Manufacturer: Model: Evaluation Performed By: INTRODUCTION: This checklist will enable the user to make an objective appraisal of the condition of the equipment. Given the variety and complexity of the equipment, many of the questions may not apply. When completing this form, rate each of the items using one of the three columns provided. Enter N/A in those columns that do not apply to the installation being evaluated. NOTE: The following items correlate to the NEII Maintenance Guidelines. The number in the Paragraph column corresponds with the Paragraph number in the Maintenance Guidelines. Cross references in the maintenance guidelines are reflected in the details column. Above INSIDE CAR 1 Emergency lighting in place and operating (refer to 3.3) 12.17.1 Elevator door operation (refer to 8.0) 12.5 2 Adjustment for quiet and smooth operation code compliance, 12.5.1 reversal satisfactory (refer to 8.1.1) 3 Car door guides condition, tight fastenings, sill condition and 12.5.1 engagement (refer to 8.3.1) 4 Noise level quiet, pivot wear, fastening tight (refer to 8.2.1) 12.5.1 Fixtures, indicators and buttons (refer to 9.0) 12.15 5 Buttons & key switches legible markings (refer to 9.1.1) 12.15.1 6 Buttons & key switches free from sticking and plugging (refer to 12.15.1 9.1.2) 7 Damaged buttons & key switches replaced (refer to 9.1.3) 12.15.1 8 Lamps replaced, long life substitutes in use (refer to 9.2.1) 12.15.1 9 Indicator lens condition satisfactory (refer to 9.2.2) 12.15.1 10 Audible signals operating (refer to 9.2.3) 12.15.1 11 Faceplates in place, plumb square (refer to 9.3.1) 12.15.1 12 Proper fastening screws (refer to 9.3.2) 12.15.1 Elevator Control System (refer 10.0) 12.16 13 Acceleration and stopping smooth (refer to 10.1.1) 12.16.1 14 Safety circuits tested, mechanical components condition (refer 12.16.2 to 10.2.1) Owner responsibility (refer to 4.0) 12.17 15 Side exits locked - keys storage (refer to 4.7) 12.17.1 16 Door, frames, etc. repaired correct door space requirement to 12.17.1 conform to ASME A17.3, Paragraph 3.4.3 (refer to 4.8) 17 Communication systems (refer to 4.13) 12.17.1 MACHINERY SPACES, MACHINE ROOM, CONTROL SPACES AND CONTROL ROOM 18 Equipment numbered (refer to 3.1) 12.17.1 19 Grounds and bonds in place (refer to 3.2) 12.17.1 Cleanliness (refer to 6.0) 12.2 20 Machinery spaces, machine room, control spaces, control 12.2.7 room & equipment general condition (refer to 6.4.1) 21 Motor (refer to 6.4.2) 12.2.7 Page 7-18 29-Nov-11
Above 22 Condition of windings (refer to 6.4.3) 12.2.7 23 Oil tank covered 12.2.8 24 Storage area (refer to 6.5.1) 12.2.9 Loss of hydraulic fluid 12.3 25 Personnel aware of environmental rules 12.3.1 26 Fluid loss record 12.3.2 27 Tank fluid level 12.3.3 Lubrication (refer to 7.0) 12.4 28 Elevator lubrication proper lubricants, schedules, clean (refer to 12.4.1 7.1) 29 Suspension means clean and lubricated as directed by 12.4.1 elevator manufacturer (refer to 7.6) 30 Non-metallic sheave liners - proper lubricant in use (refer to 12.4.1 7.7) 31 Governor ropes clean no lubricant added (refer to 7.9) 12.4.1 32 Safety, linkages, governor tension sheave and frame (refer to 12.4.1 7.10) General condition and adjustment 12.6 33 Sheaves grooving wear or damage (refer to 11.2.1) 12.6.1 34 Sheave keys and shrink fits satisfactory (refer to 11.2.2) 12.6.1 35 Pulley & coupling shaft fits secure (refer to 11.3.1) 12.6.2 36 Pulley & coupling flexible couplings, condition (refer to 12.6.2 