails/Steps 11926,550(a)(13)(i) & (II; 2

14 Glass 1926.550(a)(12) 1

15 Windshield Wipers) 1926.601(b)(2)(I) & (ii) 216 Door(s) Restraint(s) -B3o,5-1.8.1,(c) 2

17 Mirrors 1926.601(b)(4) 2

18 .Fire Extinguisher RS 19-2.28.0 2 C

19 Seats) Restraint(s) 1926,601(b)(8) 2

20 Seal Belt(s) 1926.601(b)(9) 2

21 jParking Brake 1926.601(b)(1) 2

22 Air Pressure RS 19-2,15,3.4 2

23 Controls Identified 1926.550(a)(2) 2 j-y

24 Instruments/Gauges RS 19-2.15,4.6 2

25 Electrical Switches/Functions RS 19-2,15.3 2 726 Horn 1926.601(b)(3) 2

27 L'Igths 1926,550(a)(1) 2

28 Steering RS 19-2.15.4,10 2

29 Engine Clutch ^830.5-1.8,4 2

30 Accelerator ^B3o.s•1,s.a(b) 2

31 Brake RS 19-2,15.4.10 2 °+

32 Other--=0d - --_ ^4; ss ^^Ca%ri`e.r`Po!N^r-Plano° LoYve`r:,=^,«t.^;-i(ur^_J._:,^..- -

33 Performance RS 19-2,15,4.7 2

34 Exh System/Guards & Insulators 1926,550(a)(10) 2

35 Belts/Hoses 8519.2.15.4 2

36 Guard/Cover/Rotat & Recip Parts 192s.55o(a)(B) 2

37 Other

38 Transmission RS 19 .2.15.4 239 Drive Line RS 19-2.15,4 2

40 Tire/Air,PreSSUre/WheelS RS 19-2,15.4.11 2 -'

41 Main Frame Members RS 19-2,15,4.1 2

42 Hydraulic Hoses[Tubing/Fltting 830,5.2.1.3(1) 1

43 Hydraulic Fluid Level B30.5-2,1.3(h) 144 Anti-Skid Surface 1926.550(a)(13)(ili) 2

45 Front Bumper Counterweight RS 19 .2,15.4(2&4) 2.46 Backup Alarm 1926.601(b)(4)(i) 247 Other

48 Boxes RS 19-2,15.4.1 149 Beams RS 19-2,15.4.1 150 Cylinders RS 19-2.15.4 1 _51 Floats/Pads ^830.5-1.9.3(d) 1

Hydraulic Hoses/Tubes/Fittings Rs 19-2.15,3,4 1

LE5452

Holding Valves ^830.5-1,9,3(b) 1 y=-Position Locks RS 19-2,15.4.4 1

Code Section 1 #1 (Status'

RS 19;2.-4-6 '48 1

RS 19 -2,15,9 L 1

RS 19-2.15.9 1

^830.5-1^:3(e)_ 1"830.5-1.5.2(b)

1926,550(a)(13)(I & iii) 2

1926.550(6)(13)(111) 2

192fi,550(a)(12) 11926,601(2)(i) & (II) 1

63os-1.6.1.(c) 2

RS 19-2.28.0 2

1926.so1(b)(4) 2

1926.601(b)(8) 2

1926,601 ,(b)(9) 2

1926.550(a)(1) 1

1926,550(8)(2) 2

1926.550(a)(2) 2

1926,550(a)(4) 1

^830.5-1.4,2(a)/(b) 1"^830.5-1.4.2(b) 1"830,5-1,6.2 1

RS 19-2,16.3.4 2

^830,5-1.12(b)(2) 1"830.5-1.3,2(c) 1^630,5-1.6,4 2

"830,5-1.6.3(b) 2

26.550(a)(1 & 2) 1^830,5-1.1,3 1"830.5-1. i.3 1

89 Visible from 0 eratol's Statlor^p ^830,5-1.1,3 190 Secured "830.5-1,1.3 2

91 Other- ,+-='.j^T'_•`-'. 'r4^ril' ^;,:fii _ _-^afety_DevlcgslOperaflhnal_ _ _ - - iiil[^ T •: r:t;i ^^^ ^'u:^^

92 Warning Decals 1928.550(a)(2) 1 C

93 Boom Angle Indicator RS 19 .2.19,1.3 1 `

ItemFlo, Inspected Item

HISS

1 JIvionthly Inspection Records

2 Maintenance Records31Re0air/Modification Records

SWO Item

Code Section #1 Status' No. Inspected Item

_

^e3o.5-2.1 5 2 :t7 L?r Body/Side Frames

RS 19-2.17.1.1 2 58 Chain --Candtigp/Adjustment

RS 19.7.17.3.4 1 2 1 59 1 Sprockets/Idlers/Roikem--,_

60 Track Pads/Pins

61 Travel Locks

62 Steering.- letches

63 Qttier

64 Grab Rails/Steps/Platforms65 Antl-Skid Surface

I7, GlassWindshield Wiper(s)

Door RestraintFire ExtinguisherMirrorsSeat Restraint

72, Sept B. ell] f.required

73 Operator's Manual74 Operating Instructibns/Decals

75 Eleclroculion Warning Sign - Inside

76 Hand Signal Chart77 Swing Brake/House Lock73 Positive Swing Lock79 Controls - Forces/Movements80 Air Pressure81 IFoot Brakes - Latches/Linkag82 Power Controlled Lowering83 Engine Clutch84 Accelerator/Throttle Control85 'Other

86 Per Configuration871 Durable88 Leoible

-Item -

No. Inspected Item Code SectionSWO

#1 Status'.

`19m^ . _ -. ^^R:otating=J'ppe^SUp^rs^ruct ul`^;^ "^oiitliiUed^=;-`'

^

_ __

I 113 Hydraulic Pumps) e3o.5•z,1^3(m) •.,..

- 1 ^^^ `.

114 Hydraulic Pressure 830.5-1.1.3(n)(6) 1

115 Electrical Wirino RS 19-2.15.3.7 1 '-•-1IlojivlainHoist - OuicheS%br KeS ,B3o.5.1.3.2(a)(1) i j

'117 Main Hoist N/rapping On Drum RS 19-2.15.3.6 1

118 Main Hoist -Min Rope Wraps °830.5-1.3.2.(-2)(2.)-2 1

119 Auxiliary Hoist - Clutches/Brakes 830.5-1.3,2.1 1 ^'

120 Auxiliary Hoist - Wrap On Drum RS 19-2.15.3,6 1 ,'

121 Auxiliary Hoist - Min Rope Wraps -B30.5-1,3.2(e)(2)a 1 ,'

122 Boom Hoist - Clutches/Brakes 'B30.5-1.3.1 (a) 1 (.^

123 Boom Hoist - Wrapping On Drum RS 19.2.15.3.6 1 _

124 Boom Hoist - Min Rope Wraps '°830.5.1,3.1(4)(1) 1 I SI125 Boom Hoist - Gears/Shafts/etc... RS 19-2.15,4.4 1.

126 Swing System/Assembly I °'830.5-1.4 1

127 H drau'c o alv Lim eLc _E1105-2 _ 1

128E129

Drums/Flanges RS 19.2.15.4.3 j

Clutch/Brake Protectio n ^830.5-1.9,7 1130 Torque Converter -1330 . 5- 1.6.4 1

131 Anti-Skid Surface 1926,550(a)(13)(ill) 2

132 Steps/Hand Holds/Platforms 830,5. 1.8,3(b) 1

133 Access to Cab and Roof 830.5-1.8,4 • 1 47)134 Air System - Compressor/Line/etc... RS 19-2.15.3,4 1

135 Counterweight Frame& Mounting RS 19 .2.15.4.(1 & 4) 1.

136 ICounterweight Warning S igns 1926, 550 (a)(2) 1

137 Electrocution Weming Sign Oulslde 1926:550(.)(2) 1

138- -_ _^it

139't^0:l1=1rf::.ut;^::a

Other7 }ti^`L•.;i;'-_:^? - - -. _ _- _'j1 __=^' _B_^?:of^i_SIIIS:RR:fG:^ySfa~^;t^:,l_c..:;c^..__ant-p7 vlast_v_

=?;^:,`^^''^-^'-,'pj'.i,i3:¢`t ai

"830.6-1.3,1

1

^::n,r^•^^•r_1

=1°--- _--

140 'Boom Stops °- _ RS 19-2.19.3(x)' 1

141 Inner Bail 830,5-1.3,1 ^1

142 Outer Bail/Equailzer a^ 1

143 Sheaves Rs 19.2 ,15.4,3

144 Boom Hoj, ving RS 19-2.19.3,6 1

145 Other3t;y:` t^ ^ b.D. u: ' 1i / ) {l p -

^i1-^ (,'^^(^ BQD(T3r 1.k !.T-f5.x^ IJ^`-:!:. F '1

t- .P

^ilF 4

IrL I ^'.t:.,'rv. ^=i.W:

''1$6 Boam Sectlop itleritlflcation, _ r _ ?^, ,.,.. :»r?''^147 ' o'°m•:ecfrorit=s`e.'en'se:' - ;1;/ ;"_

148 Boom ction Alignment Rs 19-2,15,4,1

149 Warning DebaL lszss5o(.)(z) p 2

150 . S:p(eader;i3'a> :: , t .. '; ^;.. _15) Sheaves R

3;15,4,3 1

152 Hoist Line Dead End 9 430,5-1.7.3 1

153 WI re Rope Retainer(s) 630.5 - 1.7,4(b) 1

154 Boom Fool Pins/Keepers Rs44-2,15.4.4 1

155 Boom Head Section RS 19-2, 4.1 1

156 Auxiliary Boom , ^d RS 19-2.16.0-, . 1

157 Lattice Membdir RS 19-2.15.4.1

158 Cord Members RS 19-2,15.4,1 1

159 En, -Connections/Pins RS 19.2.15,4.(1 & 4) 1 '

16 ther

^.-'it - -' . -_- ','dim °,-^' ( _ e^ ^ r:`Y •:3,`-'."=''L __ir''_,...

161 Positive Stops i 1926,55o(b)(1) 1

162 Sheave(s) RS 19-2.15.4,3 1

163 Wire Rope Retainer(s) 1- 8 30.5-1.7.4(b) 1 -

164 Lattice Member RS 19-2,15.4 ,1 1

165 Cord Members RS 19-2.15.4,1 1

166 End Connecllons/Pins RS 19-2.15,4.(1 & 4) 1 t-j167 Other

+ i1,Qq -1,, :,slescoplo;3 'om _., ^_ na3.r_c _

..t_..,%168 Lift Cylinders) 1330,5-2.,1.3(x) 1

:'10 A^1i+14J^,L.tNS^ECTfON^G:9f^1T(P1ltE,D_ .=-^^^y "-^__ ^^ " r ^s _^_=:5ItemNo, Inspected Item Code Section

SW9#1 Status'.

=1D ^^- ^.'P^lesco 7GBoD ^:Confln.und ^` ^,;170 Hydraulic Hoses/Tubing Fittings 830.5.n3(I) 1171 Holding Devices B30.5-2.1-31n) 1

1721 Boom Section A.!ignmeni ; RS 19-2.15.;.1 g

1 73 Wear fag s RS 19 .2.15.4.5 1 „174 Equal Extension RS 19-2.15.4 1175 Sheaves RS 19-2.15.4.3 1

176' StFucfij•ra/Weld's , 1.177 Boom Hinge Pin RS 19-2.15.4.4 1178 Boom Head Section RS 19-2.15,4,1 1179 Wire Rope Retainer -830.5-1.7.4(b) 1 ^.180 Other -'181 Other

;^"1 ^rlitd,J,i1^.1 ex^enSlIIh r,iUtanuel v^eCt1013S" .:2

182 Alignment _^3r s.^s-^1 ..1 1183 cking DetHgea - qs tsz^s4^ t q184 Strugr Merl d85-'Other

4?_.,i,t}R I at S pi1.nF _xr ' ,,^/rr9:k\Ope' ^l _._ `;4 ^,!

186a -! inch ~Sizel.Construction; Rs 19-2.18.2.3

186b Damage ; RS 19-2.18.2 1 ^.186c Lubrication RS 19-2.18.3.5 1 C.,1864 Other

_^1.8^'if^^ain^;HQis.^-_ uiL =iY... •-,'^-1.a^]i_-

=u-- r=,V- - S-^

_ ^^,?„^,5^^^=7.i.4rv1^'Ll)^_iiy;^_

^-.•/<<z187-2 Size/Construction: _Inch RS 19-216.2.3 1 e187b Damage j RS 19-2.18,2 11 87c C 0Luhrl atl n R s 1s 2..1 8.3 5 1

187d Other ( °

11;3r,

188a Size/Construction: inch RS 19-2.18.2.3 1188b Damage RS 19-2.18.2 1188c Lubrication RS 19-2.16.3.5 p1 .

T8_ 8 d Other /*K''`1t^^ BDS1t'n^.r 9)'1,t''c1nf5 _ c,. 1 3 !,y- = n } _

189d`Size SfNCtlOn: Inch RS 19-2,18.2.3

189b Damage _SRS ^a z 1a3 '1

189c Lubrication RS 1&2,18.3,

189d 0

=^ ,J +.^^ 'd7^ •^?.- r?^., rF .1_ ,tv -. ;ate o^='S^^ _s,^ _ ,S

^

x- _ti_^^

1902 Size/Construction: RS 19 -2.18.2.3 1190b. Damages 1 .190c Lubrlcallon RS 19.2,18.3,5

19^d @ttl^,ti tt)t ';L, r _ 2, `'{oo B; dL ks sB I .^"ti t ts: ^t

r rJ' RI N[ai`i $`focic_z . Ko4k^ 1

J^_ ^_ } ___^. _

191a Weight & Capacity Label 830,5-1,7.6 1

19 .1b Sheaves RS 19. 2,15.4.3 1

191c Safety Latches 1330.5-1.7.6 1

191d Wear, Twist & Throat Opening 830.10-1.2.1.3 1 1- .

191e Bearing/Swivel ••830,5-2,1.3(a)(4) 1 `j

191f e Socket End FittingWedg S ket ithng e^ 305-1,7.3, ( c) 1

191g Non-Destructive Test Results RS 19.2,15.4.9 1

191 h OtherjP

e Ro -

192a Weight &-LapaclhyLabel 830,5-1.7.6 1

192b Safety Latches 830.5- -192c Wear, Twist & Throat Openigg 133010 -12.1.3 1

192d Be ,,ring/Swivee-s "830, 3(x)(4) 1

192 e ocke End FittingVJad t n ittin 9 e 305-1.7.3. c • 1

192f on-Destructive Test Results RS 19-2.15.4,9 ^T

EngMast lZ No, L e t^hBoom D. No I Length 4 Jib I.D No. Length

T/

, Cards: Tubular Angular Cords: I ubular Angular Cords: Tubular AnFular

Lacings: Tubular Angular 11-acings: Tubular Angu L a c I q_gs: Tubular Angular

Assembled Notes:

Unassembled Notes:

*Status: (S) Satisfactory , (U) Deficiencies (IS) Parts hidden however functional Not Applicable (SWO) Stop Work Order

References: OSHA 29CFR 1926,550 & 1910.180; **ASME B30.5 (1968); ASME B30.5 (2004); 2008 NYC Building Code & RS 19-2 (2006); RCNY

E^:^^perator's manual for kick-out angle for boom

Item Numbers Deficiencies Date Corr ected

p NOM

-af -lh-spect t"

- El-

, ..~~_- -_

NYC Dept. of Buildings Cranes 8 Derricks Division - 260 Broadway, Room 501, New Yo NY 10007

Tel: (212) 566-4696 Fax: (212) 566-5871 E-mail: candd@buildings.nyc,gov

MOSILEON-GITE AND ANNUAL INSPECTION CHECKLIST

Date of Inspection: L SjW Location: IAJ if Boro: CN:

flnsoector Nar-na: Badge No.:

Type of lnspectiop"A nulnspe4jon On-Site Audit Patrol Sweep Chief Special SWO Lift# Complaint#

LlInspection Result ^o^flclencleDs Issue CD Re-inspect SWO Issued # Number of Violations Issued

Model: 7/L,- Serial No.: Year: a 60J

CD: Expiration Date:Y NPicture Taken* 'Max Capacity:

Crane Types; (a T) boom Truck (cc) Cramer Crane (D) Derrick l- (Mc) Mobile Crane (MMC) Multi-Station Mobile Crane (MT) Mobile Truck Tower Crane (P) Pile Driver

Company Name: .^i^ Contact Piame; Telephone;

Of

V,

Name:^ Last Name:

Licence No.:

Last Name:

Licence.No,: Expiration Date:

MI:

Master Hanger Special Hanger

gg

MI:

On Site: Y N NA

: Master Tower S

............ MEMMY W-MA4119

Last Name: ^ A, First Nanhe: MI:

1

-

Licence No,S Cj Expiration Date: Type: Class A /1--class class C, Class C2 Class C3

--a -S

Company Name: Contact Name: Telephone:

Licence No,: Expiration General Contractor Site Safety 'Manager

IN, gnmgSWO

Inspected. Item Code Section #1 Status*

1 Approved Permits & Plans on site BC3319.4 &.5

2 Supporting Soil/Pad/Mat RS 19-2,8.I.1 & 8.4

3 Crane set-up conformity RS 19-2,6.0 1

4 CN - On-Site Sign '-off (CD-4) RS 19-2.8.1 1

5 Approved CD (CD-2) BC3319.4 &.5 1

8 Main Frame Member Rs 1s-2.15.4.1 2

see section 10b page 2 hems 5, 7, 8 & 10K im41,1 M-110

90 T-s- ^^o6_10 se section 1 Of page 2 items 48 thru 56 1 1

z

--v

see section 1 Og page,2 items 57 thru 60

............... . . .......

