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HomeMy WebLinkAbout10050 W. 41st AvenueCITY OF WHEAT RIDGE .AA01-Ap ,w- Building Inspection Division (303) 234-5933 Inspection fin (303) 235-2855 Office - (303) 237-8929 INSPECTION NOTICE Inspection Type ile, t4 Job Address Permit Number Inspector No one available for inspection : Time - AM/PM � . * 10 < \ W 2 « 0 1 0 1 WiM I Z MF Inspected by Code Consulting LLC rl �- I I M- MMERM= NOTOM's I Emimm IM IN Expiration Date 2/112014 West Denver Properties, LLC 14590 W. Amnerst Pl. Lakewood, CO 80228 To: West Denver Propertie C 14590 W. A Lakewood , invoice. U�s m Location #: 44 Address: 10050 W. 41 st AV] Elevator R ' • �, I �M- 0 �#- 0 1 . . mm� M F-xpiration Date: 2/1/2013 •!, Amnerst Pl. Lakewood, CO 80228 Inspected by 689*1""'o Code Consulting LLC City of Wheat Ridge Municipal Building 7500 W. 29"' Ave, March 2"", 2012 West Denver Properties Attn: Elevator/Escalator Owner or Managing Agent 14590 W. Amherst P1. Lakewood, CO 80228 RE: Elevator/Escalator Registration Dear Elevator/ Escalator Owner or Managing Agent: Wheat Ridge, CO 80033-8001 P: 303.2352855 F: 303.2 37,8929 As you may or may not be aware, DRCOG's (Denver Regional Council of Governments) Elevator/Escalator Inspection Program ceased operations as of December 31 ", 201 In order to ensure the safe use by the public of the elevators in VVheat Ridge, each elevator is thoroughly inspected for specific safety requirements twice a year. The Elevator/Escalator Safety Inspection Program will now be administered by Colorado Code Consulting LLC. qypipiliqll iip�li 1111 I 11i ml I Ut It I I I I Is at I(I V'o I I Luc ts, V I SIL 717 3737V oi CIIA TYATT71 MilTY'S no rumic Safety website. If you have any questions feel free to contact the office at (303)235-2855. am= www.&wheatridge.co.us City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 303-237-8929 To West Denver Pro pertie C 14590 W. A erst PC. Aii Lakewood Please feel free to co ions regarding your invoice. I " IVRQ ' mmiF pIRt Location Address: 10050 W. 41 st AV] Elevator City of �WhcatR,�jgc -LopmET COMMUNi N Ty DiEvr- www.d.whea tai dge.coms L • a # 0 * Rol i T so o Caruso Family Partne, LLpi v 7100 W. 44t e Wheat Ridgel, V 0 e. St 1 033 w ## # IN invoice. U�• rr Location #: 44 Address: 10050 W. 41 st AV] Elevator ID: I NUM I 41M Bwilding Dppartment This is to certify that the eldVator as ihdicat this certificate has been d 2 inspected on the 'shown below and was oun safe to carry 1 1 bs. ON Inspected by 1)40"egional Council of Governmeff(DRCOG) MEEMMUM M , MMUMM 14 NMEEM�# I - I Caruso Family Partnership, LLP 7100 W. 44th Ave. Ste. 101 Wheat Ridge, CO 80033 L # 0 , * IM01#11 To: Caruso Family PartnerAip, LL 7100 W. 44th I Wheat Ridge,�:'-'80033 Please feel free to co invoice. ME= M 0 RK iwl � I �� I rp Location #.- 44 Address: 10050 W. 41 st Ave. Elevator INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 Date: 12/4/2009 To: Caruso Family PartnerE(h, ip, LLPA 101A 7100 W. 44th -Ave. Ste. 1 A1 Wheat Ridge, 0033 =- A Your annual elevator inspection fee of $210 isftfor,locatio located at 10050 W. 41st Ave. in Woobt Rjd - Id dg !Ot IN Aw�= ITng M ­MW Please remit Please feel free to invoice. Thank you, 1, if n # 44 elevator ID: I regarding your Please detach and send this stub in with your payment. Location #: 44 Address: 10050 W. 41 st Ave. Elevator ID: 1 Amount due: $21 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 By ilding Department A. This is to certify` s in �at the etor adicate,$ - -n this certificate