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aaa • INS-00008 • Report No.: TR-2026-00002 • Final Report No.: FR-2026-00001

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GENERAL INFORMATION
Report No.		Date of Inspection
Relevant Standard	EN-81-20:2020 /EN-81-50:2020/ASME17.1-2022
Client Details
Location of Equipment
Type of Inspection
EQUIPMENT DETAILS
Type Of Lift:
Manufacturer:		Suspension rope D:
Manufacturing Year:		Type (Usage):
Model:		No. of Floors:
Serial No:		Governor Wire Rope D:
Speed:		Tripping Speed:
Capacity:		Machine Type:
type of Car Doors:		Suspension Type:

No.	DESCRIPTION	REMARKS	COMMENTS
DOCUMENTATION
1	Manual and Data Sheet.
2	Drawing.
3	Maintenance logbook.
INSIDE THE CAR
1	Car floor dimension and height.
2	Car capacity, measure area and compare with rated weight.
3	Car floor, wall, ceiling verify quality fixation and strength.
4	Adequate ventilation Provided.
5	Car lighting 100 lux @ 1 m above the floor.
6	Car doors dimensions Hight ≥ 2m.
7	Door reopening functions correctly.
8	Door sill installation inspection, gap ≤ 3cm.
9	Car Operating Panel.
10	Lighting at emergency functions correctly.
11	Emergency bell.
12	Intercom.
13	Safety instructions.
14	Fire emergency activation.
15	Overload Activation.
MACHINES ROOM
16	Access door (Dimensions and locking)
17	Room condition (cleanliness, Temperature +5°C to +40°C)
18	Room light 200 lux in the work area.
19	Instruction and caution stickers.
20	Elevator hoist way light isolator
21	Machinery Emergency Stop switch
22	Pullies check the ratio between pulleys and ropes.
23	Wire ropes inspection.
24	Wire Rope diameter(mm)
25	Slab holes (Ferrules height ≥ 50mm)
26	Traction pully operation no cracks and well fixation; ropes do not slip-on pully.
27	Equipment guard.
28	Fire extinguisher.
29	Machine-Motor condition and fixation during elevator operation.
30	Emergency landing device function test.
31	Rope level mark.
32	Lift Manual rescue provided.
33	Overspeed governor. (Tripping speed)
34	Electrical tripping (Governor switch)
35	Safety gear clutch activation
36	Governor sheave guard
37	Hoisting trap door and hooks.
38	Main braker provided.
39	Controller circuit breaker
40	ELD breaker (Emergency Landing Device)
41	Insulation resistance
42	Earthing
43	Phase cables securing
TOP OF CAR
44	Operating device, Operate by continuous pressure at low speed.
45	Emergency stop switch.
46	Car top light 50 lux, socket.
47	Overhead /Refuge spaces
48	Final limit switch function test.
49	All Landing Door Locking device function test.
50	Safety guards provided.
51	Emergency door dimensions ≥ 0,40 m × 0,50 m.
52	Emergency doors check the performance of the locking device.
53	Door header check parts installation and functionality.
54	suspension ropes check quality of fixation in car & cw.
55	Guide rail fixation and condition.
56	Ensure vehicle and counterweight guide shoes fastened, aligned properly.
57	CWT locking arrangement
PIT
58	Pit access closes automatically and opens from inside without a key.
59	Pit cleanliness.
60	Pit ladder, 1.5m level different.
61	Pit stop switch functional test.
62	Overload sensor.
63	Car and CWT buffer with safety switches.
64	Oil buffers test no leakage.
65	Pit lighting 50 lux in the working area.
66	Border Between adjacent pit provided.
67	Safety stickers.
68	CWT screen guard

PICTURES

S- Satisfactory R – Recommendation D – Deficiency N/A- Not applicable
Observations / additional comments relative to this thorough examination:

General Disclaimer: This report shall not be reproduced except in full, without the written approval of Mithaq Standards. Any alteration or repair made to the equipment after inspection renders this report null and void; the equipment must be retested. Under no circumstances shall Mithaq Standards be liable for any injury or damage to persons or equipment occurring due to negligent operation. Inspections marked with (SC) denote subcontracted activities. This report relates only to the item(s) inspected according to the specified standard method(s) and clause(s). Mithaq Standards declares no actual, potential, or perceived conflict of interest regarding this inspection and undertakes to carry out its duties with the highest degree of objectivity and integrity.
Result of Examination (Conformity Statement):[ ] PASS: The equipment is safe to operate and complies with the specified standards.[ ] FAIL: The equipment has critical defects, does not comply with standards, and is NOT safe to operate.
Date of Next Inspection:	Previous Inspection Certificate:
Inspected By	Reviewed by
Name:	Name:
Signature:	Signature:
Date:	Date:

GENERAL INFORMATION
Relevant Standard	ISO 3691-2:2023, ISO 2330:2002	Date of Inspection
Client Details
Contact Name and Number
Location of Equipment
Type of Inspection
EQUIPMENT DETAILS
Equipment Description
Name of the Manufacturer		Chassis No.
Manufacturing Year		Engine Serial No.
Model		Traffic Plate No.
Serial No.		Rated Capacity
Power Source		Chain type
Lifting Height		Std. fork/attachment length