12 see section 10h page 2 Illems 54,72,77,79, BO, E12-84 I

13 see section 101 psge 2 ..... Lbern s 86 & 88 1 1

Item

No, Inspected Item Code Section19WO#1 Status*

14 see section 10j page 2 1Items 92-100,102 & 103

.:.

03

15 Excess Smoke RS 1 9-2.15.4.7 2

-_16 see section 1 Ok page 2 Items 105,106 & 108 2

17 Turntable RS 19-2.15.4.4 1

18 Pumps/MotorsNalyes/LinesiTubeE _F19 Ring Gear/Pinion Gear/Rollers RS 19-2.15.4,4

20 Main Hoist and Rope see sections 9f & 91

21 Auxiliary Hoist and Rope see sectlons 9f & 91

22 Boom Hoist and Rope see sections 9f & 91

231 Wring Boom Hoist and Rbpe5

F.

24 1 see section I Oopage 3 hems 145 , 152-154

1-14M-9-­ggg

251 see section 10q page 3 11t.rns 1 68 , 170-172

26 see sectio n Os)age 3 items 186-190 1

I 'L / I see section 1 Ut Pap e 3 1 H.— I q11i qS-._ A f I I I I I

I

1

Item

No. Inspected Item Code Section

SwoStatus* 1

Item

No Inspected Item Code Section

SWO# ,I

i

Statusl,

v. W

I Monthly Inspection Records -1330.5-2,1.5 2

rw_ '57 Car Body/Side Frames -1330.5-1.8

2 Ma intenance Records IRS 19-2,17.1.1 ain - Condition/Adjustment RS 19 .2.15,4.8

3 Ri6pair/Modification Records IRS 19.2,17.3A 2 59 Sprocl<ets/ldlers/Rollers

61-

rack,

IRS 19-2,15.4

4 1 Other Pads/Pins- RS 19-2.15.4

7n-. % iIT. 3 ,jel c -930.5-1.5.3(a)

5ISheet Metal 1 -1330.5-1.2.1 (a) 2 62 Steering Clutches -630.5-1.6.2(b)

61 Guards/Covers 1926,550(a)(8) a (io) 2 63 Other

7 Internal/External Lights • 1926,601(2)(1) & (11) 2

JHousekeeping IRS 19-2,26.0 2 64 Grabais e

a am ng Decals a es 1926.550(a)(2) 2 65 Antl-Skid Surface

10 Hand Signal Chart 1926.550(a)(4) 2 66 Glass 1926,550(a)(12)

11 Paint Condition/Corrosion Control RS 1 9-2,15.4.1 2 S 67 Windshield Wiper(s) 1926.601(2)(1) & (11) 1

12 Other 68 Door Restraint -1330.5-1.8,1.(c) 2

^- '1. -1-N 0 V 69 1 Fire Extinguisher IRS 19-2.28.0 2

13 Access - Grab Rails/Steps 1 1 926,550(a)(1 3)(1) a (111 2 70 MIn ors 1926.601(b)(1) 2

14 Glass 1926.550(a)(12) 1 4; 71 ] Seat Restraint 1926.601(b)(8) 2

15 Windshield Wipef(s) 1926,601(b)(2)(1) & (0) 2 -T—I -7 . S ,eat Belt/iffequired. 026,691,(b)(9) 2

16 Door(s) Restraint(s) -830.5-1,8.1.(c) 2 73 Operator's Manual 1926.550(a)(1) I

17 Mirrors 1926.801(b)(4) 2 74 operating Instructions/Decals 1926.550(a)(2) 2

18' Fire Extinguisher RS 19-2,28.0 2 3, 75 Electrocuflon Waming Sign - Inside 1926;5550(8)(2) 2

1'

Seat(s) Restraint(s) 1926,601(b)(8) 2 76 Hand Signal Chart 1926,550(a)(4) I

20 Seat Belt(s) 1926,601(b)(9) 77 Swing Brake/House Lock -B30.5-1.,1 ,2(e)/(b) 1.

2 1 -Parking Brake 1926.60i(b)(1) 2 78 Positive Swing Lock -B30.5-1.4.2(b) 1

22 Air Pressure.IRS 19-2.15.3.4 2 79 Controls - Forces/Movements "530.5-1.6.2 1

23 Controls Identified 1926.550(8)(2) 2 j 80 Air Pressure . IRS 19-2.15.3,4 2

24 Instruments/Gauges IRS 19-2.15.4.6 2 81 Foot Brakes - Laic -B3015-1.3.2(b)(2)

25 Electrical Switches/Functions IRS 19-2,15.3 2 82 Power Controlled Lowering -830.5-1.3.2(c)

Horn 1926.601(b)(3) 2 Engine Clutch 30. .614

27 Ligths 1926.550(i)(1) 2 j 84 Accelerator/Throttle Control -830.5-1.6.3(b) 2

Steering IRS 19-2.15.4.10 2 S 85 Other5F--

mi29 Engine Clutch -B30.5-1.6.4 2

30 Accelerator -1330.5-1.6.3(b) 2 86 Per Configuration 1926.550(a)(1 & 2) 1 1 7 1

31 Bralke IRS 19-2.15.4.10 2 87 Durable

32 Other 88 Legible -830.5-1.1.3

33 Performance IRS 191 2 90 Secured "B30,5-1.1.3 2

34 Exh System/Guards & Insulators 1926.550(a)(10) 2 2 91 Other

35 Belts/Hoses IRS 19-2.15.4 2

36 Guard/Cover/Rotat & Recip Parts 1926,550(a)(8) 2 92 Warning Decals 1926.550(a)(2) 1

37 Other 93- Boom Angle Indicator IRS 19-2.19,1.3

0MM- 1 M ...Cl--t-i*-fLfj,,Crl,.-,-^,-:;.Ici^7^rl:i^-f^^-. I R, NO, 94 Main Drum Rotation Indicator IRS 19-2J9.3(e)

38 Transmission RS 19-2.15.4 2 95 Auxiliary Drum Rotation Indicator RS 19.2.19.3(e )

39 Drive Line IRS 19-2,15.4 2 96 Load Moment Indicator -B3b.5-2A.2(a)(3) 1

40 Tire/Air Pressure/Wheels IRS 19-2.15.4.11 2 4-j 97 Load Weight Indicator IRS 19-2.19.1 1

41 sMain Frame Members RS 19-2.15.4.1 2 98 Radius Indicator IRS 19-2.19.1.3

42 Hydraulic HosesfTub ng/F1 ing 830.5-2.1.3(1) 1 99 Crane Level Indicator RS 19-2.19.3(d) 1

Hydraulic Fluid Level B30.5-2.1.3(h) 1 100 Anti-Two Block Device IRS 19-2,19.2 1

Anti-Skid Surface 1928.550(a)(13)(111) 2 101 Two-Block Warning Device IRS 19-2.19.2 1

45 Front Bumper Counterweight IRS 19-2.15.4(2&4) 2 102 Boom Hoist Shutoff" * IRS 19-2.19.3(.) 1

.46 Backup Alarm 1926.661(b)(4)(1) 2 1031 Boom Hoist Ratchet and Pawl -1330.5-1 -3;1N1

47 Other 104

010

Other

J

-M . . .. .......

48 Boxes IRS 19-2.15.4.1 1051 Performance IRS 19-2.15.4.7 2

49 Beams IRS 19-2.15.4.1 1 106 Exh System Guards & Insulators 1926.550(a)(10) 2

50 Cylinders IRS 19-2.15.4 1 107 Belts/Hoses 830,5-2.1.3 2

51 Floats/Pads -B30.5-1.9.3(d) 1 108 Guard Covefr/Rotat & Recip Parts 1926.550(a)(8) 2

52 Hydraulic Hoses/Tubes/Fittings RS 19-2.15.3,4 109 Other14: a

53 Holding Valves -193 0. 5-1. 9.3(b)

54 Position Locks IRS 19-2,15.4.4 1 5 110 Turntable/Bea ring IRS 19-2.15.4,4

55 Warning Signs 1926,550(a)(2) 111 Turntable - Rollers/Roller Path IRS 19-2.15.4.4

56 Blocking/Cribbing 1 112 Ring Gear/Pinion Gear IRS 19-2.15.4.4

- . -- - — . . • . .. — . .. . - - I . —"k n D. M r— rM. ,t A A M— A...- — 1—

Item

No. Inspected Item

170 Hydraulic Hoses/Tubing Fittin gs

171 Holding Devices

172 Boom Section Alignment

173 Wear Pads

114 tquai txi nsion

175 Sheaves

176 Striic(iir•e/iiVelds.

177 Boom Hinge Pin

178 Boom Head Section

179 Wire Rope Retainer

I 180 Other

Coda Sectionj #I] Status*

B30.5:!13(l)

830.5-2. 1.3

RS 19-2,15,1.1

RS 19-2.15.4,5

RS 19-2.15.4

RS 19-2.15,4.3

RS 19-2.15.4.4

RS 19-2.15-4.1

. ........ _:1

0 In wmq PLMEItem

No. Inspected Item Code Section

SVV0

#1 Status"

113 Hydraulic Pump(s)

_F1 4— Hydraulic Pressure 830.5-1,1.3(n)(6)

115 Electrical Wiring RS 19-2.15.3.7

116 Main Hoist - Clutches/Brakes ^630.5-1.3.2(6)('!)

Holz, - jj_

118 Main Hoist - Min Rope Wraps —530.5-1.3.2(a)(2)a

119 Auxiliary Hoist - Clutches/Brakes 1330,5-1.3.2.1

120 Auxiliary Hoist - Wrap On Drum RS 19-2.15.3.6

121 Auxiliary Hoist - Min Rope Wraps -B30.5-1.3.21[a)(2)a7—:/1 , , i

122

'

44

Boom Hoist - Clutches/Brakes

0

Hoist ­/d, k.

123 Boom Hoist - Wrapping On Drum RS 16-2,15.3,6/A

124 Boom Hoist - Min Rope Wraps ";30.5-1,3.1(d)(1))

125 Boom Hoist - Gears/Shafts 7ato RS 19-2.15.4.4

126 Swing Sembly

^s s

System/

Assembly

127 Hydraulic MotorNalve/Une/etc... I 830.5-2.1.3

128 Drums/Flanges A

129 Clutch/Brake Protection

130 Torque Converter -930.5-1,6A 1

131 Anti-Skid Surface 1926.550(a)(13)(11 1) 2

132 Steps/Hand Holds/Platforms 830.5-1.8.3(b) 1

3-3 Access to Cab and Roof

'134 Air System - Compressorkinele(c... RS 19-2,15,3A

135 Counterweight Frame& Mounting RS 19-2,15.4.(1 & 4)

136 Counterweight Warning Signs 1926,550(6)(2)

1 37 HeLiiouillon waming Sign Outside 1926,550(a)(2)

138 Other

139 GantnjIMest -830.5-1.3.1

140 Boom Stops IRS 19-2.19.3tcy

141 Inner Ball

142 Outer BaiUEqLjallzLr

—143 _^Th eaves RS 19-2,15.4. 3 I 1 A\ i

144 Boom Hoist Reeving RS 19-2.19.3.6

145 Other

146f13- Wl6flah

148 Boom Section Alignment RS 19-2,15.4.1

149 Warning Decals 1926.550(a)(2)

151 Sheaves RS 19-2.15.4.3

152 Hoist Line Dead End 830.5-1,7.3

153 Wire Rope Retalner(s) B30.5.1,7,4(b)

154 Boom Foot Pins/Keepers RS 19-2,15,4,4

155 Boom Head Section RS 19-2.15.4.1

1 56 Auxiliary Boom Head IRS 19-2.15.4.1

157 Lattice Member RS 19-2.15.4,1

158 Cord Members RS 19-2.15.4.1

— Endd Connections/Pins RS 19-2.15,4.(1 & 4)

160 Other. ... ...... . . .

161 Positive Stops 1926.550(b)(1)

'162 Sheave(s) RS 19-2A6,4.3

163 Wire Rope Retainers)

164 Lattice Member RS 19-2J5.4.1

165 Cord Members RS 19-2.15.4.1

166 End Connections/Pins RS 19-2.15,4.(1 & 4)

167 Other

168 Lift Cylinder s) 830.5-2,1.3(o)

169 Telescoping Cylinder(s) 830.5-2,1.3(o)

RS

RS 19-2,15.4.4

Other

j 1866lSize/Construction: inch RS 19-2.18,2.3

j 186b Damage RS 19-2.16.2

I 186cl Lubrication RS 19-2,18.3.5

187a Size/Construction:

RS 19-2.18.13

187b Damage_RS 19-2.18.2

87a Lub rication

RS 19-2.18.3.5

187d Other

188a Size/Construction: RS 19-2.18,2,3

lUb Damage

RS 19-x,18.2

.2

188c Lubrication RS 19-2.18.3.5

188d Other

_ 189a Size/Construction; RS 19-2J8,2,3]

189b Damage RS 19-2.18,2

189c Lubrication RS

189d Other

190a Size/Construction:

RS 19-2.18;2.3

190b Damage

RS 19-V8.2

190cl Lubrication

RS 19-2, 18.3,5

190d (Other

191a Weight & Capacity Label

830, .5-1.7.6

191b Sheaves RS 19-2,15,4.3

i g ic Safety Latches191d Wear, Twist & Throat Opening191e Bearing/Swivel191f lWedge Socket End Fitting

^B30. 5-1,7.3, (c)

191g Non-Destructive Test Results

RS 1 9-2,15.4.9

191h Other

192a Weight & Capacity Label

830.5- 1.7.6 1

192b Safety Latches

830.5-1.7.6 1

192c Wear, Twist & Throat Opening

830,10-1.2.1,3 1

192d Bearing/Swivel

—830.5-2,1.3(a)(4) 1

92e Wedge Socket End Fitting -830.5- 1.7.3.(0)

192f Non-Destructive Test Results

S 19-2,15.4.9

192g Other

Mobile On-Site and Annual Insnerflon Cherkli-,;f ^f A

.^^ -:-.^ _ ^ -....—._^.._...__.v-..:^I•j v.-..1"'-^,Y.-i:-^^•<^1It.7^^i7^^^''..F` t3?^9i3 i^il 3°a _ _^ _ ,:.1,- Ji _S'!„ u.1:i_^—;.Z._^-%2Fss:^ei..2::: - y^=;y1^ ^2^r— _ .^^=-t(I ^}^-S3•-'=^^v ^"^:= • t .1 .ILCJ - •:2(^T)?-1:^N

- _ _ -- ''^,- -- ;+sue•_ •..^^' _ -J. _- .^i. .l_ _ ._'S ._ ^_ c'".z..._^.: _ ,>.t.. -'';1^- _ ;cs',,.5,.-c^.•.lwr.^'i-+^

; l-^ - _ _ i i

Boom D. No. Length Jib I.D. No, Length Mast I.D. No, I Length1

---

1 V v - IVf

c1

-i 1

Total Length Total length S^J Total LengthCords; Tubular An ular "Cords: (/ Tubular Angular Cords; Tubular Angular -

' Lachgs , Tubular Angular _ _ Lac)ngs / ubular— - A-ngrrrar l acingse Tubular AngularAssembled Notes;

i Unassembled Notes:=Status; (S) Satisfactory (U) Defiicienpi-es —Parts(1S) hidden however functional (-) Not applicable (SIVVO) Stop Work OrderReferences: OSHA,29CFR 1926,550 & 1910.180; °*ASNIE 1530,5 (1968); ASME 1330.5 (2000; 2008'NYC Building Code 8, RS 19-2 (2006); RCNY*"*Consult operator's manual for kick-out angle for boom

=:va: - --- - - -^,s^ Y°^ 4-='+. _ ^^n.^^.'` u^:;:Trs:: <;r e:tj=---". a .a• ._,r^. sr,i:,•^.r- e-=. --%'.'ra..'^ ."c3-1=^^%4'.9''r^(lo nt!'a: " e-Fie ^3s, "^ In e. ak -e Sao d`le.U;h ns nci <a tl•ma y an-ana co=; ^de:In , a^Ar^ter;.,^ tyy``iitid..^. _ :a ln^^^4-..^.wv.._.`n^. ^r^-^__ ^_SFY_,^a:^at. ^!^•.-',:^.,>co^ Ali-.,- - - - ^ rta1^- ^.;C^ §:``I^^^.t,Y