has been inspected on the d shown below and wA ound safe to carry 2100 lbs. u Inspected by De V egional Council of Governmei Location Number: Building Name: Location: 1 ID Number: ElevatorTvpe: HP Safety Inspection Date: 4/29/2010 Elevator Inspection Date: 4129/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Caruso Family Partnership, LLP 7100 W. 44th Ave. Ste. 101 Wheat Ridge, CO 80033 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave Wheat Ridge, CO 80033 Building Department � Mk This is to certify that the ele "vator as indicated =on this certificate has been inspected on the aWshown below and waMund safe to carry 2100 lbs. Inspected by De? ver� Council of Governmeff (DRCOG) Location Number: Building Name: Location: ID Number: 1" ElevatorType: HP Safety Inspection Date: 4/1/2009 Elevator Inspection Date: 4/112009 Certificate Issue Date: 311/2010 Expiration Date: 2/1/2011 Caruso Family Partnership, LLP 7100 W. 44th Ave. Ste. 101 Wheat Ridge, CO 80033 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certify at the a evator as indicaten this certificate has been inspected on the dq - hown below and wa ,ound safe to carry 2100 lbs. Safety Inspection Date: 4/112009 Elevator Inspection Date: 4/1/2009 Certificate Issue Date: 511/2009 Expiration Date: 21112010 Caruso Family Partnership, LLP 7100 W. 44th Ave. Ste. 101 Wheat Ridge, CO 80033 Inspected by De Regional Council of Governme (DRCOG) INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 - 235 -2857 Date: 12/15/2008 To: Caruso Family Partners ' , LLP 7100 W. 44th Ave. 'Ste, t Wheat Ridge, $0033 Your annual elevato inspection fee of $210 is locati located at 10050 W. 41st Ave. in W t t Please remit payment] ter tha _ w . ary 1, 2 # 44 elevator ID: 1 regarding your Thank you, Mai Please detach and send this stub in with your payment. Location #: 44 Address: 10050 W. 41 st Ave. Elevator ID: 1 Amount due: $210 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certify that the elevator as indicatedion this certificate has been inspected on the date shown below and was'.found safe to carry 2100 lbs. Inspected by Denveh `Regional Council of Government (DRCOG) Location Number: 44 Building Name: Garuso Kitchen Location: 10050'W 41stq s >G ID Number: ...... Elevator Type: HP Safety Inspection Date: 6/..107 Elevator Inspection Date: 4/24/2008 Certificate Issue Date: 211/2008 Expiration Date: 2/1/2009 Caruso Family Partnership, LLP 7100 W. 44th Ave. Ste. 101 Wheat Ridge, CO 80033 _v N C L o N m ° m co 0 o CD CD j z a CD 0 6 ce = n N ' a a� z E s n N so N o � I ID m /D 0 b o GL BUILDING ADDRESS �IQS OWNER ADDRESS CITY ZIP CODE PHONE IAUMBER ` AUFACTURE UNIT NUMBER HHRAULIC CABLE ( ESCALATOR DUMBWAITER I , (�i} PASS [ ] PASS I [ ] a"U-e'1 FRT [ ] FRT LAST SAFETY TEST NEXT DUE DATE CONDITION DATE INSTALLED CAPACITY } ` I RECOR SPECTIONS / l 9 AJ' Q V& w 211(0 /o q// 1 ©l2l � it /Z / or/ /3 p /o/ l.�/ 1,Y/ °SAN L G / `�/ IA M / 9 l° l z� /�I �✓� e CITY OF ELEVATOR INSPECTION �J DING DESCRIPTION .r(._CbJ% --� Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2100 lbs Inspector: Bill Gardner ID NUMBER TYPE SAFETY 10050 W. 41stAve. 