11.3.2) 37 Pulley surface, smooth, minimum scoring (refer to 11.3.3) 12.6.2 38 Pump seal leakage 12.6.3 39 Valves, hoses and piping code compliant 12.8 40 Valve tests and adjustment 12.8.1 41 Oil leakage in system high pressure hose-date 12.8.2 Motor, sound isolation 12.9 42 Motor bearings run quiet and cool (refer to 11.5.1) 12.9.1 43 Motor electrical connections tight, No discoloration (refer to 12.9.1 11.5.3) 44 Motor proper rotor clearance (refer to 11.5.4) 12.9.1 45 Motor insulation resistance check (refer to 11.5.8) 12.9.1 46 Sound isolation pads in good condition (refer to 11.6.1) 12.9.1 47 Kick angles and tie downs (refer to 11.6.2) 12.9.1 Governor system (refer to 11.12) 12.13 48 Governor clean and lubricated, linkage condition, bearing 12.13.1 condition (refer to 11.12.1) 49 Governor seals and test tags in place (refer to 11.12.2) 12.13.1 50 Suitable governor marking plate in place (refer to 11.12.3) 12.13.1 51 Painting should not interfere with governor operation (refer to 12.13.1 11.12.4) 52 Governor switch operation (refer to 11.12.5) 12.13.1 53 Fly ball clearance (refer to 11.12.6) 12.13.1 54 Governor rope hitches condition, governor rope tag (refer to 12.13.1 11.12.7) Control system 12.16 55 Static motion control, safety requirement (refer to 10.2.2) 12.16.2 29-Nov-11 Page 7-19
Above 56 Fuses proper rating and type (refer to 10.2.3) 12.16.2 57 Switch gear worn or maladjusted contacts replaced or 12.16.2 corrected (refer to 10.3.1) 58 Switch gear shunts in good condition (refer to 10.3.2) 12.16.2 59 Switch gear no contacts blocked, residual guards and 12.16.2 shading coils okay, pivots lubricated, kickoff springs in place, encapsulated relay condition (refer to 10.3.3) 60 Switch gear - overload relays tagged with test data. Dashpots 12.16.2 (if used) free to operate, oil level satisfactory (refer to 10.3.4) 61 Switch gear - Switches operate smoothly, quietly (refer to 12.16.2 10.3.5) 62 Selector traveling cables and terminations (refer to 10.4.1) 12.16.2 63 Selector brushes, cams and contact condition (refer to 10.4.2) 12.16.2 64 Selector mechanical condition, keys set screws, pins (refer to 12.16.2 10.4.3) 65 Selector gears, chains, lubricated, in good condition, drip pans 12.16.2 provided (refer to 10.4.4) 66 All connections tight, no heating (refer to 10.5.1) 12.16.2 67 Controller and selector cleanliness (refer to 10.5.2) 12.16.2 69 Resistors, grids, wiring and band condition (refer to 10.5.3) 12.16.2 70 Resistors, capacitors, good condition, properly mounted (refer 12.16.2 to 10.5.4) 71 Wiring neat, bundled, terminals labeled (refer to 10.5.5) 12.16.2 72 Wiring diagrams, current, condition (refer to 10.7.1) 12.16.2 72 Main line disconnect per NFPA 70 (refer to 4.1) 12.17.1 73 Access doors, locked and keys stored properly (refer to 4.2) 12.17.1 74 Illumination, machine room and pit GFCI receptacles - Pit 12.17.1 light guarded (refer to 4.4) 75 ABC fire extinguisher in machinery spaces, machine room, 12.17.1 control spaces and control room (refer to 4.5) 76 Machinery spaces, machine room, control spaces and control 12.17.1 room environment (refer to 4.9) 77 Smoke detector main line disconnecting means required with 12.17.1 machine room sprinklers (refer to 4.10) 78 Test tags and seals (refer to 4.11.1) 12.17.1 79 Suspension means, rope tags (refer to 4.11.2) 12.17.1 80 Code data plates (refer to 4.11.3) 12.17.1 TOP OF CAR Cleanliness (refer to 6.0) 12.2 81 Car top (refer to 6.1.1) 12.2.1 82 Hoistway rails (refer to 6.3.1) 12.2.6 Lubrication (refer to 7.0 & 12.4.2) 12.4 83 Elevator lubrication - proper lubricants, schedules, clean (refer 12.4.1 to 7.1) 84 Guide shoes, pivots, stems, etc. (refer to 7.2) 12.4.1 85 Rails with roller guides - no lubrication (refer to 7.3) 12.4.1 86 Rails with slide guides - lubricant suitable for safeties (refer to 12.4.1 7.4) Page 7-20 29-Nov-11