NO	Description	Remarks	Comment
Documentation
1	Equipment Document
2	maintenance record
3	previous inspection record
4	Cabin condition
5	Sharp edges
6	Chassis integrity
7	Starting & movement
8	Parking brake
9	Steering
10	Travel controls
11	Engine System
12	Hydraulic System
13	Cooling system
14	Fuel system
15	Exhaust system
16	Marking
17	Cracks / welds
18	Shank angle (±3°)
19	Blade thickness (10% wear)
20	Tip height difference (≤3%)
21	Chain condition
22	Corrosion / cracked plates
23	Chain elongation (≤3%)
24	Equal tension
25	Safety Devices
26	Overhead guard
27	Seat belt
28	Horn
29	Lights
30	Mirrors
31	Fire extinguisher
32	No excessive tilt
33	Reverse alarm
34	Functional Test
35	Lift / lower
36	Tilt forward/back
37	Side shift
38	Main cylinder creep
39	Tilt cylinder creep
40	Load Test
41	load chart
42	devices towing
43	Mast vertical
44	Footstep
Photos
S - Satisfactory R - Recommendation D - Deficiency N/A - Not applicable

Was the Examination Carried out?	☐ 6 months interval ☑ 12 months interval ☐ According to Examination scheme ☐ Occurrence of Exceptional circumstances
Identification of any part found to have a defect which is or could become a danger to persons and a description of the defect?
*Is the above an existing or imminent danger to persons Note-This is a reportable defect**
Is the above a defect which is not yet but could become a danger to persons
Particulars of any repair, renewal or alteration required to remedy the defect identified above

General Disclaimer: This report shall not be reproduced except in full, without the written approval of Mithaq Standards. Any alteration or repair made to the equipment after inspection renders this report null and void; the equipment must be retested. Under no circumstances shall Mithaq Standards be liable for any injury or damage to persons or equipment occurring due to negligent operation. Inspections marked with (SC) denote subcontracted activities. This report relates only to the item(s) inspected according to the specified standard method(s) and clause(s). Mithaq Standards declares no actual, potential, or perceived conflict of interest regarding this inspection and undertakes to carry out its duties with the highest degree of objectivity and integrity.
Result of Examination (Conformity Statement):[ ] PASS: The equipment is safe to operate and complies with the specified standards.[ ] FAIL: The equipment has critical defects, does not comply with standards, and is NOT safe to operate.
Date of Next Inspection:	Previous Inspection Certificate:
Inspected By	Reviewed by
Name:	Name:
Signature:	Signature:
Date:	Date:

GENERAL INFORMATION
Report No.		Date of Inspection
Relevant Standard	SASO-ISO-9927-1:2014 BS 7121-2-3:2012 ASME B30.5 :2021
Client Details
Contact Name and Number
Location of Equipment
Type of Inspection
EQUIPMENT DETAILS
Description of Equipment
Name of the Manufacturer		Traffic Plate No.
Manufacturing Year		Main Wire rope
Model		Auxiliary Wire rope
Serial No.		Auxiliary Hook Block capacity
Power Source		Max Boom Length
Main Hook Block capacity		Number of Falls
Chassis No.
Max Crane Capacity with full Configuration is ______	Current Crane Capacity with Radius______ & Boom Length ______ is_________

NO	Description	Remarks	Comment
Documentation
1	Equipment document
2	previous inspection record
3	To ensure safe operation of cranes, the proper working and operational conditions shall be maintained.
4	Load Rating Chart
5	Horn
6	Reverse Alarm
7	Lights (head Light, reverse light, Brake light, Indicators, signal light, Revolving beacon)
8	Cabs
9	Stability (Backward and Forward)
10	braking systems
11	Hydraulic system
12	Tires
13	Chassis
14	Outriggers
15	Crane Travel
16	Travel Brakes and Locks
17	Limiting and indicating devices
18	Safety switches
19	controls and emergency stop
20	Booms
21	Wire ropes
22	Sheaves
23	Hook
24	Anti-Two block
25	load test
Photos
Photos
S - Satisfactory R - Recommendation D - Deficiency N/A - Not applicable

Was the Examination Carried out?	☐ 6 months interval ☐ 12 months interval ☐ According to Examination scheme ☐ Occurrence of Exceptional circumstances
Identification of any part found to have a defect which is or could become a danger to persons and a description of the defect?
*Is the above an existing or imminent danger to persons Note-This is a reportable defect**
Is the above a defect which is not yet but could become a danger to persons
Particulars of any repair, renewal or alteration required to remedy the defect identified above

General Disclaimer: This report shall not be reproduced except in full, without the written approval of Mithaq Standards. Any alteration or repair made to the equipment after inspection renders this report null and void; the equipment must be retested. Under no circumstances shall Mithaq sssThis report relates only to the item(s) inspected according to the specified standard method(s) and clause(s). Mithaq Standards declares no actual, potential, or perceived conflict of interest regarding this inspection and undertakes to carry out its duties with the highest degree of objectivity and integrity.
Result of Examination (Conformity Statement):[ ] PASS: The equipment is safe to operate and complies with the specified standards.[ ] FAIL: The equipment has critical defects, does not comply with standards, and is NOT safe to operate.
Date of Next Inspection:	Previous Inspection Certificate:
Inspected By	Reviewed by
Name:	Name:
Signature:	Signature:
Date:	Date:

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Client: aaa
Process Title: saso
#: INS-00008
Inspector: Quality Admin

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