Item Numbers Defic$encles Date Corrected

r -

I

^:S - - ..J ^ c>x^E^ r1F:T..^- t-. _ _t.-n.^,^.^ i_ _w .y„

_ "---^,._ -.,^s. -;^A.^aclt•«^ ° XI'.*l f _ - _ _ _ ^ .'.^1? -mil _ ti?1.:h1 • _ - `R:\i^`:::.Tf ^•`•. - '^TrT ' ^_W^_^. ,:^ai^ ._.. ^^'} 1^5'tF^:^'^^ '^7_ ^ ^^`^ l^Yw. ^'.:l ^'7'^^. ,_..u^^ ,"""Y+^.fx_ 5`f^ ^=^'^E.9-^ , `i•^ ^r?.-= ^ F.^

j^v^...r_T^^,G- ^ <^•` v3 w^. T,^`^=`"^:-',.mac - :,%^•^—.r_-?rr_w,,,i.,__ ' . s'^ ,- _h^, ,_,.m'„-^•-

,rlc^% is--+,:^7^^. ^ c^-`q'u•:^4:. uc<:` - t"- .`z^-`^ ^c:^.:a.- .af -^,1^.._>.Gu._e„ ^ i _._._v^:'"_,^.:,rs r _ .^^' --^. ^,

- ` r^ 'a'_ Te - - ^I , -_ _'i„- - - - - i•,-.d^; y., ^_- '^-rS _ ^' ^,i=f?r”...^_ •.^ ^ - _ .17- trS. •.6E - ^,..,-^ . ^.: e' '` l `^ - . ^" ^.^•=j,-`s,-';^ ^^ - .. f?^n3S;':^•r= G^ - ::;,r^-. • j-^. ^."""^^b;^^

N Signature of Inspector Dates

C ^

me Signature of Supe 1 Inspector Date

NYC Dept. of Buildings Cranes & Derricks Division - 280 Broadway, Room 501, New York, NY 10007

Tel: (212) 566-4696 Fax: (212) 566-5871 E-mail: candd@buildings.nyc.gov

Tower Crane Original Copy

Inspect i o n Checklist

Date of Inspection: t2,13 /do

CN Number: 040v-r AVfA0 '-1 t7

Inspector Name: , ofe^g4, #;Ae®

Type of Inspection: Erection

ensio Re-inspection

Inspection Results:No eficif

Was SWO Issued:

Site Location: Wb 6--ld jlvtA Cq,%n ie — Boro:

CN Expiration Date: Phase: Current Height:

Badge No.: ?_Z.7-7

Assembled Load Test Unassembled Jump-Up Jack-Down Dismantle

Audit Patrol Sweep Chief Special SWO Lift# Complaint#

es-,Okay to Issue CD Re-inspect:

SWO # if issued: Number of Violations Issued*:

Make: F Avtr(rrc ru%rGo Model: m 760 # Serial No.: Cd 7 Year: L006

CD: Expiration Date: -to Max Capacity: 70 7ai"' Boom/Jib Length:

Type: u in Hammer-Head Power Plant: Electric GiClimber Type: Interns External

:^i?^ t " ^•^' _- - '-- ==^ta`.":d'=""-` T^ar*^-A s-^ ^sF ., -.s.tv,3 -ns QWrie:Irfotnatfon ,ti r r kCa -.3.:- ..41,._'•`r,i,s-''-..«,r?,,.•^Mt':^t-",^k-.'.''..,h.^^..';er.-h'"'-,i-._'',',.` .'.^vV_':=-'?

Crane Owner Name: Contact Name: Telephone: ^d -c^^^ 3 63

.5 Rig.gerlftforaratlon^^ -_^,a:_,^xt:,,'.^.^"-^'-^,''^.^ ,,..^-•.-.zi---^*.^.^(e^a.^-'^7r^ T`^?.ilF^tL`^'7"'a.^-^x.-: i ^ „-.,;-•6'•..'.:5^^._'^+^src.3;xi•,oa-,-+ _-t-":w--r

Last Name: First Name: MI:

Licence No: Expiration Date: Type: Master Tower Special Master Hanger Special Hanger

-- __ -. "'?.,`rwY•°'+S =r:' -;,^a-^ie.•^.,:r-:F'''^-'sue-`':=.^"-c'T".T..=.- ra 'i^A-':r_c^t--';ci:c".".` 5i'- "^`i°.,^.?^":=,? '?5^^ -Goa ^zSafe.:. G' rr diiato^ nfi^mati'o.:.^^ _ ^:,^ ^ ^.' • ^ ,s :^^c. ^ €^ ^=^e^ ,^^^` , .sy = ^^;,^ ^ i...: ,^^..ii:^^.-,^-,_....^.. ;^^^.,. ^-^r. ^..^,e.<.. ^,. ,_a,-S. _e'c:n•.s^µs,-,^wk ,t: -'-:'?^:^^^r.`^..M.x^ti ,r.r_.^=r ..,_ e.r-sT^.%a,Tf.'S*.4-. ^.5.-. 4,^.

Last Name: First Name: MI:

Licence No: Expiration Date: On Site: Y N

Last Name: (,w owt First Name: pw 3 ( MI: F

Licence No: 9 Expiration Date: Type: Class AClass B Class C1 Class C2 Class C3

_S^^General-Ci'o tract^rdSife^Safe -M na of I fioerrtal;^dn •=ass .^' ^`'^'^^'^=^^1°'=""= m^^ '`-^ ^' ^.^.- -= a' = 'X - ""' "`' ^%•

Company Name: Contact Name: Telephone:

Address: City: State:. Zip:

Licence No: Expiration Date: • General Contractor Site Safety Manager

9 =(O: S.ITE-LO-6Gl1NI tTi4 ^10'N kPlSPE TI .N' " sItem SWONo. Inspected Item Code Section #1 Status*

= '9` ^`<" - F1'ii`SA ttcatiot_i _ P_I nrbata ^ '-^=^^;^_w'1: Approved Plans on site BC3319.4 &.5 12 Crane set-up conformity Rs 19-2.8.0 1 f

31 Jump Logs Bc331ss 1 --

9{qN SIDE ©OGfMENT^ATIQN_f1SPECTfO_ N_^coriftntae_dItemNo, ' Inspected Item Code Section

SWO#1 Status*

4 CN - On-Site Sign-off (CD-4) RS 19-2.8.0 & BC3319A 2 rr5 CD - Approved CD (CD-2) 8C3319A & .5 26 Plumb & Torque Report (CD-6) BC3319.8.2 2 .y7 Notice Raising/Lowering (CD-7) RCNY 6-01(i) 1 3

Tower Crane On-Site Inspection Checklist Page 1 of 4 (Draft) C & D From CD-14B Rev. Mar. 10, 2009

- -ItemNo. Inspected Item Code'Section

SWO#1 Status`

10a%^r^, _ Fy Er:'ectionSite Data _ t41

1 Foundation Plans # 1

2 To er Crane Foundation Pad 1

3 AnchbIRS, 1

4 Template 2

5 Housekeeping6 Tower Base Perime rotection 2

7 Other

8 Slab Tie-in Reinforcing: oor 19 Tie-in Slab: floor 1

10 Collars: floor 111 Wedges: floor 112 Tie-ins: 3 floor13 1 Tie-in' olts: floor 1141 1 1

15 j Collarffie Allachmenls; none _wire rope —chains 1

-16- Montly Inspectlo`n^ec—ords - - - 217 Maintenance Records 218 Repair/Modification Records 219 Other

'y'..,}} Jyl,.^rd

l. =ri.y. .:'^^. . _

-+@c•3" 1'^' _ _ {^i

rye .`rr.-e.^:y:._-1:^.^'={3=^1'TJ

20 Sheet Metal 221 Guards/Covers 2 S22 Internal/External Lights 2 J23 Housekeeping 2 524 Safety/Warning Decals & Labels 2 S25 Hand Signal Chart 2 -

26 Paint Condition/Corrosion Control 2 S27 Other

^^,10e r^;^^^ Qperator_s^C^b-^.RSta^ion9^^r^"^;28 Housekeeping 229 Grab Rails/Steps/Platforms 2 530 Anti-Skid Surface 2 S31 Glass 1

32 Windshield Wiper(s) 133 Door Restraint 2 334 1 Fire Extinguisher 2351 Mirrors 2 -i36 Seat Restraint 2 337 Seat Belt/if required 238 Operator's Manual 139 Operating Instructions/Decals 240 Electrocution Warning Sign - Inside 2411 Hand Signal Chart 142 Swing Brake/House Lock 143 Positive Swing Lock 1 S44 Controls - Forces/Movements 1 f45 Air Pressure 246 Foot Brakes - Latches/Linkage 147 Power Controlled Lowering 1 548 Engine Clutch 2 ^J49 Accelerator/Throttle Control 2 350 Other

..Cf ;g=acs'f :.fGr^^'...—.=;-^S

51 Per Configuration 152 Durable 153 Legible 1 S54 Visible from Operator's Station 1 f55 Secured 2 S

56 Other

10 O, P1;SfTE l^lSt?ECTIOP! CONS IfUEDy _ .ItemNo. Inspected Item Code Section

SWO#1 Status°

1pg ti, o- `n FfowerPlaht UPIPers ^^ rr

57 Performance 2 s

58 Exh System Guards & Insulators 2 S'58 Belts/Hoses 2 j60 Guard Cover/Rotat & Recip Parts 261 Other

62 TurntableBearing i63 Turntable - Rollers/Roller Path 164 Ring Gear/Pinion Gear 165 Hydraulic Pump(s) 1 }66 Hydraulic Pressure 167 Electrical Wiring 168 Main Hoist - Clutches/Brakes 169 Main Hoist - Wrapping On Drum 1 S70 Main Hoist - Min Rope Wraps 1 371 Auxiliary Hoist - Clutches/Brakes 1 S72 Auxiliary Hoist -Wrap On Drum 1

- 73IlaryHoisMln ope raps 1 S74 Boom Hoist - Clutches/Brakes 175 Boom Hoist -Wrapping On Drum 1 y76 Boom Hoist - Min Rope Wraps 1 S77 Boom Hoist - Gears/Shafts/etc... 1 j78 Swing System/Assembly 1 Ij79 Hydraulic MotorNalve/Line/etc... 1 3

80 Drums/Flanges 1 S

811 ClutchlBrake Protection 1 S82 Torque Converter 1

83 Anti-Skid Surface 284 Steps/Hand Holds/Platforms 185 Access to Cab and Roof 186 Air System - Compressor/Line/etc... 187 Counterweight, Frame, Mounting 1 1 S88 Counterweight Warning Signs 1 189 Electrocution Warning Sign Outside 190 Other 4-

eR' 'j— ? ^u afet bev_ cesl0pe_raftorLal Ards91 Warning Decals 192 Boom Angle Indicator 193 Boom Hoist Shutoff 1 S94 Boom Hoist Ratchet and Pawl 1 s95 Lower Hoist Limit Device 1 s96 Trolley Limit Device 1 397 Main Drum Rotation Indicator 198 Auxiliary Drum Rotation Indicator 199 Load Moment Indicator 1

ty'

100 Load Weight Indicator 1101 Radius Indicator 1102 Crane Level Indicator 1103 Anti-Two Block Device 1 -104 Two-Block Warning Device 1 p105 Wind Velocity Device 1 5106 Weather Vaniing 1107 Aircraft Strobe Light 1

St^pP_o?'^Syst_eR%cy^^;-,^.108 1 Gantry/Mast 11091 Boom Stops 1 !J1 10 Inner Bail 1 -Z111 Outer Bail/Equailzer 1 ITS112 Sheaves 1 117S

113 Boom Hoist Reeving 1 jP114 Other •-

Tower Crane On-Site Inspection Checklist Page 2 of 4 (Draft) C & D Form ^4B Rev. Mar. 10, 2009

10;«ON;S.ITE;IPlSPEGTIQM CON71R1.UEf7

ItemNo. Inspected Item Code Section

SWO#1

I

Status.

L•<af;tiGe^Booin:115 Boom Section Identification 1 Xf116 Boom Section Sequence 1 ;t117 Boom Section Alignment 1118 Warning Decals 2 ;?119 Spreader Bar 1120 Sheaves 1

121 ISheave Marking i121 Hoist Line Dead End 1122 Wire Rope Retainer(s) 1 TJ123 Boom Foot Pins/Keepers 1 g^124 Boom Head Section 1 r4125 Auxiliary Boom Head 1 Cd1261 Lattice Member 1127 Cord Members 1 CS128 End Connections/Pins 1 4^129 Other

1'0 1 ^cn^+ ..., w ,t Lafttbe.`34 JibSection-identification - 1- -

1 1 Jib Section Sequence 113 Jib Section Alignment 1133 ositive Stops 1134 S eaves) 1135 Sh ave Marking136 Wirk Rope Retainer(s) 1137 Jib F of Pins/Keepers 1138 Jib He d Section 1139 Auxilia Jib Head 1140 Lattice mber 1141 Cord Met ers 1142 End Conne ions/Pins 1143 Other

1^0'^ r^^ z - - -._ ;nom`-T dlle. ',^^u ^,_;x^} - ,-x^,,^^__ -,E.rt°^;..F•.^:1441 Frame 1145 Rails. 1146 Rollers/Wheels 1147 Breaks 1

148 Sheaves 1

149 Other

_ n^ a r Iufas _etro_ -.;u- a 4^` i

150 Mast Plumbness:151 Other

X1,52 IV14sFramm Sec ron^; . r `^Y^ ;r•

152a Chords: flo152b Lattice: floor152c Base Plates: floor152d Top Plates: floor152e Other

y 'sb Mast°°1>_sfe-riin^ ,5:,

..f'erii:; "_- rzi=,9.,.X- °= r== `_=zF

-~153a Bolts: floor153b Washers: floo r

153c Nuts: floor153d Pins: floor153e Keepers: floor153f Other

.^1'64.`;MasE^$`a _ty`Gua_r_ds:^,z;f•: - ^^^^^'_,.:;;-*>:^r^_^ :,.. w'=4"".^c= — mil•.'. _.Si?:.

154a Platfor floor154b Rail! : floor154c To oard: floor154d L dder: floor154e /Walkway: floor

f Other

1Q° GPI SITE IF1 TINUED"ItemNo. Inspected Item Code Section

SWO#1 Status}

Y 1 x55 4borii Hoist _s r r ^sy x _ti

155a Size/Construction:T i Inch RS 19-2.18.2.3 1 f

155b Damage RS 19-2,18.2 1 f155c Lubrication RS 19-2.18.3.5 1 S155d Other

156a - ♦ -inchSize/Construction:` ' " RS 19 .2.18.2.3 1156b Damage RS 19-2.18.2 1 f156cl Lubrication RS 19-2.18.3.5 1 S156d Other

= 157rtiatil>a Hoisl/IWhi qtr e_r T Z^ r^^zy t

157a Size/Construction: I a t, jnch RS 19-2,18.2.3 1f

157b Damage RS 19-2.18.2 1 S157c Lubrication RS 19-2.18.3.5 1 S157d

158 aI958BoomPei _ dansrr^' 'c

Other

Size/Co ioSize/Constructio n :ntutl hn. Inc=a yr=;

R S 1 9-zie .2. 3

—

^^5_?;ua1

-,

15-8b Damage - RS 19-2.18.2 1 ,158c Lubrication RS 19-2.18.3.5 1 j`

158d Other

"_ t59 ;lib Pettiar7tx`" tit^^i«`ts ; -=k^1159b

/Construction;: inchDamage

RS 19-2.18.2.3

z 1159c Lubrication RS 19-2.18.3.5

159d Oth

40p2"a f Mo47CS; Blck`stl Batfs^;•ta,160^^..^-. 2 `` "-N^`^^^M. tn$loetc^5nkt.9gi+;, ^.^^^^•^^^ r-^y -c3, ^.n.•^

,• ,-,^ .x,w. ^..^;^t1-kv;;:=fir:

.,>-..._160a Weight & Capacity Label 1 3^160b Sheaves 1 ^^

160c Safety Latch 1 1^160d Wear, Twist & Throat Opening 1 f160e Bearing/Swivel9 1 ^160f Wedge Socket End Fitting 1 ^^160g Non-Destructive Test Results 1160h Other

"1Cr1 SBalt & iook 1s' a n161a Weight & Capacity Label 1 xJ161 b Safety Latches 1 ^^161 c Wear, Twist & Throat Opening 1 ,TJ161d Bearing/Swivel 1 ^^161e Wedge Socket End Fitting 1 y)

161f Non-Destructive Test Results 1 d161g Other

162a ength: ft

162b Lo Radius: ft162c Boom le:-,de 9162d Parts of Li162e Rated Capaci Tons162f Test Weight: Tons

162g I Rated Capacity %: %162h Other

._,1 63a Leng th: 163b Load Radius: ft163c Boom Angle deg163d Parts of ' e:163 d Capacity: Tons163f Test Weight: Tons

163g Rated Capacity %:

Tower Crane On-Site Inspection Checklist Page 3 of 4 (Draft) C & D Form CD-14B Rev. Mar, 10, 2009

7!r--,_ .<..<... .._:._.:. ,: . -........: _.-.

