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Home My WebLink About3655 Luthern Parkway- 111 1111; 51 � - a HOT � �ililil r i1 tl Inspected by C 1 o Code Consulting LLC mms s� I ► mmummm Expiration Date: 2/1/2014 Lillibridge i--.rAn-Pkm, Wheat Ridge, CO 80033 all =��ilililll MOMEM • MINIMUM FN Expiration Date: 2/11/2014 Lillibridge mm- Wh•at Ridge, CO 80033 Inspected by C61 o Code Consulting LLC City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 Fax: 303-237-8929 U»»»§�< 1 111111 11111 j 111111 111111111111 , 1� 1 1111 IMITINIVIII '111M I ff!ili Location #* 1■ Address: 3655 Lutheran Pkwy Elevator ID: 1 City of Wheat Ridge Building Division 7500 W. 291hAVe. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lillibridge 3555 Luther Pkway. e #31 Wheat Ridge "W00033 �=Il UBE= rr Location #: 19 Address: 3655 Lutheran Pkwy Elevator ID: 2 m 50 tw1rj-r*w"V:1 IIIIIIIIII III!I111 III & . a a Inspected by C " o LL "' Code Consulting C MEMIS= a • i � mmomm Expiration Date 2/1/2013 Lutheran Med. Ctr. Engineering Derj 8300 W. 38th Ave, Wheat Ridge, CO 80033 » � \: � f f � � ± mmmw:»I°< mmumm Expiration Date : 2/1/2013 Lutheran Me d. Ctr. Engineering De 8300 W. 38th Ave. Wheat Ridge, CO ■0033 Inspected by Code Consulting LLC To: Lutheran Med. Ctr. En ring 8300 Wt Rid ve 9 , Whea " e, 0033 • . 0 0. • .. # IN TM. Nr#�= MOM rr ml• ,, III I • Location Address: 3655 Lutheran Pkwy Elevator m City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 # I U»�»< <,« MI-EP �-- � ■�& M#�< 1119 Location #: 19 Address* 3655 Lutheran Pkwy Elevator ID: 2 770TATIVI .. A* M- Building Dppartment "d 'n'01 This is to certify'th s, iddicatedI bn fl to has I. , the ef tor ' this certite been inspected on the 11611" , shown below and wa , and safe to carry 2500 lbs. moubm Expiration at 2/1/201E Lutheran Med. Ctr. Engineering Deu 8300 W. 38th Ave. Wheat Ridge, CO 80033 Regional Council of Governm RCOG) Inspected by Denvt� 0 t . . 0 # • M m �m i N M. Z 0 # - A Expiration Date: 2/1/201U Lutheran Me d. Ctr. Engineering Dept, 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by lie µi V"""' l Council of Gov emmehf , (DRCOG) To: Lutheran Med, Ctr. Enq',f ering pt. 8300 W. 38ftAve. Wheat Ridge, 0033 located at 3655 Lutheran Pkwy in,Wh'Oat,"- U V !11 ,nvoice. 0 s 0 * • 0 111111 1 1'11111l:�Jp� llili : Location 19 Address: 3655 Lutheran Pkwy Elevator Em 4 1 . . 0 • # • 0 • To: Lutheran Med. Gtr. En ring 8300 W. 38th Wheat Ridge, B0033 Your annual elev" inspection fee • 210isdue,forlocati located at 3655 Lutheran P at Uw� tt fl 10 • �70 lmn•.� Location 19 Address: 3655 Lutheran Pkwy Elevator Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building D partment k This is to cert ify` t the el ° ator as' ndica this certificate has been inspected on the d, shown below and wasbund safe to carry 2500 lbs. Safety Inspection Date: 7/7/2010 Elevator Inspection Date: 7/7/2010 Certificate Issue Date: 3/112010 Expiration Date: 2/1/2011 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De egional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Buildingepartment This is to certify -ba t the B ator a dicated , " n this certificate has been inspected on the c�a shown below and wa ound safe to carry 2500 lbs. _ —, Inspected by Dew Regional Council of Governme"(DRCOG) Location Number: Building Name: RMB Location: ID Number: Elevator Tvoe: HP Safety Inspection Date: 71712010 Elevator Inspection Date: 7/7/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 211/2011 