1 HP 6/../07 Caruso Family Partnership, LLLP 7100 W. 44th Ave. Ste, 101 Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 10/24/06 2/1/07 2/1/08 Caruso Family Partnership, LLLP 7100 W. 44th Ave. Ste. 101 Wheat Ridae. CO 80033 ZARLENGO R RAUB LLP January 20, 2007 City of Wheat Ridge 7500 West 29 Ave Wheat Ridge, CO 80033 CERTIFIED PUBLIC ACCOUNTANTS AND BUSINESS ADVISORS 50y5'A`RSOFSERVICE 1956° 24)06 RE: Caruso Family Partnership, LLLP, (Formerly K &P Properties) Property/Elevator Location # 44 To Whom It May Concern: Please be advised K &P Properties has changed their name to Caruso Family Partnership, LLLP. Everything else remains the same. If you should have any questions regarding this matter please feel free to contact us. Thank you, Robert Zarlengo Zarlengo Raub LLP Managing company 303 - 421 -4775 DENNIS A. HEIN, CPA, CVA JUDY A. MARTILLARO, CPA ' TIMOTHY J. RAUB, CPA ' CAROL A. WILSON, CPA, CVA, CFD ' ROBERT J. ZARLENGO, CPA, CVA 7100 WEST44TH AVE - SUITE 101 - WHEAT RIDGE, COLORADO 80033 TEL303.421.4775 - FAX 303.420.3627 - WWW.ZARLENGORAUS.COM Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2100 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 10050 W': 41 st Ave. 1 HP 3/../05 K & P Properties Inspection Issue Expiration 10050 W. 41 st Ave. Date Date Date 11/13/05 2/1/06 2/1/07///////// // Wheat Ridge, CO 80033 K & P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 `AL- CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 K & P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Elevator ID # 1 Total Cost Due: $132.00 Iwo L Elevator Inspection For: 10050 W. 41 st Ave. Property /Elevator Location # 44 K & P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2100 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 10050 W. 41st Ave. 1 HP 3/../03 K & P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 10/28/03 2/1/04 2/1/05 K & P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2100 lbs Inspector Bill Gardner K ex P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 10/23101 1115/02 1/15/03 K ex P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 21001bs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 10050 W. 41st Ave. 1 HP 2/../01 K ar P Properties 10050 W. 41 st Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date "° '' `4/3/01 4/30/01 2/1/02 PLEASE R1 MRM MIS INVOICE S S WITH YOUR Phi VUENT Thank You City of Wheat Ridge 7500 W. 29th Ave. WheatRidge,'CO 80295 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 44 Elevator Address: 10050 W. 41 st Ave. 141 '` Total due: $120.00 00 City of Wheat Ridge _ Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80215 Er 1 ELEVATORS OR COMPANY ANNUALTEST <❑ ACCEPTANCE TEST HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) >f NAME OF BUILDING - LOCATION e H • !3 ?t ELEVATOR SERIAL N0. '° CITY & STATE (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR NO. CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR 420AI&AL RATED CAR SPEED a� 73' F.P.M. RATED CAPACITY a�� LBS. TYPE O F ELEVAT V1 RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI At 7.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEMENT REQUIRED NOT MORE THAN 6 YEAR INTERVAL. Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replacement Date — Hose Tagged With Replacement Date & SAE Type Condition of Reservoir Oil Physical Dimensions of Reservoir Make (3) Round Trips Before Setting Relief Valve ®: Test the relief valve setting by first inching the empty car up to engage the plunger stop ring, and then by applying additional pump pressure as required to check the setting. The maximum setting must be no greater than 125% of working pressure to comply with the American National Safety Code ANSI A17.1 Rule 1005 & 303. Relief Valve Setting Y10 P.S.I. (Should Be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve Setting P.S.I. (If Required) No Load Working Pressure: Up 140 P.S.I. � No Load Car Speed: Up - F.P.M. Down 1. ', F.P.M . . Relief Valve Sealed: NOTE: Code Requires Relief Valve Setting Be Sealed_ See Rule 1005 and locate car at any convenient level. Open the disconnect switch and locate the elevation of the platform with respect to a convenient reference. Do not shut off any valves in the line. Provide adequate timbers or pipe as well as safety slings to support car and load if entering the pit. Tank Oil Level At Start of Standing Test e Tank Oil Temperature At Start of Standing Test After a minimum of 15 minutes, note the positio .of the plafform with respect to the chosen reference. Length of Time Car Standing -Empty r`r"F,( _Amount Car Settled During Standing Period f° Oil Temperature At End of Standing Period ='% �`- Tank Oil Level At End of Standing Period Amount of Leakage At Packing During Test Condition of Piston Packing A NOTE: -A CHANGE IN CAR POSITION WHICH CANNOT BE ACCOUNTED FOR BY VISIBLE OIL LEAKAGE OR TEMPERATURE CHANGE OF THE OIL INDICATES A LEAK IN THE CYLINDER OR IN THE UNDERGROUND PIPING, AND NEED FOR FURTHER INSPECTION TESTS OR REPAIRS. Pres::Switch Rule 306.14 Tested *Heavy Load Working Pressure: Up P.S.I. *Heavy. Load Car Speed: Up F.P.M. Down �'' F.P.M. Normal and Final Terminal Stopping Devices Tested Standby (Emergency Battery Lowering) Power Operation Tested A` Power Door System Tested: Torque ` , r, # Kinetic Ft. # Emergency Terminal Speed Limiting Device Tested Was The Test Satisfactory: - Yes 1541 No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test Qndicate Name and TlOe) MECHANIC'S SIGNATURE A " SUPT. SIGNATURE -� _� /!.p -%✓� by Copy of this Report Given to Customer: Yes ❑ No 9f CUSTOMER'S SIGNATURE - Acceptance Test Only pc -@o-cs . WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK - ZONE COPY Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2100 lbs Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 10050 W. 41st Ave. 1 HP 21../01 K at P Properties 10050 W. 41St Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 10127100 10/31/00 10/31/01 CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303 - 235 -2855 INVOICE Date: ]an. 2, 2001 K 8t P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For 1 10050 W. 41st Ave. Total Cost Due: $120.00 Property /Elevator Location # 44 K at P Properties 10050 W. 41 st Ave. Wheat Ridge, CO 80033 PLEASE mmm 7wis iNvoicE srus wnw Youn PAYmt Atr Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80215 (303) 235 -2855 Please .call if you have any questions Property /Elevator Location # 44 Elevator Address: 10050 W. 41 st Ave. Total due• $120.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80215 Job Located at CDC U:) 1 have this day inspected this structure and these premises and have found the following violations of City and/or State laws gov- erning same: P�� You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. p Date } Inspector for Building Dept. DO NOT REMOVE THIS TAG FORM WR6 -22 BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE `co Correction Notice Job Located at 1� I have this day inspected th tats strstr cct re --and- these - premises and have found the following violations of City and/or State laws gov- erning same: You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. Date 5o2L , O t Inspector for Building Dept. DO NOT REMOVE THIS TAG .FORM WR6.22 Date : 5/10/99 Caruso Kitchen Designs, Inc. 10050 W. 41 st Avenue Wheat Ridge, CO 80033 Quantity 1 Description Elevator inspection for: 10050 W. 41 st Avenue Total Cost $90.00 Caruso Kitchen Designs, Inc. 10050 