[Equpment;Charac4errs.hcs,=^,^;; t:.^^^, ^-- - -f .^,^.^^-'- ^^.^:^'^ _ max.^- :.^., ^vz- _ ^s:s

,^:•.r.". ^` u'=,^^=_: n •., i:- =c

^"''^*

Boom I.D. No. Length Jib I.D. No. Length Mast I.D. No. Length

6vs+^ ! b^'

Total Lengthl gth Total Length

Cords: %4 Tubular Angular Cords: Tubular Angular Cc ds: Tubular Angular

Lacings: Tubular Angular Lacin . Tubular Angular sings: Tubular Angular

Assembled Notes:Unassembled Notes:

*Status: (S) Satisfactory (U).Deficiencies (IS) Parts hidden however functional (-) Not Applicable (SWO) Stop Work Order

References: OSHA 29CFR 1926.550; **ASME B30.3; 2008 NYC Building Code & RS 19-2 (2006)'; RCNY

j$ "m ^' - a^co anradb ins ectro and iiialntenanc records n acop[dancefF15^94x ^0'0'Annual: er3eWadfCerEtft too Dperatolt renewals al ba gip, p e x r,,L-^..:^.,- ma 4 •.^ ^°.s.7,frri.^.^.w•..'z:: .^L'- s,.,47 ..r.^s. ^a-•yx>:^^.,..;9+ a<.. - -.•.'s.^r.».z->^:- =^^as s,. ,.r.">;^^._,^__:,^^^.-•^•r .^.cc^. c,,_

Item Numbers Deficiencies

^Lifd •i rrl an TB 1wmss: ^,

Date Corrected

- - ' -^ .^ h, _rmp-.; - -^ - - - ^3a ' ^• `..7r,'-. -'t rr_r.<, 4:>c:.ysJ•^^r:-rc:x e^^`a. s . ?i xY 1 . ^: ^:: r' - '.^rv= 7ae^, ;;^= y77r-t^^`'-'^ :z=i^`'r 't?-^ ,,, ^k; ^`3! _ _ ^•i,'y;.°-tv-.,^%( _ r- ^^i^._;. -- -^ -1s Re rks

fee N. LL' R-a- v 74 r

Low 131 ^l

_(4y ins ec orts &Sr7 -etvi"in° ;Ins 'tars 'nd":rsemeij = Ls... »a 5- Name Aignature f I Spector Date

Name Signature of Supervising Inspector Date

Tower Crane On-Site Inspection Checklist Page 4 of 4 (Draft) C & 0 Form CD-14B Rev. Mar. 10, 2009

lSBT-1f^IiT;B'f<l: I;Q_..._=,^ rr y

- - _ - -

n,

ItemNo. Inspected Item Code Section

SWO#1 Status*

- -1 Approved Plans on site BC3319.4 s.5 1 S2 Crane set-up conformity Rs 19-2.8.0 1

'•L1'_?i.... ^..^^ •r ':C

31Jump Log s BC3319 6 1

iNYC Dept. of Buildings Cranes & Derricks Division - 280 Broadway, Room 501, Jle %,v York, NY 10007Tel: (212) 566-4696 Fax: (212) 566-5871 E-mail: candd@buildings.nyc.gov

T

om' / P, r^ CO-ra n 9riginal Copy^4J it ^

^ns,pectdon Checklis t_i- ns eetio.'I r - _r7 n. ttfo matl

Date of Inspect,d

iion: I Z 3 /1.0 Site Location: W67,-JW T> o 'df2 Ce, Soro:

CN Number: CN Expiration Date: Phase: — Current Height:

Inspector Name: Badge No.:

Type of Inspection: Erection Assembled Load Test Unassembled Jump-Up Jack-Down Dismantle

D E'xtensi Re-inspection Audit Patrol Sweep Chief Special SWO Lift# Complaint#

Inspection Results: o Deficiencie Okay to Issue CD Re-inspect:

-Was S^ALOO1ssu-ed: 54104 ifiss_ued: - --Number-of-1liolations-Issued'-. - --- -

it

:w, an vwmuuna u, iauiein season

-:.vHq,:,c:.v:o..^,c.:-,^u.^r,Ln4.,.^J.:.. ^i^Y.• z ^ °,;^'_ -- ...a-,y ti:^ss _ ,`r•-' - - -L-wi'^ = , m.- _,q: :-`.4;v. n••_".v.::.` ..f. .1 -. J,. ^:1^ +:..'-" : ^ i.r.- : ^4.^ .:;-a3,'.3".

Crane Owner Name: ^cr/41Q U2^ • di co Contact Name: Ai—'Y Telephone: t'-.rl7/Gc3r

Address: I1 0 6ej 7- 47, S 4 1704 City: State: f3,Y Zip:100 r7

:. ,>:^. _:^..., ._.. :_._.:..^., .... ;..:.:moo.. ;.^_--^•-iy .. :-r':—nn^:^r^i ,^..af:.^^. F.^NS.-^ ?:% _ •G.r..-....vx '^ ...'.^-_ - i.'.+u':^, •;♦r L, - .:tm ^^.^, y..^t^ • ice ;. =-?a ..- __ s;^= `" - -z'''r`'; - :'.'^-n.^. ^'z • Y^ ^Je: . : K L. t .^:; '.ii'^"fii'^ x ._ ;>:.i,.=4..•-.r,Us.er.:I: fo,rmatcon •.^„^,_^`,^, ^r<_ ^:^ ^_ ,,-^:a';^.^i%;fit_ ^^

Company Name: Contact Name: Telephone:

Address: Cii`y: State: Zip:

[

Ri""'er q.orrnaYion.^

Last Name: First Name: MI:

Licence No; Expiration Date: Type: Master Tower Special Master Hanger' Special Hanger

_^=M^::6 fane SafE t COYrtlinat r lnforriiatl m ` _ a _ e^ q va n ar., c in49i^ . .^^ a ?r:,'.'7^.< f 33 . J

Last Name: First Name: MI:

Licence No: Expiration Date: On Site: Y N

F `H°di"st`^lla'cFi`:o`ntdt.. .. •aio. s:r_,.- _,^^_. =fir ` :_:. _.'° -, r ^^ r.:.^..^,-<. s..7.. ^ the ^JPecat. :^ ©^fn .^`_; =^-^^=fir .^:^;: ^K%:a•:.:i^^--^..^:^^..,^?^',_=^.rn^7``^..,s ;_gyp;-,_r^^^ r._, 4 fit':

Last Name: ®v iva/ First Name: ^^^ i ^l MI:

Licence No: ^d Expiration Date: ^f-1 f ype: Cl ass A Class B Class C1 Class C2 Class C3

temNo. Inspected Item I Code Section 19V,10#1 Status'j

l0'a' Pre .rectiortSite=DataFoundation Plans #

2 T;a er Crane Foundation Pad

3 Anch s 14 Ternplat 25'Hcus°k°°pii c, i i 2 i ^

6 Tower Base Per eter Protection 2

7 OtherOt51" ; ° > nGuyss upp0 4y".$

8 Slab Tie-in Reinforcing: floo 1

9 Tie-in Slab. floor 1

10 Collars: X floor 1

11 Wedges: floor 1

12 Tie-ins: floor 1

13 Tie-in B s: floor 1

14 Guy, 1

1 larM. Allach.mts: none wire rope _chains 1

10c:.e, y r>^i3^orlcalDofa i v ;ti,'

16 Montly Inspection Records 2 S17 Maintenance Records 2 S

18 Repair/Modification Records 2 5

19 Other

'^'I;Q.0 y^t'-'_^tii ^:^^ - _ x"1 ^=.^sGene alf'^^4. "` tr^i."cni^q.=•s^?...''^ i.F

20 Sheet Metal 2

211 Guards/Covers 2

22 Internal/External Lights 2 5

23 Housekeeping 2 S

25 Hand Signal Chart 226 Paint Condition/Corrosion Control 2

27 Otherh- 10-e u; (lpe""r_at'or_s Cah U^ 5tatton ,_,a °t. '^^1

28 Housekeeping29 Grab Rails/Steps/Platforms 2 _$

30 Anti-Skid Surface 2 J31 Glass 1 ST32 Windshield Wiper(s) 133 Door Restraint 2

341 Fire Extinguisher 2 5

35 Mirrors 2 S36 Seat Restraint 2 5

37 Seat BelUif required 2 m

38 Operator's Manual 1

39 Operating Instructions/Decals 2

40 Electrocution Warning Sign - Inside 2

41 Hand Signal Chart 1

42 Swing Brake/House Lock 1 m

43 Positive Swing Lock 1 3

44 Controls - Forces/Movements 1 S45 Air Pressure 2

46 Foot Brakes - Latches/Linkage 147 Power Controlled Lowering 1 3

48 Engine Clutch 249 Accelerator/Throttle Control 2 ,3'50 Other

=1'Of` } .`:rjf_:r=s oact;eFrart:^ ^:== rte;;; =3_; s=51 Per Configuration 152 Durable 1 S53 Legible 1 354 Visible from Operator's Station 1 f55 Secured 256 .Other

cIT^°f^JSPFCTIQ . Q1tTfhlU.^9 _ .ItemNo. Inspected Item Code Section

SWO#1 5'

f0 _ =<Pov"verlantsFJ' er r = -_ = =57 Performance 2

58 Exh System Guards & Insulators 258 Belts/Hoses 2 S60 Guard Cover/Rotat & Recip Parts 2 S

i 61 IOther I i

I h' - g,. _apeP'.Superstructur.^,. -62 Turntable/Bearing 163 Turntable - Rollers/Rol er P athath 1 ^

64 Ring Gear/Pinion Gear 165 Hydraulic Pump(s) 1 S66 Hydraulic Pressure I67 Electrical Wiring 168 1 Main Hoist - Clutches/Brakes I69 Main Hoist - Wrapping On Drum 1 S70 Main Hoist - Min Rope Wraps 171 Auxiliary Hoist - Clutches/Brakes 17 ux racy-Hoist= rap On Drum — I —'i— — a73 Auxiliary Hoist - Min Rope Wraps 174 Boom Hoist - Clutches/Brakes 1 f

75 Boom Hoist - Wrapping On Drum 1 S76 Boom Hoist - Min Rope Wraps 1 j77 Boom Hoist - Gears/Shafts/etc... 1 j78 Swing System/Assembly 1 y79 Hydraulic Motor/Valve/Line/etc.., 180 Drums/Flanges 1 Y81 Clutch/Brake Protection 1

83 Anti-Skid Surface 2 S84 Steps/Hand Holds/Platforms 1 -5 .a85 Access to Cab and Roof 1 S86 Air System - Compressor/Line/etc... 1 a

87 Counterweight, Frame, Mounting 188 Counterweight Warning Signs 189 Electrocution Warning Sign Outside 1 m

90 OtherCO.I -g _ _ ty_ e Ices1O'perattonal5Prds

^91 Warning Decals 192 Boom Angle Indicator 1 S93 Boom Hoist Shutoff 1 j94 Boom Hoist Ratchet and Pawl 1 S95, Lower Hoist Limit Device 1 -396 Trolley Limit Device 197 Main Drum Rotation Indicator 198 Auxiliary Drum Rotation Indicator 199 Load Moment Indicator 1 S

100 Load Weight Indicator 1 S101 Radius Indicator 1 S

102 Crane Level Indicator 1103 Anti-Two Block Device 1 S

104 Two-Block Warning Device 1 3105 Wind Velocity Device 1106 Weather Vaniing 1107 Aircraft Strobe Light 1 Q

.-I.^.. J,Y. .. `7 .__ ^:f :.:. -.. i._.-.pP -h.:..•.1!-t

ry`w'-xl....^`3: ^.w'12_^d..--_ ^.trf'r+_.e-E_„-'fr-.^108 Gan" /MastryMast109 Boom Stops 1110 Inner Bail 1111 Outer Bail/Equailzer 1112 Sheaves 1 ^1

113 Boom Hoist Reeving 1114 Other

- F.IN5F?EO.TIOPI-:=:C ...I^1tJED^^'^:^t;X^^==`^_:='_^^_ :.-.:^.:^::__.•Item SbVO

No. Inspected Item Code Section #1 Status°°

10k _ t^ ^;Gatttce.'So_om_ + -xqgr

115 Boom Section Identification 1

116 Boom Section Sequence 1

117 Boom Section Alignment 11118 Warning Decals 2f1191SpraadPFBar I l 1 ^,

120 Sheaves 1 3^

121 Sheave Marking 1 ;^f

121 Hoist Line Dead End 1 f:~122 Wire Rope Retainer(s) 1

123 Boom Foot Pins/Keepers 1

124 Boom Head Section 1 ^125 Auxiliary Boom Head 1 ^5

126 Lattice Member 1

127 Cord Members 1 _F, f

128 End Connections/Pins 1

129 Other^'"t,Qlj^ . ^^` r ^ T 1a. I aytlC8;31b ^, t -.,".'r^-:^ ?F^. .r

130 Jib Section Identification ?131 Jib Section Sequence 1

132 Jib Section Alignment 1

N3 Positive Stops ?1 A Sheave(s) 1

135 Sheave Marking8 136 ire Rope Retainer(s) 1

137 Ji ool Pins/Keepers ?I.138Jib ad Section 1

139 Auxilia Jib Head 1

140 Lattice ember ?141 or Me ers ?142 End Conne tions/Pins ?143 Other

it - ':l': :Oils" .J_;N_c= *_tV>:_ ^_1t3E•y __"y'• sk:_".' i;:^'I^Q'(Tt^ ^^„_ - - '-^='. , ^TF ..Y^:,T3;-°.^ _ --.'--^r ^ ^ . 'r"^c^_.s:^..--•__. _

144 Frame 1145 Rails ?146 Rollers/Wheels ?

1147 Breaks

148 Sheaves 1

149 Otherfir:;`^ 1OR:.-;^Ji•^i?^%y=='--..F^:x=_»L:^^^= I^aS^•' :C. -O, (1,,:s^ ^'-.' :>=^._!:za:. -,%^Sr— .^^^=::

150 Mast Plumbness:151 Other

152a Chords: (loo

152b Lattice: floor

152c Base Plates: floor

152d Top Plates: floor

152e Other

153a Bolts: floor

153b Washers: floo

153c Nuts: floor

153d Pins: floor

153e Keepers: floor

153f Other+5"^ast:: fe - `Guards. :e: -- ir.;_

154a Platfo floor

154b iddt

er:

floor

154c d: floor

154d floor

154 Walkway: floor154f Other

tlx.: ON::51_..E-1M E I . D_ ^^ - - -

-Item1 No. Inspected Item Code Section

SwO#1

iStatus'"

-. ;q5 a66.m biorsr x; _

155a Size/Construction: 1 q inch RS 19-2'18.2.3 1f

1551b Damage RS 19-2.18.2 1 ft 155c I Lubrication Rs 19-z.18.3 5 ? ;

Q 155d 10ther d

f56'Main= Hoist. "156a Size/Construction: rg inch RS 19-2.182.7 1156b Damage RS 19-2.18.2 1 S156c Lubrication RS 19-2.18.3.5 1 J

156d Other ^-t`157 4trt(liarj'_f toishJlPlhrpIt7e_y py w_157a Size/Construction: ` inch Rs 19-2.18.2.3 ! 1 S157b Damage RS 19-2,18.2 1 f

157c Lubrication RS 19-2.18.3.5 1157d Other —

`1^68 Bdo1^i P°rlaarixs _ 4 ^.^h _ ^ ^ 5;' L,-,^;

-158a Size/Construction' inch_

Rs 1 9-2.18 - 2.J 1 9

158b Damage RS 19-2.18.2 1s158c Lubrication RS 19-2.18.3.5 I 1 1

158d= 9

Other -'r -34C9GH- P ;'?3 vvrti:=tr^cJrber^dants_€r yt'1^ '1tti%a°:3"'%^=,yi ax-. ,..