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Dgpartment 7 µ This is to certify``tta t the ek for as iridicatedlMn this certificate has been inspected on the 8joE °shown below and wMund safe to carry 2500 lbs. Safety Inspection Date: 1/14/2010 Elevator Inspection Date: 1/14/2010 Certificate Issue Date: 311/2010 Expiration Date: 211/2011 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 i Inspected by D&NV& =Regional Council of Governmeh DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certify'that the eil'tor a indicated.M6n this certificate has been inspected on the dWshown below and wd'R safe to carry 2500 lbs. Safety Inspection Date: 1/14/2010 Elevator Inspection Date: 1114/2010 Certificate Issue Date: 3/112010 Expiration Date: 2/11/2011 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Dd Council of Governme r (DRCOG) invoice. A-V Thank you, INVOICE City of Wheat Ridge Building Division 7500 W. 29 th Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 Fax: 303-235-2857 Date: 12/4/2009 To: Lutheran Med. Ctr. Engft� ering Wept. 8300 W. 38th-.,,6.ve. Wheat Ridge, C , 60– 0033 1P SON j- Your annual elevat6f inspection fee of $210 is dUe-fo, r l # 19 eleval I " o located at 3655 Lutheran Pkwy iq,�atf M.. – c g qu - M dim A ll Please remit payment,446 that3ruary M Mt, ,!S – , tg M -1 Mg , Moil Please feel free to contact ourofffice if yger#a - #,, – U — stions regarding your Please detach and send this stub in with your payment. Location #: 19 Address: 3655 Lutheran Pkwy Elevator ID: I Amount due: $210 ID: I 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 A To: Lutheran Med. Ctr. Engr ering Q' ,,ept. 8300 W. 38th-, W 4 011 Wheat Ridge, 00 0033 4 - 1 -1 U.W Your annual elevator inspection fee of $210 is duejor location # 19 elevator ID: 2 located at 3655 Lutheran Pkwy in- Wheat ,R' Am AF ON _ Please remit payment Ad'16ter tha gg Please feel free to regarding your -e if yo o C06 ct 00 ice invoice. Thank you, Please detach and send this stub in with your payment. Location #: 19 Address: 3655 Lutheran Pkwy Elevator ID: 2 Amount due: $210 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave Wheat Ridge, CO 80033 Safety Inspection Date: 7/2512007 Elevator Inspection Date: 7125/2007 Certificate Issue Date: 51112009 Expiration Date: 2/1/2010 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De egional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Safety Inspection Date: 7/2512007 Elevator Inspection Date: 7/25/2007 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De egional 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 ID: 1 located at 3655 Lutheran Pkwy in , eat AM Please remit payment liter th y ary 1, Please feel free to invoice. if regarding your Thank you, i5'a"6yf Dcaca M Please detach and send this stub in with your payment. Location #: 19 Address: 3655 Lutheran Pkwy Elevator ID: 1 Amount due: $210 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 Please feel free to invoice. Thank you, oUMice if ERE regarding your Please detach and send this stub in with your payment. Location #: 19 Address: 3655 Lutheran Pkwy Elevator ID: 2 FOW 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 indicated on this certificate has been inspected on the date shown below and was found safe to carry 2500 lbs. Safety Inspection Date: 4/21/2002 Elevator Inspection Date: 7125/2007 Certificate Issue Date: 2/112008 Expiration Date: 2/1/2009 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DenveY Regional Council of Government (DRCOG) 