Above 87 Car safeties - rails free of oxidized lubricants (refer to 7.5) 12.4.1 88 Suspension means clean and lubricated as directed by 12.4.1 elevator manufacturer (refer to 7.6) 89 Governor ropes clean, no lubricant added (refer to 7.9) 12.4.1 Elevator door operation (refer to 8.0) 12.5 90 Door gib condition, tight fastenings, sill condition and 12.5.1 engagement (refer to 8.3.1) 91 Tracks, rollers, bearings general condition and lubrication (refer 12.5.1 to 8.3.2) 92 Up thrusts (refer to 8.3.3) 12.5.1 93 Door closers (refer to 8.3.4) 12.5.1 94 Tracks smooth (refer to 8.3.5) 12.5.1 95 Relating mechanisms (refer to 8.3.6) 12.5.1 96 Hydraulic checks condition (refer to 8.3.7) 12.5.1 97 Door operator should be clean, lubricated, minimum oil leaks - 12.5.1 condition 98 Door motor brushes (refer to 8.4.2) 12.5.1 99 Gear backlash keys, set screws or pin loose, belts worn, 12.5.1 improper adjustment (refer to 8.4.3) 100 Car door contact condition, adjustment (refer to 8.5.1) 12.5.1 101 Hoistway door interlocks proper operation (refer to 8.6.1) 12.5.1 102 Hoistway door interlocks condition, adjustment, wear (refer to 12.5.1 8.6.2) General condition and adjustment 12.6 103 Sheave grooving wear or damage (refer to 11.2.1) 12.6.2 104 Sheave keys and shrink fits satisfactory (refer to 11.2.2) 12.6.2 Suspension means and ropes (refer to 11.7) 12.10 105 Suspension means equalized (refer to 11.7.1) 12.10.1 106 Suspension means - proper fastenings installed (refer to 12.10.1 11.7.2) 107 Suspension means (refer to 11.7.3) 12.10.1 108 No lubrication on governor ropes (refer to 11.7.4) 12.10.1 109 Suspension means inspection (refer to 11.7.5) 12.10.1 110 Suspension means, clean, lubricated, as directed by elevator 12.10.1 manufacturer no corrosion, no slippage (refer to 11.7.6) 111 Antirotation devices installed 12.10.1 Governor system (refer to 11.12) 12.13 112 Governor rope hitches condition, governor rope tag (refer to 12.13.1 11.12.7) Rails & Brackets (refer to 11.13) 12.14 113 Rail bracket fastenings secure, support structurally sound 12.14.1 (refer to 11.13.1) 114 Clip bolts tight, sliding clips satisfactory, fishplates tight (refer to 12.14.1 11.13.2) 115 Rail alignment (refer to 11.12.3) 12.14.1 116 Rail blades rust free and unpainted spacing satisfactory (refer 12.14.1 to 11.12.5) Elevator control system (refer to 10.0) 12.16 117 Safety circuits tested, good mechanical condition (refer to 12.16.2 10.2.1) 29-Nov-11 Page 7-21
Above 118 Traveling cables, condition, attachment, protection provided 12.16.2 (refer to 10.6) 119 Car top exit openable from outside only (refer to 4.6) 12.17.1 120 Test tags and seals (refer to 4.11.1) 12.17.1 121 Suspension means and rope tags (refer to 4.11.2) 12.17.1 OUTSIDE HOISTWAY Elevator door operation (refer to 8.0) 12.5 122 Adjustment (refer to 8.1) 12.5.1 123 Quiet and smooth operation, code compliance, reversal 12.5.1 satisfactory (refer to 8.1.1) 124 Noise level quiet, pivot wear, fastenings tight (refer to 8.2.1) 12.5.1 Fixtures, indicators and buttons (refer to 9.0) 12.15 125 Button & key switches legible markings (refer to 9.1.1) 