159a ion: inch RS 19-2.18.2.3 1159b Damage 1159c Lubrication RS 19-2.18.3.5 1159

t'tQp_•^_•,u,`. _ BIZ"- HQOt{s;!;t3iocks;&_B;all"s=,,-;^`t,^;`' ^^,w "t^ ^^,^ 3^-;a:nT.t} Mafn^.gl,OG$n^,QQl:4ia,.t^-,t?,i'x^c*yet.x--ru-^?r"^'r:h”+ r'c^,-+a. vr--^>e^a y;i

160a Weight & Capacity Label 1160b Sheaves 1

160c Safely Latch 1160d Wear, Twist & Throat Opening 1160e I Bearing /Swivel 1160f Wedge Socket End Fitting 1

160g Non-Destructive Test Results 1160h Other

^a:..{'6:fi^yl_ iSall`_&':'1.'oo'Ccr'=;ra>:r.:^^, <==err_'- ^; :a^>^^.F, . ^-h .J_^. w.lv- ^--.:,4.+- =_y-. r_^~^_.li'^^^rc.l'vC ^ _ ^ —:C.^.'_^h^^3n.'(1.R4^__-.>•^-^^^;n y -^-=•

161a Weight & Capacity Label 1161b Safety Latches 1161 c lWear, Twist & Throat Opening 1

161d Bearing/Swivel 1

161e Wedge Socket End Fitting 1161f Non-Destructive Test Results 1 v161g Other

=tipsy Load

^t?2 BQOkiT^-^`a^„_, u'•4^'^"^`^.^S'-r a-.k°_'"zs',^irc-.T K;s^'d"•."-4^,^°^^^y^^•^,11'.pr,^

—.G..,>- x^eax^4z^

162a - ngth: ff162b Loa Radius: ft162c Boomle: deg9162d Parts of U •162e Rated Capaci ' Tons

162f Test Weight: Tons162g Rated Capacity %: %162h Other

- - ^^,,< J.^`^.^^"_'-y^-`^ _ _ - -,r i;^si"<,;^.[t^i1s; iCi,i'n a,J.•- -`.-:^::'t

163a ftLength:163b Load Radius: fl163c Boom Angle: deg163d Parts of Line:163e Rated Ca ity: Tons163f Te eight: Tonsn g Rated Capacity %:

^^= -^QUtbCilErltCh rd C_ fsigtC ,. T i-t < n

Boom I.D. No. Length Jib I.D. No. Length Mast I.

q

I ^ ,

I

Total Length 6 / Total Length - - -- — Total-Lan-gttTj - -or s: — ^Tu u ar Angular Cords: Tubular Angular j Cords: Tubular Angular

Lacings: ' Tubular Angular Lacings Tubular Angular Lacings: Tubular AngularAssembled Notes:Unassembled Notes:

'Status: (S) Satisfactory (U).Deficiencies (IS) Parts hidden however functional O Not Applicable (SWO) Stop Work Order jReferences: OSHA29CFR 1926.550; °°ASME 830.3; 2008 NYC Building Code & RS 19-2 (2006); RCNY i

rJ _ v8`r!'__ - - __ r

:) ^' x^CIL31t718 ,..:' ttS:q:9. 1:0'i0'An nu al<Re iewaf of'6irt11 ie:o0 e^ation cenewal`shal[ibe acco4n an,ed b'si (ts action an'dan rnteirancerecoFd >Incacc cd3ncm -It. ^a , P,. >. .: ..P_^. 4:P._- — ..._; -....a. _._. a . ,. .. .. ^-"... Ogg 1, '.a±;'ii=. :N3 d:i :tim "';iise.^Sr_. _ !_ _^zry `°— _ _ _ ^_^5' '' 8Y''w h 1,__hand S. S

Item Numbers Deficiencies Date Corrected

{

jii

)

I

i

I

.'t:..;3'^ -_ l^=^c^=-: -- - ._.i •ir='Re_Yalr: ^.u^>f _ _ _ -^Ia"r - 3 1^^a^. ae[ %^-x,•'i..;r..- - ,'yx. ^ - _rr^--., a.,^^^'^%'e "'itiu4'^ - - ^' r = - ra•.^ .may.. .^c:^`-7sy ^ ^ ,7".i :s^,a:}^3-:zEeia^k,,.: x:lti - ..•_4 _^ .z. -v_^4z; ^g^-.....mom _:s:;-.,._kii::a_^S^T.+^ - P , _ -.^..^- _q ^. _ _ _ ^xt"' f ..i^.y_i=tea: ^',^^'-^^^-N^:L•n=^;^,^£

73'.ILgk ^l--,11a-. 3d Z ;ru P7 S' /d cau(ivr

a Sign at e of I spect Date

o ' lG»r% ! Z ^ame Si re of Supervising Inspector Dale

3&13

NYC Dept. of Buildings Cranes 0*1 Derricks Division - 280 Broadway, Room 501, New York, NY 10007

Tel: (212) 566-4696 Fax: (212) 566-5871 E-mail: candd@bujIdings.nyc,gov

MOMLE OWES TE AND ANNUAL INSPERCTION CHECKLiST

1ADate of inspection: Site Location: blx 71 Bor CN:

Inspector Name: Badge No.: i

Type of Inspection: Annual Re-inspection On-Site Audit -Patrol Sweep Chief Special SWO i ComplainW,

Inspection Result Issued # Number of Violations Issued

L

II Z model: Z Serial No.: -7 Year,

CD:- Expiration Date: Max Cai Picture Taken: Y

LCrane Types: (ET) Boom Truck tcc) crawler Crane /. (D) Derrick (MC) Mobile Crane tMMC) Mufti-Station Mobile Crane (MT) Mobile Truck Tower Crane (P) Pile Driver

'Crane Owner I e* Names- -- - Telephone;

Company Name;

Nq

Last Name: First Name: MI:

Licence No,: Expiration Dater Type: Master Tower Special Master Hanger Special Hanger

jLast Name- First Name: MI:

Licence No.: Expiration Date: On Site: Y

"W., IIION,0-if -Item SWONo, Inspected Item 'Code Section #1 Status*

1 Approved Permits & Plans on site 6C3319.4 &,6

2 Supporting Soil/Pad/Mali RS 19-2.B,1.1 -*8 8.4

3 Crane set-up conformity IRS 19-2.8,0

4 CN - On-Site Sign * off (CD-4) R5 19-2.8.1

5 CID - Approved CD (CD-2) BC3319,4 &.6

6 Daily/Montly Inspection Records -830,6-2,1.5 27 Signed & Dated —830.6-2.1,5 2

8 Main Frame Member R519-2,15,4,1 2

r10 see section 10f page 2 items 48 thru 56 1

............... . .. ...

11 Isee section 10g page 2 Items 57 thru 60 1

Mr,12 Isee section 10h page 2 Items &4.72,77,79, ao, 82-84

13 Isee section 1 0i psge 2 items 86 & 88

T U-7, I-Q-N.PItemNo. Inspected Item

SWO'Code Section #1 Status*

141 see section 10J page 2 jilerns 92-100, 102 & 103PEN-

15JExcess Smoke RS 19-2.15A7 216 1 see section 10k page 2 Items 105, 106 & i os 2

17 Turntable RS 19-2.16A.4

18 Pumps/MotorsNalvestl_inesffube 530.5.2.1.3(1)1 119 Ring Gear/Pinion Gear/Rollers RS 19-2,16.4.4

20 Main Hoist and Rope see sections 9f & 91

21 Auxiliary Hoist and Rope see sections 91 & 91

22 Boom Hoist and Rope see sections 91 & Di

2311-uffing Boom Hoist and Rope I

221241 see section 10o page 3 items 148, 1

5%X 'M251 see section 10q page 3 items 168,170-172

gg-,261 see section 10s page 3 items 186-190

L 27 1 see section 10t page 3 1

Mobile On-Site and Annual Inspection Checklist 15aae I of 4 tnrqffl r. R. n r­ teM A

10,. ANiNUpt JNSP^C r i0:b

ItemNo. Inspected Item Code Section

SWO#1 Status*

1e _ _ _ :..., Ff)s grlcf Date L

1 Monthly Inspection Records ^830.5-2.1.5 2

2 Maintenance Records RS 19 .2.17.1,1 23 Repair/Modification Records RS 19-2.17.3,4 2 Y4 Ofher

1 Ob ___ _ - ^e;,e1 at ^ _ -

5 Sheet Metal ^830.5-1.21(a) 26 Guards/Covers 1926.550(a)(B) & (10) 27 Internal/External Lights 1926.601(2)(1) & (4) 2 <;8 Housekeeping RS 19.2.26.0 29 Safety/Warning Decals & Labels 1926.550(n)(2) 2 j

10 Hand Signal Chart 1926.550(a)(4) 211 IPaint Condition/Corrosion Control RS 19-2.15.4.1 212 Other^^ f z

x , t Drivels gab,statlon ti n:

13 Access - Grab Rails/Steps 1926,550(a)(13)(1) & (ii) 214 Glass - -1926;550(a)(12)-- =I- -15 Windshield Wiper(s) 1926,601(b)(2)(1) & (i)) 216 Door(s) Restraint(s)17 Mirrors 1926.601(b)(4) ' 2

18 Fire Extinguisher RS 19-2.28.0 .1 219 Seats) Restraint(s) 1926.601(4)(8) 2201 Seat Belt(s) 1926.601(b)(9) 2211 Parking Brake 19W601(b)(1) 222 Air Pressure RCS 19-2.15,3,4 223 Controls Identified 1926.550(a)(2) 224 Instruments/Gaug es RS 19 .2.15.4.6 226 Electrical Switches/Functions- RS 19 .2.15.3 226. Horn 1926.601(b)(3) 2

27 Ligths ^' 1926.550(a)(1) 2

28 Steering,: RS 19-2.15.4.10 229

rEngine Clutch "B30.5-1.6.4 2

30 Accelerator" "830.5-1.6.3(b) 231 Brake./' RS 19-2.15.4.10 232 Other

=~ ^,_

1.Od•:^?i3 taz_: ,.-.^:. ^aerlerPovu_er tPlan^-L©weP^ t33 Performance RS 19-2.15.4.7,y..-

34 Exh System/Guards & insulators „_92s:55o(a)(1o) 235 Belts/Hoses a -- RS 19-2.15,4 236 Guard/CoverlRota1'& Recip Parts 1926.550(a)(8) 237 1 Other--

^'00^tRx1tu' q /t v'l,3- _ Yv '{}C YI rl.e^Y.S'

38 Transmission RS 19-2.15.4

39 Drive Line R5 19-2.15,9- 240 Tire/Air Pressure/Wheels RS;18=2:15.4.11 241 Main Frame Members RS 19-2,15.4.1 242 Hydraulic Hoses/Tub(ng/Fitting B30.5-2,1.3(1) 143 Hydraulic Fluid Level' 830.5-2.1.3(h) 144 Antl-Skid SUrface 1926.550(a)(1 3)(M) 245 Front Bumper Counterweight RS 19 .2.15.4(2&4) 246 B.adkup Alarm 1926.661(b)(4)(1) 24' Other

- -{

48 Boxes Rs 19-2.15.4,1 149 Beams RS 19-2.15.4,150 Cylinders RS 19-2.15,4°"` 151 Floats/Pads ^830:5.1.9.3(d) 152 Hydraulic Hoses/Tubes/Fittings RS 19-2.15.3,4 153 Holding Valves yF'- "630.5.1.9.3(b) 154 Position Locks RS 19-2,15.4.4 155 Warning Signs , r: 1926.550(a)(2) 156 Blocking/Cribbing 1

1 Q fJAL-rN5 ^P 1:IJ K 9Pr T1R1iEL?

ItemNo, Inspected Item

SWOCode Section #1 Status*

^4 g . = . Ctayvler A^semPOi .y .::•-.57 Car Body/Side Frames -B30,5-1.8 158 Chain - Condition/Adjustment RS 19-2.15.4.8 159 Sprockets/Idlers/Rollers RS 19.2.15.4 1 j60 Track Pads/Pins RS 19-2.15.4 161 Travel Locks °830.5-t5.3(a) 1 _7

62 Steering Clutches "830.5-1.5.2(b) 1 %^63 Other

} ^foh r. y ..^ < _., ..: -- --.:^peCator's CaU ^ Station .. t t,,..: ` . ::.: ..64 Grab Rails/Steps/Platforms 1926.550(a)(13)(I & iii) 265 Anti-Skid Surface 1926.550(a)(13)(111) 266 Glass 1926.550(a)(12) 1

67 Windshield Wiper(s) 1926.601(2)(1) & (1)) 168 Door Restraint "B30.5-1.81,(c) 2 j

69 Fire Extinguisher RS 19 .2.28.0 270 Mirrors 1926.601(b)(4) 2

- -7-1- Seat Restrain t 1926.so1(b)(8] 2" 72. Seat Belt/if.required 1b26,601.(b)(9) 2

73 Operator's Manual 1926.550(a)(1) 174 Operating Instructions/Decals 1926,550(a)(2) 275 Electrocution Warning Sign - Inside 1926.550(a)(2) 2

76 Hand Signal Chart 1926,550(a)(4) 177 Swing Brake/House Lock "830.5-1.4,2(a)/(b) 1.78 Positive Swing Lock "830.5-1.4.2(b) 1

ice'

79 Controls - Forces/Movements -B30,5-1.6.2 180 Air Pressure RS 19-2.15.3,4 2 j'81 Foot Brakes - Latches/Linkage ""830.5-1.3.2(b)(2) 1

821 Power Controlled Lowering "B30.5-1.3,2(c) 1 -^83 Engine Clutch ^630,5.1.6,4 284 Accelerator/Throttle Control "830.5-1.6.3(b) 2 "7

85 Other ---

86 Per Configuration 1926.550(a)(1 & 2) 1 '87 Durab)e "B30,5-1.1.3 1

88 Legible "B30,5.1.1.3 I 'j

89 Visible from Operator's Station "830,5-1.1.3 1'90 Secured ^830.5-1.1.3 291 Other -

_ -^I^-^-rte,,: -==-=sr_% -- -_:=4-

PA . Y7 , e_y_iOeslOp- -- -•^:^- - - -:ratibna(Alds ----^> =s^. -4^r92 Warning Decals 1926.550(a)(2) 1 -^`

931 Boom Angle Indicator RS 19-2,19,1.3 194 Main Drum Rotation Indicator RS 19-2,19.3(e) 195 Auxiliary Drum Rotation Indicator RS 19.2.19.3(6) 1 .961 Load Moment Indicator "830.5.2.1.2(a)(3) 1 j

97 1 Load Weight Indicator RS 19-2.19.1 1 ^°98 Radius Indicator RS 19-2,19,1.3 199 Crane Level Indicator RS 19-2.19.3(d) 1

100 Anti-Two Block Device RS 19 .2.19.2 1 <101 Two-Block Warning Device RS 19-2,19.2 1 > '102 Boom Hoist Shutoff**" RS 19-2.19,3(c) 1 ;^103 Boom Hoist Ratchet and Pawl "830,5-1.3.1(c) 1104 Other

(; 10k ..:, ^, - • -- ^ - i'oVyer)?lant :UPpp rk:^ . _

-

-

1051 Performance RS 19.2.15.4.7 2106 Exh System Guards & Insulators 1926.550(a)(10) 2107 Belts/Hoses B30,5-2,1.3 2

108 Guard Cover/Rotat.& Recip Parts 1926,550(a)(8) 2109 Other

-il),I,.. ?.•- r^ , R4Eaflt?g'Lfpper.Su_ ,}eCstrttetute ,110 Turntable/Bearing Rs 1s-2.15.4.4 1

`..

111 Turntable -Rollers/Roller Path R5 19-2.15.4.4 1112 Ring Gear/Pinion Gear RS 19 .2.15.4.4 1

- o -4: A /nrnf) C & D Form CD-14A Rev, A,)r. 23. 2009

'.'(- ' :sj ' -^ f`t" ^l 1 .L•I^" - _^5 1,-. 1- ^ F1;i3:

-ItemNo,

IInspected Item

SWOCode Section #1 Status*

-=1Dm = _Ra>attli9iU.pEr•upr^rutyrs_^ConLtnt7ed _

113 Hydraulic Pump(s) 830.5-2.1.3(m) 1

a 114 Hydraulic Pressure 830.5-1,1.3(n)(6) 1115 Electrical Wiring RS 19-2.15.3.7 1116 in Hoist - Clutches/Brakes ^B30.5-1.3,2(a)(1) 1'V1 7 Main Hoist - Wrapping On Drum RS 19.2.15.3.6 1118 Main Hoist - Min Rope Wrap s "330.5-1.3.2(a)(2)a j i

119 Auxiliary Hoist - Clutches/Brakes B30.5.1.3.2.1 1120 Auxiliary Hoist - Wrap On Drum RS 19-2.15.3.6 1 5'121 Auxiliary Hoist - Min Rope Wraps ^830.5-1.3 (a)(2)a 1122 Boom Hoist - Clutches/Brakes -B30.5-1.3.1(a) 1123 Boom Hoist - Wrapping On Drum RS 19.2,15.3,6 1 5-124 Boom Hoist - Min Rope Wraps "B30.5-1,3.1(d)(1) 1 .j125 Boom Hoist - Gears/Shafts/etc... RS 19-2.15,4.4 1126 Swing System/Assembly -830.5-1,4 1 "`127 Hydraulic MotorNalve/Llne/etc,.. 830,5-2.1,3 1"128 Drums/Flanges RS 19-2.15.4.3 1

729 Clutch/Brake-Protectiotr130 Torque Converter ^`830.5-1,6.4 1131 Anti-Skid Surface 1926.550(a)(13)(11l) 2 ^!132 Steps/Hand Holds/Platforms B30.5-1,8.3(b) 1133 Access to Cab and Roof B30.5-1.8,4 1 --134 Air System - compressorlUne(etc... RS 19-2.15.3.4 1

135 Counterweight Frame& Mounting RS 19-2.15.4.(1 & 4) 1136 Counterweight Warning Signs 1926,550(8)(2) 1137 Ele&ocullon Waming Sign Oulside 1926.550(a)(2) 1 j

138 Other 1

i.10.(^ a.j^ni;`,+^zt'r:7 ^-BOO/Tl SU^pQr'^_6.)!Stenr:r^,

139 Gantry/Mast ^63D.6 -1.3.1 1140 Boom Stops RS 19-2.19.3(0) 1141 Inner Bail °'830,5-1.3.1 1142 Outer Bail/Equallzer --30.5-1.3,1 1 ^^143 Sheaves RS 19 .2,15.4.3 1 S

144 Boom Hoist Reeving RS 19-2.19.3.6 1

145

iV

Other -^"-

146 tbbb l.;8ecfl6ijjdetif lfl600.Soom

48[

j4Boom Section Alignment RS 19-2.15.41 1

149 Warning Decals 1926,550(a)(2) 2

150' Spge^der.B'ar, ..1 .