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 indicated on this certificate has been inspected on the da,'fe shown below and was ; found safe to carry 2500 lbs. Inspected by DenVe""'Regional Council of Governmer",(DRCOG) Location Number: Building Name: M'OB I Location: ID Number: ElevatorTvoe: HP Safety Inspection Date: 4/21/2002 Elevator Inspection Date: 7/2512007 Certificate Issue Date: 2/112008 Expiration Date: 2/112009 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 � ELE V�}7'aRS � F, 1 9 �°-�e PY' �• .Qec�yo K '. NexK daye of -,,, �^WV� i :�a�¢ Ma -�✓ed re cei ved F �G [ins�O�c�e� I (- 8 ` lk F( qpq S a 5 -a - s- - i - 7 y S 74 1CY-1454 -19 cY: ku> -- ; L: n Ia Ilj i:� ,. Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue — Wheat Ridge, CO 80033 BU,- CITY OF WHEATRIDGE ELEVATOR INSPECTION ZIP CODE ZIP CODE BUILDING NAME M� V a n ,r -/ i . 7/ A PHONE MANUFACTURE UNIT NUMBER RAULIC CABLE h�� ESCALATOR DUMBWAITER PASS FRT J J PASS FRT 1 LAST SAFETY TEST _ NEXT DUE DATE MATERIAL LIFT �l DATE INSTALLED CAPACITY �� / ��' / wheelchair Iift l l a g� o C 4f RECORDED SP CCIONS - Z. q � _0 w DeY ,Yb- Dka2gop \ �� to d ) 7 -2-3- j- to —a4w CITY OF / GE DEPARTMENT OF COMMUNITY DEVEI ELEVATOR INSPECTIONS ESS CITY UVVJNGN - AUUHLSS ,36 z'� CITY ZIP ODE a — �iZ, 1 .mss MANUFACTURE UNIT NUMBER - t CITY OF / GE DEPARTMENT OF COMMUNITY DEVEI ELEVATOR INSPECTIONS ESS CITY UVVJNGN - AUUHLSS ,36 z'� CITY ZIP ODE a — �iZ, 1 .mss MANUFACTURE UNIT NUMBER CABLE /YLc�� / ,H- yY�'DRAULIC IMPASSE ER ED PASSENGER ❑GEA ❑FR HT ❑FREIGHT ❑GEA IpST_Rq FFTY TFST NF fH,IF.f1pTF _. CONDITION REI -50 6 T X 41 � Jt �� CF ffff 3117, y CITY OF UNIT NUMBER DEPARTMENT OF COMMUNITY DEVEL ELEVATOR INSPECTIONS ❑PASSENGER Cl PASSENGER ❑GEP BUILDING ADDRESS CITY ZIP CODE ❑FREIGHT El FREIGHT ❑GEP . ADDRESS CITY ZIP CODE MANUFACTURE UNIT NUMBER HYDRAULIC CABLE ❑PASSENGER Cl PASSENGER ❑GEP ❑FREIGHT El FREIGHT ❑GEP LAST SAFETY TEST NEXT DUE DATE CONDITION - RECORDED INSPECTIONS sz 2�� sz k C/ ��, 1 7� 1 1 2 6145K C � 4W Fag Lutheran Med.Ctr. Engnrg Dept CITY OF WHEATRIDGE 8300 W. 38th Avenue ELEVATOR INSPECTION BUI Wheat Ridge, CO 80033 TY ZIP CODE OWNER ADDRESS CITYor ZIP CODE MANUFACTURE UNIT NUMBER ^� HYDRAULIC PASS I I FRT CABLE Y)' I I PASS I I F . LAST SAFETY TEST y NEXT DUE DATE ly I I MATERIAL LIF M C / ZA � a ? ./ / [ ]wheelchair lift RECORD INSPECTIONS 3 IZ-v5'W J 1 liL� 7_. CITY Or , rZ6 DEPARTMENT OF COMMUNITY DEVEL( ELEVATOR INSPECTIONS 3 6s �Qr ILDING ADDRESS CITY ZIP CODE MANUFACT UNIT NUMBER Pd CABLE HYDRAULIC /2 y O 1al PASS ENGER ED PASSENGER ❑GEAR �l[(L C/ L� ❑FR EIG T ❑FREIGHT ❑GEAR LAST SAFETY TEST NEXT DATE CONDITION RECC C / 1 <2S , i MANUFACTURE UNIT NUMBER HYDRAULIC CABLE ❑ PASSENGER ❑ PASSENGER' ❑ GEAI ❑FREIGHT ❑FREIGHT ❑GEAI LAST SAFETY. TEST NEXT DUE DATE CONDITION 9a' % i7 /J RECORDED INSPECTIONS c ,aq; 9 C? ,z6 ■ CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 1 Elevator Inspection For: 3655 Lutheran Pkwy Total Cost Due: $132.00 Property /Elevator Location # 19 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 2 Total Cost Due: $132.00 Elevator Inspection For: 3655 Lutheran Pkwy Property /Elevator Location # 19 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th 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 2500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Pkwy 1 HP 4/21/02 Lutheran Med. Ctr. Engineering Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 1/13103 211/03 2/1104 Wheat Ridge, CO 80033 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th 