12.15.1 126 Button & key switches free from sticking and plugging (refer to 12.15.1 9.1.2) 127 Button & key switches - damaged buttons replaced (refer to 12.15.1 9.1.3) 128 Indicator & signal lamps replaced, long life substitutes in use 12.15.1 (refer to 9.2.1) 129 Indicator & signal lens condition satisfactory (refer to 9.2.2) 12.15.1 130 Indicator & audible signals operating (refer to 9.2.3) 12.15.1 131 Indicator & signal faceplates in place, plumb, square (refer to 12.15.1 9.3.1) 132 Indicator & signal proper fastening screws (refer to 9.3.2) 12.15.1 133 Unlocking device key storage (refer to 4.3) 12.17.1 134 Doors, frames etc. repaired (refer to 4.8) 12.17.1 135 Landing illumination (refer to 4.12) 12.17.1 PIT Cleanliness Refer to 6.0) 12.2 136 Pit dry, free from rubbish, rust removal, painting/repair required 12.2.2 (refer to 6.2.2) 137 Oil from pit container, properly removed 12.2.3 138 Scavenger pump protected, quantity returned monitored 12.2.4 Lubrication (refer to 7.0) 12.4 139 Elevator lubrication proper lubricants, schedules, clean (refer to 12.4.1 7.1) 140 Guide shoes, pivots, stems, etc. (refer to 7.2) 12.4.1 141 Rails with roller guides - no lubrication (refer to 7.3) 12.4.1 142 Rails with slide guides - lubricant suitable for safeties (refer to 12.4.1 7.4) 143 Car safeties rails free of oxidized lubricants (refer to 7.5) 12.4.1 144 Safety, linkages, governor tension sheave and frame (refer to 12.4.1 7.10) 145 Plunger, cylinder and packing 12.7 146 Cylinder single bottom (see note) 12.7 147 Inspect or test cylinder 12.7.1 Page 7-22 29-Nov-11
Above 148 Plunger finish, packing gland area clean 12.7.2 149 Test cylinder protection means 12.7.3 150 Examine exposed cylinders 12.7.4 151 Valves, hoses and piping code compliant 12.8 152 Oil leakage in system high pressure hose-date 12.8.2 Ropes (refer to 11.7) 12.10 153 Runbys satisfactory (refer to 11.7.9) 12.10.1 Buffers (refer to 11.10) 12.11 154 All buffers secured in proper position (refer to 11.10) 12.11.2 Safeties (refer to 11.11) 12.12 155 Safety mechanisms, free of rust, dirt, lubricated, proper safety 12.12.1 jaw clearance (refer to 11.11) Governor system (refer to 11.12) 12.13 156 Governor tension frame, free vertical movement, bearing and 12.13.1 sheave condition, stops properly adjusted (refer to 11.12.8) Elevator control system (refer to 10.0) 12.16 157 Safety circuits tested, good mechanical condition (refer to 12.16.2 10.2.1) 158 Access doors, locked and keys stored properly (refer to 4.2) 12.17.1 159 Illumination, machine room and pit - GFCI receptacles - Pit 12.17.1 light guarded (refer to 4.4) 160 Code data tags (refer to 4.11.3) 12.17.1 MISCELLANEOUS 161 Scope (refer to 2.0) 12.1.1 (a) Written maintenance control plan (b) Trained personnel (c) Plan execution 162 Managed maintenance system in place and being used (refer 12.17.1 to 3.4) 163 Equipment Record (Refer to 3.5) 12.17.1 Elevator cleanliness (refer to 6.0) 12.2 164 Proper fluid disposal 12.2.5 165 Storage area (refer to 6.5) 12.2.9 166 Unlocking device key storage (refer to 4.3) 12.17.1 167 Communication system (refer to 4.13) 12.17.1 Define contract responsibilities (refer to 5.0) 12.17 168 Code and safety tests (refer to 5.1) 12.17.1 169 Test and callback records (refer to 5.2) 12.17.1 170 Environmental regulations compliance (refer to 5.3) 12.17.1 171 Firefighters service test record (refer to 5.4) 12.17.1 172 Underground hydraulic systems test (refer to 5.5) 12.17.1 29-Nov-11 Page 7-23