151 Sheave s RS 19-2.15.4.3 1'152 Hoist Line Dead End B30.5-1.7.3 1153 Wire Rope Retainer(s) B30.5-1.7,4(b) 1"'154 Boom Fool Pins/Keepers RS 19 .2,15.4.4 1 ^`155 Boom Head Section RS 19-2,15.4.1 1 /^^156 Auxiliary Boom Head RS 19-2.15.4,1 1 ^Aa157 Lattice Member RS 19-2,16.4,1 1 /-^

158 Cord Members RS 19-2.15,4.1

159 End Connections/Pins RS 19-2.15.4.(1 & 4) 1160 Other

161 Positive Stops 1926,550(b)(1) 1162 Sheave(s) RS 19-2,15.4.3 1 C163 Wlre Rope Retainer(s) =•B30,5.1.7.4(b) 1164 Lattice Member RS 19-2.15.4.1 1 f S165 Cord Members RS 19-215.4.1 1 j166 End Connections/Pins RS 19 .2.15,4.(1 & 4) 1 -j167 Other ^-

- _%'r„ '•-7flre3.c¢p!'.a

168 Lift Cylinder(s) __< ---- -' ^Ba0,5-2.1.3(0) 1169 Teleseoping Cylinder(s) 830,6-2,1,3(0) 1

1(0^I•u_A^::i>?c?>Drr c^1r)^ItAD-Item

No. Inspected Item Code SectionS WO

#1 Status'`

_0bl : coplc Boom _ Contrtl et9 =_°_r;i- ,_ __ __V170 Hydraulic Hoses(Tubing Fittings B30.5-27%3(i) 1

171 Holding' Devices 830.5-2.1.3 n) 1 ,172 Boom Section Alignment RS 19-2.15.4.1 1173 Wear Pads RS 19 .2.15.4.5 -'' 1174 Equal Extension RS 19-2^3:a 1

Sheaves RS ,19-2.15.4.3 14SirucflireNVelds ^ 1

Boom Hinge Pin RS 19-2.15.4.4 1178 Boom Head Section=' RS 19-2.15.4.1 1179 Wire Rope Retainer -B30.5-1.7.4(b) 1180 Other181 other'

_^?,U`^ : ^T ``^^ ^^pllci:rtjb, Ex^en^foh,^Manu;41 vectlotis ^ ^;;;^'182 Alignment183 Locking Devices RS 19 . 2,15.4.4 11'84 'Strucfu^ebh/elds. 11-85 tk8i--- - -

^^^I,O^;,k^.,.^_;,^;^

'n 186a Size/Construction:' ' inch Rs 19-2.18.2.3 1186b Damage RS 19-2.1B.2 1186c Lubrication Rs 19 .2,18.3,5 1 ^j

186d

r 8t^Other

aii]a+.. t'i's _ _ si• -.si;y7-'.,`'•:^,:^=3_,:^:^^ ^^;;'F= 1^,=.^•.+.,^:v,:^_vra,}.

187a Size/Construction; (Z : indh_

RS 19-2.18.2.3187b Damage RS 19-2.18.2 1187c Lubrication RS 19.2.18.3,5 1

187d Other

-1888 SizelConstruction: ih tTr RS 19-2,18.2,3 1188b Damage Rs 19-2.1B.2 1188c Lubrication RS 19-2.18.3,5 1

188d Other

l 'y1s'^ ''^-y^^=:t. •^189a Size/Construction; ' inch Rs 19-2.18.2.3 1189b Damage RS 19 .218.2 1189c Lubrication RS

189d Other

'- Ly^9Q ^- k1^e17^^f1'i^ 4 ^_ n

^ ^ •,.^

190a Size/Construction: Inch RS 19^z218;2s8-" __T_190b Damage RS 19-2.18,2 1

190c Lubrication_. --" RS 19-2.18.3.5 1

190d ther'"c ' ^(oo{ts, Bf ot1 Balls , L:_ 1 t -:f

1; tI91;fVLs^^3. 81OCk1^`F^lo^{(a^3.::,;^r.^;.-

^; 5 ' X__, i _ S^3 ' _^^.1918 lWeight & Capacity Label ^B30,5 -L7.6 1 Z'

191 b Sheaves RS 19 .2.15.4.3 1'

.191c Safety Latches B30.5-1.7.6 1 ^^'

191d Wear, Twist & Throat Opening B30,10-1,2.1.3 1

191e Bearing/Swivel "830.5-2.1.3(a)(4) 1

191f EWedge Socket nd Fitting "B30,5-1,7. 3, ( c) 1

191g Non-Destructive Test Results RS 19-2.1.5,4.9 1`

191h Other

192a Weight & Capacity Label 030,5-1.7.6 1

192b Safety Latches 830.5-1.7.6 1

192c Wear, Twist & Throat Opening B30,10-1.2.1.3 1

192d Bearing/Swivel IT30,5.2.1.3(a)(4) 1

192e Wedge Socket End Fitting ^830.5-1.7.3.(c) 1 S

192f Non-Destructive Test Results RS 19-2.15.4.9 1 7.;

192g Other r °-

Mobile On-Site and Annual Inspection Checklist Page 3 of 4 (Draft) C & D Form CD-14A Rev. Apr. 23, 2009

0.•c.t:;, ^r u^ ridrit°; tiara f] 6's -Boom I.D. No. Length Jib LID. No. Length lust LID, No, Length

177TTotal Lengt Total Length / y Total Length

Cords: Tubular - A guiar Cords: Tubular 1 Ang lar Cords: Tubular Ang ular__Lacings Tubular- -Angular- - Lacmgs: Tutu a Angular Lacings: Tubular Angular

Assembled Notes:Unassembled Notes:

*Status: (S) Satisfactory (U) Deficiencies (IS) Parts hidden however functional (-) Not Applicable (SWO) Siop Work OrderReferences: OSHA 29CFR 1926.550 & 1910.180; **ASNIE 830,5 (1868); ASNIE B3. 0.5 (2004); 2008 NYC Building Code & RS 19-2 (2006); RCNY*'*Consult operator's manual for kick-out angle for boom

.. r_ Y'.. w, t.•,. - .,. r.._^-,T .. ter:';°^-T=itL•!a.•, _ ..:s:r,?• - _t; - - n._:(. ^._^.1_ nL.-er,. --

- !ns Sc1 c9 d" alnfeiigKae:r:,.c' '?f'Ya''dord epJl,.3e. tTa ^,a !S .aY. EI'o t,ra exp l_Ma4 'e>aacgm :^Df.^d:by1_ p. ..1 ..^_in..._ _g, t$_r! R_... a_Q:.YlI_.'_ {... .:.^' ••^. _ _^7,^T17 ,^<.^r3,^ `1.9 - 2 JO k14h , s4. n ^ 'W OR _4l,•^^•-,(^r..=-^re'.!J r i 11 ^-^(r, p.._-..^.."^ ^r^.., ^...-_.:..:

Item Numbers Deficiencies

^:-.. sr_: '[ir:v _:l - -n e_ Ifrlb;:- n ;'^8:1=_gg.,L; ..- t,Cr' • ^t^5;:.:

Date Corrected

yy y,- r_ =L-K _(},. LSD -

^_=-- r.:.:r,..:;: ,.x^L.J^t._,.:^^^...^-^,sr^. . i'::.._^:a^r:'s •xr:...li ^.3. {...a:.3,^r]u... r ..r. ._. iy-^- - _ _ _ 't::r?=_^-T7_

/,(,,/t-^'i--/=.-:^:1.^:a:%`ri+-///_.;,, /91_,i"^

/^,../^- / f_

r

tam4` s: eat.-r<: &`S sf, t, -ndo'r:"e nt.. <.rra ; ^;, ;•_~'^ ^' (^ ^ --.. Q rr.. , ktpgfy,i _ fly i1sP^^ Qr ^,:r _ rs r71^_ . •rrr^ -^, s _ _ 3„>:E,.^a.

Name 3iSignatu spector_^ P Date

Name Signature of Supervising Inspector Date

,Mobile On-Site and Annual Inspection Checklist Page 4 of 4 (Draft) C & D Form CD-14A Red. Anr 9'A 9nnn

I RN 1.11 1, OEMN 11 RUN MI-1:171021-

tLIMo. I Inspected Item Code Sect! #1 status*

-?7 -7

14 see section 101 page 2 J14a

g 'P

92-1(31), 102 & 103

15 Excess Smoke RS 19-2.15.4.7 2

16 see section I 2-^ge

i tems 105, 105 & 108 2

- Or17 able RS 19-2.15.4,4

Pumps/MotorsNalves/Llnesffube 030.5-2.1.3(l)(m)(n) I

19 Ring Gear/Pinion Gear/Rollers RS 19-2J8.4,4

20 Main Hoist and Rope Fee sBcllons Of & 91

21 Auxiliary Hoist and Rope see sections 9(& Q(

22 Boom Hoist and Rope see sections 91 & 91

23

24

LuMng 5oqm' H.qIs( and Rope7^ ^-7

see section 1 00 page 3 1Items 148, 152-154

1

251 see section 10q page 3 Ill.ms 158, 170-172

:1- a1am'-wo^-aw, ^':,:LTA— gpkg mg-7-5wam zmmv

26 1 see section 1 0s page 3 1 items 186-190 1 1 1

1 27 Isee sartinn I nt no— 'A 4 .. ...... - I I

ON

NYC Dept. of Buildings Cranes & De-iTlcks Division - 280 Broadway, Room 501, New Yo*, NY 10007

Mat u. a IC;l a ^ ^ — Tel: (212) 566-4696 Fax: (212) 586-5871 E-mail: candd@buildings.nyc.gov

MOSILEE ON-SME AND ANNUAL JNSPECTIONCHECKUST

............ .....................

! Date of lnspertlor! • -,c1 Y-Mt—

Inspector Name: Badge No,:

Type of Inspection- Annual )Re-Inspection On-Site Audit Patrol Sweep Chief Special SWO Uft# Complaint#

Inspection- Results: No Deficiencies Issue CID Re-Inspect SWO Issued # Number of Violations Issued

NNP:WIAW^ 1-9F RORKMV, ANNNR, ^V^

Make: Model: JZT 60(o C Serial No.: 22-S 7 7Z Year: a-^JaR

11 CD: Expiration Date: '2-11 /10 Max Capacity: T-c)r,3 Picture Takenfly N

lGreve Type s: (ST) Boom Truck (CC) crawler Crane (D) Dar-rick (MMC) Multi-Statlon Mobile Crime (MT) Mobile Truck Tower Crane (P) Pile Driver

fflane 0^wner

.

NziM, —C, ^'^ ,^^^^Co^ntact Name; e, v-^,,Te^l.phon,. j Lj -2-

FVT2- WE-,

Company tact Name: i j, CJ:tj-A-<:) v-N Telephone: 212-

111; 1110 -111 1 R, 1; W NO ...... . . . .....^ . .1 Worm,11-1g

e; First Name: MI:

LExpiration Date: Type: Master Tower Special Master Hanger Special Hanger

LIC

U

ILast Name: First Name: MI:

Licence No.: Expiration Date: On Site: Y^N NA_

n2-0-0, 21-0.5-

Last Name:

1Licence No.: I Expiration Date: Class 03

­4. ............... ........ .............................. ...........-------4

Company Name: Contact Name: Telephone:

Licence No,: Expiration Date:^eralCont^r^acR^or Site Safety 'Manager

"lo, Inspected Item Code Section 1 #1

W®rawl,^j 571 Car Body/Side Frames "B3o,5-1.8 I

58 Chain - Condition/Adjustment RS 19-2,15.4.8

RS 19-2.15.4

60 Track Pads,/Pins RS 19-2.15.4

61 ITravel Locks

62 1 Steering Clutches "B30.5-1.6.2(b)

63 Other

Ad I64 Grab Rails/Steps/Platforms

IMIRML 1 -151' ME , 01 ^ ^1 11 926,550(a)(13)(j & 111) j

NME "N2

65 Anti-Skid Surface 1926.550(a)(13)(111) 2

1 67 Windshield Wiper(s) 1926.601(2)(1) &(0) .1,

68 1 Door Restraint 2

69^Fir,-Exti^nguizher RS19-2- 28.0 2

-70 I-Mirrors- - ^-A-926-601(b ,;) 2

71 1 Seat Restraint 1926.601(b)(B) 2

72j:Sopt pe(IJIf4equired

73 operator's Manual 1928.55D(a)(1)

74 Operating Instructions/Decals 1926.650(a)(2) 2-

75JEloctrocuuonWamina Sign- Inside 1026.550(o)(2) 2

76 Hand Signal Chart 1926.550(a' )(4) 1

77 Swing Brake/House Lock "930.5-1.4,2(a)/(b)

78 Positive Swing Lock .1330.5-1.4,2(t ) )

79 Controls - Forces/Movements "B30.5-1 .6.2801A)r Pressure RS 19-2,16,3,4

8.1 Foot Brakes - Latches/Linkai g'-a

8Z Power Controlled Lowering '830.6-1.3,2(0)

83 1 Engine Clutch "B30,6-1,6A 1 2

841Acc,a lprator/Throttle Control "B30.5-1.6.3(b) 2

8510therN^M

861 Per Configuration 1026,550(a)(1 2)

871 Durable

88 Legible -030.5-1.1.3

89 Visible from Operator's Station -93 1.3

90 Secured 2

bi

92

I Other

N31 , 104-1001 R, R .

Warning Decals , 1926.660(a)(2)

93 Boom Angle Indicator R S 19-2. 101 1.1

94 Main Drum Rotation indic ator95 Auxiliary Drum RDtailoh Indicator RS 1012110.^tL

96 Load Moment Indicator

97 Load Weight Indicator RS 19-2. 19.1

98 Radius Indicator RS 19-2.19.1 . 3

99 Crane Level Indicator Rs 19-2.19,3(d)

100 Anti-Two Block Device RS 19-2.19.2

iOl Two-Block' Warning Device RS 19-2,1x.2

1021 Boom Hoist Shutoff * ' RS 9-2.19.3(0)

103 1 Boom Hoist Ratchet and Pawl --530-9.1.11(0) 1

104

105

0(her

Performance Rs 19-2.1-5.4.7

106JExh System Guards & Insulators 1926.560(a)(10) 2

11 07113alts/Hoses 1330.5.2.1,3 2

108 1 Guard Cover/Rotat & Recip Parts 1926.550(a)(8) 2

109 Other-NAMW-U

I 10Ru rntable/Bearing RS 19-2,16.4,4

's/Roller Path RS 19^-2.16AA

1121RInq Gear/Pinion Gear RS 19-2.15.4.4

Item

Inspected Item Code statu5'I

4UP-4N

IF I Monthly inspection Records -B30.5-2.1.5 2

r.0U J ^6ail ii,- R$ 1&2.17, i . 1 2

3IRepair/Modificatlon Records I RS 19-2,17.3,4 2

4 Other

51 Sheet Metal 2

6 1 Guards/Covers a (10) 2

711niernal/External Lights 926.601(2)( 1)&(1 1 ) 1 2

BIHousekeeping kS 19-2.26.0 2

9 Safety/blaming Decals t . Labels 1 1926.550(a)(2) 2

10 Hand Signal Chart 1926.550(a)(4) 2

Paint Condition/Corrosion Control I RS 19-2,15.4,1 2-jlj

1210ther I.