W. 41 st Avenue Wheat Ridge, CO 80033 ® ELEVATORS DOVER ELEVATOR COMPANY 0 ANNUAL TEST �7 HYDRAULIC INSPECTION &TEST a 11 ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATEI Q � � OFFICE NAME OF BUILDING _ * r N F LOCATION 7 rJ �• vt ELEVATOR SERIAL NO. CITY & STATE J (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 0 - BUILDING ELEVATOR N ) CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR ) e-T RATED CAR SPEED ) ZS F.P.M. RATED CAPACITY Z 0 � LBS. TYPE OF ELEVATOR RATED CAPACITY TEST TO COMPLY WITH AM ERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEMENT REQUIRED NOT MORE THAN 6 YEAR INTERVAL _11 1� Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. — J Iv Hose Replacement Date i 1 Hose Tagged With Replacement Date & SAE Type _ (i I - Con dition of Reservoir Oil � I� Physical Dimensions of Reservoir 3 1 Y Z-f x 41 Make (3) Round Trips Before Setting Relief Valve ED Test the relief valve setting by first inching the empty car up to engage the plunger stop ring, and then by applying additional pump pressure as required to check the setting. The maximum setting must be no greater than 125% of working pressure to comply with the American National Safety Code ANSI At 7.1 Rule 1005 & 303. Relief Valve Setting :39D P.S.I. (Should Be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve Setting P.S.I. (If Required) No Load Working Pressure: Up ZC) 0 P.S.I. No Load Car Speed: Up 124 F.P.M. Down J F.P.M. Relief Valve Sealed: e-S NOTE: Code Requires Relief Valve Setting Be Sealed. See Rule 1005 and locate car at any convenient level. Open the disconnect switch and locate the elevation of the platform with respect to a convenient reference. Do not shut off any valves in the line. Provide adequate timbers or pipe as well as safety slings to support car and load if entering the pit q e Tank Oil Level At Start of Standing Test (p Tank Oil Temperature At Start of Standing Test �17� After a minimum of 15 minutes, note the posi4on of the platform with respect to the chosen reference. ( t Length of Time Car Standing -Empty 1�+ Imo_ Amount Car Settled During Standing Period Oil Temperature At End of Standing Period 100 Tank Oil Level At End of Standing Period Amount of Leakage At Packing During Test ( ) 0 n 12 Condition of Piston Packing . C NOTE: A CHANGE IN CAR POSITION WHICH _ CANNOT - BE ACCOUNTED - FOR - BY - OIL LEAKAGE TEMPERATURE - CHANGE OF - _- THE OIL INDICATES A LEAK IN THE CYLINDER OR IN THE UNDERGROUND PIPING, AND NEED FOR FURTHER INSPECTION TESTS OR REPAIRS. Pres. Switch Rule 306.14 Tested *Heavy Load Working Pressure: Up P.S.I. *Heavy Load Car Speed: Up F.P own F.P.M. Normal and Final Terminal Stopping Devices Tested t Standby (Emergency Battery Lowering) Power Operation Tested !� Power Door System Tested: Torque ZO # Kinetic u + Ft. # Emergency Terminal Speed Limiting Device Tested ® Was The Test Satisfactory: Yes ® No ❑ If not explain- �- 'EXL 1 C C 6\ Representatives of the Insurance Company, City or State Inspector or Owner, Present at test: Qndicate Name MECHANIC'S SIGNATURE SIGNATURE Copy of this Report Given to Customer: Yes ❑ No [F CUSTOMER'S SIGNAT RE .'Acceptance Test Only oc -60 -GS WHITE - BRANCH COPY YELLOW - CUSTOMFR cnpv Dlnit! - 7MIC nnov e ' o ELEVATORS DOVER ELEVATOR COMPANY -I] ANNUAL TEST - HYDRAULIC INSPECTION & TEST } c - ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE g f OFFICE C i - -� NAME OF BUILDING K -t_ LOCATION � ;G � �-' � � )�` I" i�`E ELEVATOR SERIAL NO. r.- ef, < -! -, a 1 CITY & STATE L-+ -- 1 -n 1 4e, (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. -q O 3 -I ! 