13 jAcc' ess - Grab Rails/Steps

14 Glass 1926.550(a)(12)

16 Windshield Wiper(s) 1925.601(b)(2)(1) & (11) 1 2

16 Door(s) R stralnt(s) 1 2

17 Mirrors 1926,601(b)(4) 2

18 Fire EAngu(sher

lSeat (s)

RS 1.9-2.2

19 Restraint(s) 1926,6o1 (b)(6)

2TOSeat Belt ( s) 1928,801(b)(9) 2

21 j Parking Brake 1926,601(b)(1)

221AIr Pressure R3 19-2.15,3A 2

23 ControlsIdentified 1926,550(a)(7) 2

2411nstruments/Gauges RS- 19-i15.4.6 2

25 Electrical Switches/Functions Rs 19-215.3 2

26 Horn 1926,601(b)(3) 2

27 Lights 1926.650(d)(1) 2

28 Steering RS 19-2.15.4,10 2

29 Engine Clutch -B30.5-1.6.4 2

30 Accelerator "530.5-1.6.3(b)

3116 rake RS 191-215.4,10 2

321 Other

33 1 Performance Rs 19-2.15.4.7- 2

341 Exh System/Guards Insulators 1926.550(a)(10) 2

351 Bells/Hoses 85 19.2.16.4 2

36IGuard/Cover/Rolat Recip Parts 1926.550(a)(8) 2

37 Otherg

38 Transmission I R819-2.15.4 2

39 Drive Line I RS 19-2,15.4

40 Tire/Air Pressure/Wheels I R S 1 s-2.15,4.11 2

41 Main Frame Members I RS 19-2.16.4.1 2

42 Hydraulic HosesfTubing/Fiffing 1330,6-2.1,3(() 1

43 Hyd raulic Fluid Level I

44 Anti-Skid Surface

45 Front Bumper Counterweight RS 19-2.15.4(2&4) 2

.46 Backup Alarm 192061(b)(4)(i) 2

47 Other

may rp - --j- !^tvgr'ff Rx"

48 Boxes RS 19-2.1641

49 Beams RS 19-2.15.4.1

50 Cylinders RS ig-2.1 5.4'

51 Floats/Pads -930,5-1.9.3(d) 1

52 Hydraulic Hoses/Tubes/Fittings RS 19-2.16.3,4 1

53 Holding Valves "030.5-7,9.3(b) 1

54 Position Locks RS 19-2,16,4.4

Mobile On-Site and Annual Inspection Checklist Page 3 of 4 (Draft) C & D Form CD-14A RPV. Anr_ 73 7nn4

Total Length TaNI Length

Cords; Tubular Angular01-a r IrCor-d--^

ToUi LanUth

Tubular A-ng-ular^P Cords. Tubular Angular1 15 acirmgs: - Tybi, a- - A- ng u la —1n g s: Tubular Angular qLacings: Tubular Angular

Assembled Notes:

Unassembled Notes:

I*Status: (S) Satisfactory (U) Deficiencies (IS) Parts hidden however functional Not Applicable (SWO) Stop Work Order

References: OSHA 29CFR 1925,550 A "ASME E330.5 (1963); ASME E330.5 (2004), 2008 NYC Building Code & RS 19-9 (2006); RRCN`!

*""Consult operator s manual foP kick-out angle for boom

M-L 11 i^ I n Ig I , '11, 1110 U4`920.

Item Numbers Deficiencies Date

L-f El

0

Ctlax-17- 7r- F

lyName Signatuf of spectof Date

C:5::)l 1 ^^j

Name Signature of Supervising inspector Date

Mobile On-Site and-Annual Insnectlon Checklist Pane 4 of A In- f+l

NYC Dept. ai Buildings Cmines t9_4 Derrlck5 DivIzIon - 280 Broadway, Room 501, tiletiv Y orit, we 1002Lff Tel: (212) 566-4696 IF= (212) 5d6-5871 E-mail: candd@buiidIngs.nyc.gQ)jT_ tun a =a U E;T^

MOBILE ON-SITE AND ANNUAL INSPECTION CHECKLIST

Data of hspecflon: ;L, h, J I I Site Location: M- ;-Jd T-IS14 IGI,^_ Boro:­^j

Inspector Name: V.-KA 11,' Pei— Badge Na.:

Type of InspectionrAnnuaI Re-Inspection On-Site Audit Patroi Sweep ChlefSpeC!21 S W 0 L ffi,# Complaint4'

Iflspection Results: No efioienc Issue CD Re Inspect 5V^/0 Issued # Number of Violations Issued

Make: Model: 610 6 Serial No.: ^,?­7 Year: P

Icb: 3 7rd Expiration6ate: z L) /11 Max Capacity: 0 ro ^ Picture Taken: q N

kano Types: (EIT) Boom TruO (oc)crawiarcrana ID)Danick (MC) na (110MC) Mullf-Mallon FIubfla Q aria (MT)Muh11Q Tick TowarCrane (P) Pile Dover

s _,^, I ­ &WIrkWON=

Crane Owner Name: Ca LY/ cl u, jivo C', n -S P"e, C, neaciNama: Telephone: Z.^ I ?-V- g o Do

Company Name: Contact Name: Telephone;

gag 2,IT 1^ MEW,WE

PLast Name: First•Name: MI:

Licence No.: —Expiration Date:' Type: Master Tower Special Master Hanger Special Hanger

4M

Last :Nlame: "11 4 A

Licence No.: Expiration [Date: Zo 1z. Typgv lass Class B Class C1' S' Class C2 Class C3

UZ

Company Name: Contact Name: Telephone:

,Licence No,: Expiration Date: -General Contractor Site Safety Manager

Ell n.

Item

No. Inspected, Item Code Sec lon

TWO

#1 tatus*

I Approved Permits & Plans on site BC3319.4 A.z1 1

2 Supporting Soil/Pad/Mat RS 1sz, 8.i 8.4 1 1

3 -Crane set-up conformity RS X2.8.0

4 CN - On-Site Sign-oft -4) 19-2.8.1

5 j CD - Approved CD (C BC3319.4 &.8

WIN,

6 Daily/Monfly Inspection ReGo sI

713igned & Dated -Pqn sq is

i4r

8TMain Frame Membej/ RS 19-2.15.4.1 1 2

9 see section 1 0b pa 2 cams 5, 7, 8 & i 0 1 2

,!M

-11 sees Ion 10g page 2 items 57 thru 60 1

12a section 1 0h page 2 Rams &4,72,77, 79,80,82

70-MMU;M REM R131see section 10i psge, 81

Mobile On-Site and Annual Inspection Checklist Page

" N. OEM ORN WI ; iS MOR 0, 1 -Item

N Inspected Item

SWO

'I

Code Section # Status

14 see section 10j page 2 Items 92-1 00, qd& 103

0.A

15 Excess Smoke M11 9-2,15.4.7 2

16 see section 10k page 2 )6rns 195, 105 & 1 08 2

17 Turntable RS 19-2.15.4.4

18 Pumps/Motors/Va as 00•5-2,1.3(1)(m)(n)

19 Ring Gear/Pinion Gea ollem RS 19-2.15.4.'4 1

20 Main Hoist and Rogd see sections 91 & 91 1-. 21 Auxiliary Hoist R_ See sections 91' & 91

22 1 Boom Hoist FRope sea sections 9f & 91 1 1

23 Ituffirld"s - Hoist and Rope j

24jffe'p6cti6.n 1 0o page 3 Hems 14a, 162-154

25 . e section 10q page 3

.0a

,e61see section 10s page 3

Items 168, 170-172

W

items I&I

271 see section 10t page 3 1 items 1911192.­r U

of 4 (Draft) 0 & D Form CD-14A Rev. Apr, 23. 2009

Mobile On-Site and Annual Inspection Checklist

Ala, Inspected Item1

Code Section 1 #1 1 Stratus * ll No. Inspected Itemi^ ^^mo=o

^ It si: rca^)'--'^_7at 2rr^ _E _- -- =saa

1 Monthly Inspection Records °'830,5 21.5 2 j r Body/Side Frames2 Maintenance Records RS 19-2.17,1.1 2 3 58 Chain - tlon/Adjustment3 Repair/Modificatlon Records-.. RS 19-217,3,4 2 . 3 ; 59 S ®ckefs/Idfer/R i

4, Other 6o Track Pads/Pins

_ ^L+f^^ w'1,_^_^•'2if°'a='2s-:a.-:_:n<a^•^f^^',^^i'?.r.•`cy^';:i ^y,^2t^=r.. ..^';^•'^5=^^^,s I 9-1 • 1 ,dvBi ^.0"S.nn ,®,•;

5 Sheet Metal F"83o.5.1,2I(a) w

2 62 1 Steering Clu -6 Guards/Cover I 1926,550(.)(.) & (10) 1 2 1 S 6310th7 1nternaVExtemal Lights 1926,601(2)(1) & (11) 2 1 s 11- a'e

Code Section 1 #1 I Status

NT Mr = f"B90,5 . 1.B 1

RS 19-2.15,4.8 I a

R 15.4 199-215.4 1

8 Housekeeping Rs 19-225.0 1 2 64 Grab Rails/Steps/Platforms 1926.550(a)(13)(I a III) 2 S9 Safety/WamIng Decals & Labels 1928,550(a)(2) 2 3 65 Anti-Skid Surface: 1926.550(a)(13)(Ill) 2.

10 Hand Signal Chart 1926.550(9)(4) 2 > 68 Glass 1926.11(.)(tz) 111 IPaint Conditlon/Cotiosion Control RS 13-2,15A.1 2 q 67 Windshield Wiper(s) 1926.501(2)(1) & (11) 1 512 Other 63 1 Door Restraint °°630.51.6,1.(c) f 2 ! g

_ _ _v_ aQix rat fl ._ . _ -^ rn 69 Fire Extinguisher RS 18-2.28.0 2 S13 Access - Grab Rails/Steps 1e2s.55o(a)(13)(I) & (II 2 s 70 Mirrors ium.sol(b)(4) 214 Glass. 1926.550(2)(1d) 1 5 71 Seat. Restraint 192B.BD1(h)(6)

1 WfnosYile c+ pap (sj- ;-182s.5oC(s7t'S(q 37u -3 ; - - ?. * 7t-selof. r'^7!^11 d - - 49zsf044b)(e)- -,16 1 Door(s) Restraint(s) °°830,5-1.8.1•(0) 2 S 73 Operator's Manual 1926.550(a)(1). ' 1 s171 Mirrors 192e,15131(b)(4) 2 3 7 Instructions/Decals .1928.550(a)(2) 1 2 S18 Fire Extinguisher RS 19-2,26.0 2 1 75 Elec"cu0on Waming Sign- Inside 182fi,65D(e)(2) ' 2 3

19 Seats) Restraint(s) 1926,6o1(bya) 2 _ S 761 Hand Signal Chart ters ,550(e)(q) 120 1 Seat Belt(s) 1926,601(b)(9) 2 1 77 Swing Brake/House Lock °'630.5-1.4.2(a)r(b) 1 . 521 Parking Brake 1926.501(b)(1) 2 S 78 Positfva Swing Lock "830.5-1,4.2(b) 1 S22 Air Pressure RS 19-2,15,3,4 2 79 Controls - Forces/Movements X630.5 tsz 123 Controls Identified 1926.550(a)(2) 2 5 80 Air Pressure RS 19-2 .15.8,4 2 524 Instruments/Gauges RS 19-2,15.4,6 2 81 Foot Brakes - Latchbs/Linkage "630;5 1.3.2(b)(2) 1 3

25 Electrical Switches/Functions RS 19-215.3 2 s 82 Power Controlled Lowering ° 830,51.3, (c) 1 326 1 Hom 1926,5o1(b)(3) 2 5 83 Engine Clutch °630,5-1.6.4 2^27 L'Igths ' 1926.650(a)(1) 2 1 Jr 84 Accele.rator/Throttle Control "830.5.1.6.3(b) 2 S28 Steering RS 19-2.15,4.10 2 3 I 85 Other

F

=291 engine Clutch I -330.s_4 .sa 230 Accelerator °'830.5-1,6.3(b) 2 9 86 Per Configuration 1926,550(a)(1 & 2) 'I31 a I Rs 19-z15A.10 2 S B71 Durable' 630,5 1.1.3 132 .Other d 88 j Legible °f630.51.1.3 1

"._ _* l', ^.J^a ,Qi+t',^ iryC)"_=•^._^ ^. 89 Visible from Operators Station `"830.5-1. 1.3 17 ,F33 Performance RS 192,15,4.7 2 S 90 Secured °'830.5-1.1.3 2 j341 Exh System/Guards & Insulators 1926.550(6)(10) 2 ; 91 Other

ea]> 6_

92 Warning Decals 1

gj_ _a (, 56'E

1926,650(.)(2)

=_' ('

I ` ^

1^ 1S=•._35 Belts/Hoses RS 19-2.15.4 2 S36 Guard/Cover/Rotat &'Recip Parts 1926.550(6)(8) 2 5

37 Other - 93 Boom Angle Indicator F Rs 1s 2.19,1.3 1 S__ - inter_• ; _ ^_^ 94 Matn Drum Rotation Indicator Rs 19-2.19.3(.) 1 S

38 ITrEinsmission I RS 19-215.4 2 :rS 95 Auxiliary Drum Rotatioh Indicator • Rs 19-219,3(e) 1 .39 I Drive Line RS 19-2,15.4 2 95 Load Moment Indicator "630.5-21.2(a)(^) 1 S

97 Load Weight Indicator RS 18-2,19,1 '1 998 Radius Indicator RS19-2 19.1.3 1 S99 Crane Level Indicator RS 19-219.3(d) 1

100 Anti-Two Block Device RS 19-2.19.2 1 5101 Two-BtockWarning Device RS 19-2,19.2 1 5102 Boom Hoist Shutoff' RS i9-2,19.3(c) 1 5103 Boom Hoist Ratchet and Pawl

.104 Other

105 Performance RS 19-2,.15.4,7 J 2 ^

_5S 106 Exh System Guards & Insulators 1926.550(a)(10) 2 S

107 Belts/Hoses 830.5-2,1.3 2 3108 Guard Cover/Rotat & RecipParts 1926.550(.)(8) 2 Y109 Other

3 110 Tumtable/Seanng RS 19-2,15.4,4 1.3 `; 111 Turntable - Rollers/Roller Path RS 19-2.15.4.4 1

.F 112 Ring Gear/Pinion Gear RS 19-215.4,4 1 Y

Page 2 of 4 (Draft) C & D Form CD -14A Rev. Apr, 23, 2009

40 Tire/Air Pressure/Wheels RS 19-2.15,4,11 241 Main Frame Members RS 19-215,4.1 242 Hydraulic Hoses/Tubing/Fitting 830.5.21.3(1) 1

Item -- SWO

No. Inspecbad Item Code Sacdon 11 St=

113 Hydraulic Pumps) 830,5 21,3(m) 1 . 5

114 Hydraulic Pressure 830.51,1,3(n)(6) I

115 Elecfr7cal Wiring RS 19-215.3,7 1

116 Maln Hoist - Clutches/Brakes '830.5 1.3.2(9)(1) 1 3

11 7 Alain Hoist - 1AlrappIng On Drum RS 19-2.15,3.6 1

1 1 18 Main Hoist - Min Rope Wraps -E30.5-1.3.2(a)(2)a 9 S

119 Auxiliary Hoist - Clutches/Brakes 930,5-1,3,2.1 1Auxiliary Hoist - Wrap On Drum RS 19-215.3.6 1k1120

21 Auxiliary Hoist - Min Rope Wraps "1330.5-1.3,2(a)(2)a 11221 Boom Hoist - Clutches/Brakes "830,5-1,3.1(9) 1

123 Boom Hoist - Wrapping On Drum Rs 19-2,15,3.6 I

124 Boom Hoist - Min Rope Wraps B3o.'1,3,1(d)(1) 11251 Boom Hoist - Gears/Shafts/etc... RS 19-2,15,4.4 1.

•126 Swing System/Assembly °°830,5-1,4 1

127 Hydraulic Motor/Valve /Line/etc... 830,5-2,1,3 1

128 Drums/Flanges RS 19-2.15.4.3 1

129 Clutch/Brake Protection-13Z orq a onvelfer ( 33o,d-1,5,9 1

kid Surface 192s,55o(a)(13)(uq 2

i4—

/Hand Holds/Platforms 830,5-1.6,3(b) 1 sss to Cab and Rooflem - Compreasor/line/etc,.. -

V

ndRS 19-2.15.3,4

terweight Frame& Mounting RS 19-216,4,(1 & 4)

terweight Waming Signs 1926,660(a)(2)

ullon Waming Slgn 0utalda 1926.550(e)(2) 1 ,

' 138 Othero

Gantry/Mast)

1

°°830,5 1.3.1 1

^'

140 oom Stops Rs 19-2.19.3(c) •1141 Rijer Ball "830,5 1.3.1

142 Out BalUEquallzer °"990.5 1.3.1 1

rl 4 43 1 Shaa* , Rs 10,9.15.4 1

144 Boom Hoist Reeving Rs 19 2. .8 9

1481 Boom Section Align me RS 19-215.4.1 9 11r 18

149 Warning Decals 1926.550(a)(2) 2

15i3.S.^f^ad2r1^'a;r:;.. •• . , - -,,^` .• ,r;: 1•

151 Sheaves RS 19-2.15,4,3 1 1,

•152 Hoist Line Dead En 830.5-1.7.3 1 1

153 Wire Rope Retai r(s) B .5-1.7.4(b) 1 19

154 Boom Foot Pi /Keepers RS 1 16 ,4,4 1

155 Boom Hea ection RS 19-2.1.1 1

156 Auxiliary oom Head Rs 19-2.15,4,1 1 1 f

157 Lattic ember RS 19-2.15,4,1 1 1;

158 C Members Rs 19-2.1-9,4.1 1'

159 nd Connections/Pins RS 19-2.15.4.(1 & 4)

OtherY- ^{hi(l:!ag :.v ,7 S^v^:

1k61LLIti^^ M

1 sitive Stops

..ra •--^+.^- ^i: -^C'^^4^^l^ L.^§n= ^^'.-

tsz6,6so(bi(1) 1

1

"^'"t 1

^' if

162 SheaV RS 19-2.15.4.3 1:

163 Wire Rope Retainer " • AN 1 w,._

164 Lattice Member RS.19-2,15.4 ,1 1 1;

165 Cord Memb R 4.1I

1 c

166 En nectlons/Pins RS 19-2.15.4.(1 & 1 1 t

167 Other

1681 Lift Cylinders) 1 B30,5 2.1.3(0) 1

1`

1169 Telescoping Cylinder(s) 639.52.1,3(0) 1 '

S.,.0 11

Mobile On-51te and Annual Inspection Checklist Page 3 of 4 (Draft) C & D Form CD-14A Rev. Apr. 23, 2009

Boom I.D. No. Length Jib I.D. No.

^^+Z ^a^ ^ ^ J•^t^ ®.^ 3^'etZ

1lflast I.C. ^!®. Length

Total Lengthl g Jw Total ? :angtthl I Total 1_a gtr`sg - - - ^ - Tubular- - angularCords° Tubular An ular Cords: Tubular -Angular- ^"Lcin9w. Tubular n0lar I uings. Tuf ular Angular L^cir^^s: Tubular angular

ss®mbled dotes:Unassembled Notes:

*Status: (S) Satlssactory (U) Deficiencies - i.,t (IS) pares hidden h6weverfunctional (-) Not Applicable (SW®) Stop Work OrderRaferances: OSHA 29CFR 7926.550 w 11590.100; "ASIME 036.5 (1962); ASME 830.5 (200,4); 2006 NYC Building Code a, RS '19-2 (2006); RCMY*"Conduit operator's manual for trick-out angle for boom

lame //nature of Supervising Insped.%tomDate-

Mnhila r)n SIfP and.Annu _-nal Innarflnn Ch

l

ar_klief Pace 4 ofd !nr r+^ r s n . _— ... .

as ti„e n--Q!+- Ana a— —[ 1--fl— r hcn4l:rF Paoe A of A (Draft) C & D Fort CD-14A Rev. A p r, 23. 2609

OCT-01-2009 I6:17

OCT-01-2009 i4;62 DCM 420 W 42 ST 12122790926 PZ05

NYC Rapt, 13f Division -2805rop-Adry, Room 901, MGWYOrg , WY 50007t= aaeo^evoor3 W: (212) 866•4698 Fwr. (212) 56&5871 E-mail: c3nddV_)hulldlagu,nmgav

MOMLE ON—SITE AND &AUNNUAL UN""S'PECTOM, CHECKUST

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ntod Name: Telephone:

General Contmdor Site Safety ManagJ

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0,I.%V NOW ^iI.Yj in R. I a M—M V M.. I

Maln Frame Membir WkA PI .0 M TI, 2 T-1

OCT-Oi-2009 14 :60 DCN 420 W 42 ST 12i22790926 F.00

^„ , ..^-•ids: • b"^ ;, + ^ vim- m.^-^n _: ^ti "`` sf F_'_ ^ ^ ,'.?^^::.r. ?^^^a^'^ a^^ - : _,^;?^ _.,,^^^^

9 Safi /W$rnin- Decale 6' Labels . 192c.560(B)(2) 216 bend Signal Chart j 16k659i0)(4) 211 Paint Condillon/curroslon Control i Rs 1D &16.4,1 21

- - - --

9 3 Accea-9 - Greta Retl^t s 19m.5s0(a is o 8 i 214 Glass 102'6.560(!3)(12) 1

R 4l1(IfldnhleldLnfJpar(s}- - - 4®29009(6)((1)(1)ski!}16 )5eot%) Re6trp int{€) 0,^1,s,1.(®) "17 Mirrors1026.601(6) 4}

18 Fire Extimgulshar RS 1F

19 Seat s) Reatralnt s 1D^,@0,(bue> x20 seat Seit(s) 162D,801(b)(9)

21 Parking Brake ia28.W,(bxi) 22Z Air Pressure R5 10,Z15,3.4 2

23 Oontrole Identified 1916,6500)12) 2

24 InntnimentslGauges PS 1 p,2,15,4.8 226 Electrical Switch e^uncilonD AS 16.2.,5.9 226 Horn ^6E101(b m 227 Qbths i8ae,3 0(®)(,) 228 Steering RS IT12i5.4.10 229 Engine Clutch °sdO6.1.8.4 230 'Aerator n3o51, s.6iq) 2

31 Wake RS is•z,ib,a,16 ^ e

OPt)le

33 Performenoa RS if^2.i6A.7 2

34 Exh SyStamfGuards to insulatom 19m6m(a)(10) 2

35 Belts/Ho5e6 RS 1M.16.4

35 Guard/Cover/Rofat 9,Recip Parts i926.5b0(a)(0I 2

37 Other

38 Transmission R3 19-2 ,16.4 2

35 Drive Line Rs,D 2 try 4

40 Tire/Air Pressure/Wheels RS ,D x.,6,4.11 241 Main Frame Members RS 19 2 16,4.1 a42 Hydraulic Hose sNubing/FiHIng 030.6,2,,. 1

43 Hydraulic Fluid Level 830,5.2, , (h) 1

44 Anti-Skid Surface 19266 0)(13}(111) 2

45 Front Bumper Counterwalght Rs 2,16.4(294) 2

.46 Backup Alarm 8,801(6)(4)(1) 2

47 Other

48 Saxes Rs 1a215A1 1

49 Seams Rs 1D-2.16.4.1 1

50 Cylinders RE 104- 15.4 1

51 Floats/Pads M 93a,s 1,9,3(!x) 1

52 Hydraulic Hosast7 s/F@tings Rs 18-2 ,15.3.4 1

53 Hokfing Valve- -sab,6,.D•?(b) 1

54 Position Lock RS 10.2,15.4.4 1

INo, InapcbW Item

I 57 "ar sody/Sid9 F1`Rmos

58 Chain 4 ^ndltlor>fAdJua o;cnt69 Sprc(i(ot9llf11eP./Roll ®Pe

W Track P°adS/Pins

e1 TravEl Loa"

62 Steering Clutched -^ Oth®P

1 64 Grab RalID/61epa/Platforma

65 Anti Skld Burfarero Glae8

-67 Windshield WipeftDoor Raotralnt

69 Fire Exxon uisher70 Mirrom1 met Restmint

a t foe" r r Np!rX - - ;73 Operstorb Menuat /

74 ®p®ratin Instnacxioons/De^el J

Elo*=Ai0n Wemlfm Sian - maid®

76 Hand Sigm it chart77 Swing Brake/Hou9e La76 Pesli(ve 5wftog Lock79 Controls ^ t'orces M , ents

80 AirPresssur^81 Foot Brakes - La es/Linkage

62 Powe r Gonirolf Lowering83 Engine Ciut84 Aecelarato rotkle Control®ti Oihsr

88 Per onflgurat)ond7 r'b ckln.aur v

ible8♦Vlclbie from Opf6Patoes Staflon

90 Secured

91 Other•. •h.. y

92 Warning Decals03 Boom Angle Indicator94 Main Drum Rotation Indicator

95 Auxlllary Drum Rotation Indicator96 Load Moment Indlcator

97. Load Weight Indicator98 Rradlu5 Indicator99 Crane Level Indicator

100 Anti-Two Black Device101 Two•Blook Warning Device102 Boorn Hoist Shutoff°°"103 Booth Holsl Ratchet and Pawl104 Other

i06 Performance100 6xh System Guards & Insulators107 Delia/Hcaaes108 Guard Cov®r/Rotat & Renlp Parts

109 Otherrg

110 Turntable/Bearin g

sWOCnde ftcflon .011 ^ a*

aG30,5.9,D 1rs 1szis.^.c i

I RSRS 19.2,15A

"080.E 1.5,3(0), 1 ,,^^^B3n.111.sa(b) 1

iDZa,s6tr(a1(1 0 s 01) 21iers.sso llslfmJ 2

1929. te)t92) 112x6, 1(2)(1) A (II) j

0,61.9,9,16)as au2.2s.e 2

1826.00, )(4) 2192fi807(b)(0)

3s X-011( ,®26.680{2)(1) 1

9926.560( .2)' Z

1829,660(OX2)

9szG.65a(0#^1 1-93o,3-1,4,2(o)!(b) 1,

°°e?0.61,4.2(6) 1'°030.5-1,62 1

RS1D-2163,4 2

«920,6-1,3,2 (b)(2) i°5130,6 1,3,2(0) ;

'930,5-1,9.4 2-930X5 1.8,3(b) 2

19286s0(e)(1 62) 1^B3Q5.1.1,9 1

^e30,61,7.3 1^39,^9.1.3 2

t,, y

,e2s.sao(a)(2) i

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Rs 192,19,1.3 1

Rs i621D.3(a) 9RS i9-2,10,3(x) 1

-Sab.6.2.1,2(au7) 1RS 16.2.19,1 1

Rs i9.2. In. 1,3 1

Ra iaz,s.3(rg 1RR 19-2.19.2 1RS 19.2,19,2 1

Rs 19-aAD.316) 1^e3as.,,3.t(e) 1

R8 10-2.16.4,7 21926,65DW00) 2

®30.82.1.2 2

1926,650(0)(9) 2

RS 19 .2,16,4 ,4 1

55 Warning S! g8 162&550(a)(2) 1 111 Tumtabie - Rollers/Roller Path RS 16-2.15.4,4 1

56 Blockin ri

a

bbing 1 112 Ring Geer/Plnlon Gear Rs 19.2.15,4,4

-

1

SNn111 r71^.0 (fR a nd Bromial fn-41—/"6+n -LIi^6 Donn y9 •I ^ lrlrnkl f! d P9 Ms r,w P. r1.A^A ®.., A+o H9 NRflfl

OCT-01-2009 16 : 15 12122790925 981 P.03

itemNo. Ir8pef1sd Its Cad® Seetl®m

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1 I'thonthiy Inapeetlon Records °eso,^ z.,,6 22 Maintenance Records I P.5 10-2.17.9.13 Repairfmodlfleetlad'Records R9 iF2,17,^4

n 4 Other

f ~PR3•'^- _ .^, Fy 4..?F°i,_*c ^.- -E!_^-. _ ,_k i^ 9 ".w _U?;',:e`R'._~-

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b Sheet Mat71 °^36,3.1.2.1(a^ ^_

6 GUerdS /Q®V®PS 1^9,668(e)(!1) f4 (18) v7 internallEAemal Lights 1929.601(2)(1) 9 (11) °28 H®UBake® in 0 RS -2,28.0 2

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OCT-Di-200S DCVi Ai 20 G! 42 ST'. w• . •

A21-1 22790325 P.02SVVQ f

a, j (fispaued Ibm_^NI i I

Code 80GUOUI stapsF N ®, InSPOUDd Item Code secuon I gatusil"i

113 Hydraulic Pump 170 Hvdrau Ir oseaf •ubing Fillings 83D.5, , 3(1)

114 H Faullc Pressure 1 171 [Holding Devices

115 Electrical V111ring RS ID•2.16 . 3 . 7 I I 172 Boom se,rtion Alignment AU I

116 Main Hoist - Clutche--JOrakes 1 73 Wear Pads RE 19-2.16.4,5

117 Main Hoist Wrappinci On Dfum RE 19 .2 16.3 's 1 174 Equal E)denslon I RE 19-2.15,4

I IS Main Hoist - Min P— wr-9 175 Sheaves ps 1912.15.4.

11 9 Auxiliary Hoist - Cl utches/13 rakes 1 830.5.12.2.1 1 70 -t- ""' 'TVa"-;^ tualufw

77 Boom" Hinge P;n

178 Boom Head Sex-tion RS 19.22 1

'1179 Nre Rope Retainer "930.5-1

923 Boom Hoist - Wrapping On ®rum RS 19•?. 95.9,6 1 180 Other181 Other

7

V126 Sy4ng SyeterWuuahibty 1 182 Alignment RE

127 Hydraulic MutorN21vvreilllhed/al 1 9f13 Locking Devictes 18-115. .4

128 DrurnsiRgnoas R U-2.1 .3

129 Ulurcillbrako PIDE&CIfon ­a30.s•tA'7 1 185 Other130 Torque Converter ITU 'r-911

131 Anil-Staid Surface IN

132 Sle-1wand waddelfol Ina SL-E/ oris F06f Dw if

3 Access to Cab and Roof 186b Damage . fj PU 19.2,16.2

13 Air SyMm -I 9p-2 I 5 'S.4 I I I 186c Lubrication RE I8-2118.1.5 1

'135 Counterweight Frame& Mounting jps_v4.is.4,1 A 4) 1 1860 Other

139 Co j tang inhi VA/Arninei Signs 10 G.69

137 F) rocullon Wamhn Sinn OtAWO t 8.590(02) 1 187aj8lze/Con*frucVon:,,..I hRE

16--2_t&2,3

138 Other 11 _1.1376 Dama_qe RE 19-2. 1 B.2

a 07, 1 1870 Lub0caliRE

19-2.10As 1

139 Gantry/Mast 1 1874 Other

140 Boom Stop4RE

1 1^-2, 1 U 1tow_)-.

141 Inner Sail 188a Slza/Con3lructlon: I Inch RS 19-2.18.2.3

142 jOuter Sall/Equaltzer x930 .5.9,39 1 1886 Damage RE

143 Sheaves 1/1 RS I S.2.16,4.3 1 188c Lubrication

1 1441800m Hois t Reeving rRE

42.19.3.6 i 9880 Other

145 Other1 696 81ze/Consiruction: inchj RE 19.218.2.3

RE

Lubrication RE 19418A5

948 Baorn Section A(ignmeni Rs 99 216.0,1 1 1694 Other

1904 Size/Cons1rucflq^:.- Inchh RE 19- M& .3

51 Sheaves R3 I8-2.95.4,3 1 ^9Ob Damage RS 19-2.1 n.2

152 Hoist Line Dead End I 1 90c LubrfcatFon- Rs 10.2.18.3.5

153 Wire Rope Retains I 19ad Other

154 Boom Foot Pins/K pers Rs to 2,16.44 1,..

155 I Boom Head Sectl^n RG I D-2.15.4 1

1 58 JAUXIllary Boom FAad-R8 19in Weight & apaofty Label 030,5-1,7.8

157 Lattice Member RE 10-2.16.4.1 1916 Sheaves 1

168 Cord Member RE I9-2.15.4.1 1 991 c 60ity L tches

159 End Conne 'bns/Pins RS 19-2.15 4,(1 a 4) 1 19ld Wear, 1!

ist & Throat Opening

160 Other 1918 Bearltifi/SwivelX , -830 6-1.7 3.( 01

161 Positive VPR 1026,65o(b)(1) i fej g Nonpostrucilve Test Results RE 19-215A6

162 Sheave(d) RE 19-2.16.4.3 1 191h 0- _r163 Wire Rvpe RefBinw(s) 830.6 t.7 J(b)

164 "ttl*Member RE 19-2.9571 71 192a eight Capacity Label 030.6-1.7.6

165 Cord embers RS 10-2-16.4 1 9 1 926k oGafety Latchet 830.5-1.7.6

16G I End ponnectionsiPins RE 19-2.19.4.(1 & 4) 1 192 Wear, Twist b Throat Opening

167 Ottr 19 Bea ring/Snl al

a Wedge SocketEnd FIU)ng

168 Cy(Inder(s) /92f Non-Destructive Test Results RE 10 2 15 4. 9

189 elescaping Cylinder(s) Other

M bile On^Slte and Annual Inspection Checklist Page 3 Of 4 Mrzftl C & D Form CD-14A Rev. Apr. 23, 2009

OCT-01-2009 1615 12122790925 .9e% P.02

OC"1-01°2009 1 4 261 DCM 420 U 42 6i 12122790925 P.06

Mobile ®n-Site and.Annual Inspection Chachlist Pane 4 of 4 (Draft) C & 0 Form CD-14A RSV. Aar. X3.2009

OCT-01-2009 16 : 17 12122790925 99% P.04