0 � BUILDING ELEVATOR NO. CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATO 0 III RATED CAR SPEED F.P.M. RATED CAPACITY (} LBS. TYPE OF ELEVATOR 2 RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONALSAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEMENT REQUIRED NOT MORE THAN 6 YEAR INTERVAL. / 'A � , Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replacement Date Hose Tagged With Replacement Date & SAE Type ! 1f Condition of Reservoir Oil r 1 Physical Dimensions of Reservoir = I , 7 -1 l Make (3) Round Trips Before Setting Relief Valve'- Test the relief valve setting by first inching the empty car up to engage the plunger stop ring, and then by applying additional pump pressure as required to check the setting. The maximum setting must be no greater than 125% of working pressure to comply with the American National Safety Code ANSI At 7.1 Rule 1005 & 303. Relief Valve Setting %` /i P.S.I. (Should Be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve Setting P.S.I. (If Required) No Load Working Pressure: Up Z-0 0 P.S.I. No Load Car Speed: Up 1 i'_ F.P.M. Down -t F.P.M. .Relief Valve Sealed: 1_ : NOTE: Code Requires Relief Valve Setting Be Sealed. See Rule 1005 -and locate car at any convenient level. Open the disconnect switch and locate the elevation of the platform with respect to a convenient reference. Do not shut off any valves in the line. Provide adequate timbers or pipe as well as safety slings to support car and load if entering the pit. Tank Oil Level At Start of Standing Test ! i r Tank Oil Temperature At Start of Standing Test / t! After a minimum of 15 minutes, note the positi of the atform with respect to the chosen reference. Length of Time Car Standing -Empty 6' 3 ,ru"o , !'. Amount Car Settled During Standing Period X1 >^ 4 Oil Temperature At End of Standing Period Tank Oil Level At End of Standing Period _ �� Amount of Leakage At Packing During Test 1/ r1.,�, Condition of Piston Packing n/ ' NOTE: A CHANGE IN CAR POSITION WHICH CANNOT BE ACCOUNTED FOR BY VISIBLE OIL LEAKAGE OR TEMPERATURE CHANGE OF THE OIL INDICATES A LEAK IN THE CYLINDER OR IN THE UNDERGROUND PIPING, AND NEED FOR FURTHER INSPECTION TESTS OR REPAIRS. Pres. Switch Rule 306.14 Tested -� Al *Heavy Load Working Pressure: Up l/ ' A �'., P.S.I. *Heavy Load Car Speed: Up F.P Down F'I ✓/ F.P.M. Normal and Final Terminal Stopping Devices Tested 4 Standby (Emergency Battery Lowering) Power Operation Tested Power Door System Tested: Torque -- l) # Kinetic Ft. # Emergency Terminal Speed Limiting Device Tested: El , --r Was The Test Satisfactory: Yes jZ No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test: MECHANIC'S Copy of this Report Given to Customer: Yes ❑ NOR] 'Acceptance Test Only DC -W -GS WHITP - RRAIUCW rYIOv SUPT. SIGNATURE CUSTOMER'S iC) CD 0O C Ca 0O cCD A i 1 N (p OD❑ CD co N O °m� w N CA) 0 E N m " o' f O O 0 ° r O D c D O Z CD CD CD O c Z m W m 2 T m Z V! cn _ N N CD N CD O CD C CD O j N 3 f O O 0 ° r O D c D O Z CD CD CD O c Z m W m 2 T m Z V! N CD CD O O N 3 N (D 0 N Qo W 0 0 c 0� ^ O ` , n CD (D N (D = (D W :E C �o r CD v � 0 w N ^ Y ) CD � 3 Q NQ D 60 �N o cn m 6(D Z p a 0 ' -q Z A CD v ° o z 3 CD O. N O (T OC EF i y/ E . . \/ . CD �¥} 7 \ c : CD . o /? \ 0 ;v o <= .o _ \E § %f \ j E; . 0 / k \ \\ m /�� - $ ( D 2 . . .( . « / � (< \ B \.D _ 0 ( 2\ J O o ' -0 5 - h a � z .f = . /& » § § = k� _2 .� � U) .0 � R m � CL= / § ƒ m . .} m i � ..§ � 2 )� ^0 Co ® . 0 CD W m« %\$ cr - m 0M . �7� 0W . \ -1 3 \ m .