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 2500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Pkwy 2 HP 4/21102 Lutheran Med. Ctr. Engineering Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 7/17/02 2/1/03 2/1/04 Wheat Ridge, CO 80033 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th 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 2500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Pkwy 1 HP 4/21/01 Lutheran Med. Ctr. Engineering Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 1/4/02 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th 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 2500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Pkwy 2 HP 4/21/01 Lutheran Med. Ctr. Engineering Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 1/4/02 2/7102 2/7103 Wheat Ridge, CO 80033 Lutheran Med. Ctr. Engineering Dept. 8300 W. 38th 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 2500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Pkwy 1 HP 4/21101 Lutheran Med. Ctr. Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 1/29/01 5/31/01 211/02 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 2500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Pkwy 2 HP 4/21101 Lutheran Med. Ctr. Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 1/29/01 5/31/01 211102 NC 1-8 VA ...... ..... ... ........ .. ... ........ . TO THE ORDER OF U.17HERN MEDICAL CENTER EXEMPLA MEDICAL GROUP I Cents CITY OF WHEAT RIDGE 7500 WEST 29TH AVENUE WHEAT RIDGE CO 80033 f ,Z u• L454 Lquo 404 1 20 38 241: 96. L 2-4681" X55 ��.m.�p� 14� - 2 Ac 1c) INS] LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 Date: 11/4/1999 Quantity Description Total Cost 1 Elevator inspection for: 90.00 4851 INDEPENDENCE ST �v Lit LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 Date: 11/4199 LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 Quantity Description Total Cost 1 Elevator inspection for: 90.00 4851 INDEPENDENCE ST LUTHERAN MEDICAL CENTER 8300 W 38TH AVENUE Wheat Ridge, CO 80033 .c `* ELEVATORS �9 DOVER ELEVATOR COMPANY (9 ANNUAL TEST HYDRAULIC INSPECTION &TEST DATE ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING f # ; { LA a9 fy t 0 LOCATION '7163Z 4' €¢S 14'FOUrJ ELEVATOR SERIAL N0. _ 6' �!�`�% �`+� CITY & STATE ,.+r`.�t'.''J+ "1 12li d C: e, f �, (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 03 eJ140 BUILDING ELEVATOR NO. rte- CUS P. O. N O. JOB NO. MAKE OF ELEVATOR f16VP -fZ- RATED CAR SPEED F.P.M. RATED CAPACITY '�'� LBS. TYPE OF ELEVATOR /lA f RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONALSAFETY CODE ANSI Al 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 Aa 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 '-Z50 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 f P.S.I. No Load Car Speed: Up F.P.M. Down /60 F.P.M. Relief Valve Sealed: W ' 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 f " Tank Oil Temperature At Start of Standing Test r ' o After a minimum of 15 minutes, note the position of,the platform with respect to the chosen reference. Length of Time Car Standing- Empty Amount Car Settled During Standing Period 4. Oil Temperature At End of Standing Period i`.°'7 r G Tank Oil Level At End of Standing Period Amount of Leakage At Packing During Test Condition of Piston Packing 4 e 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 �ze S Standby (Emergency Battery Lowering) Power Operation Tested AIIA Power Door System Tested: Torque V ; If Kinetic !E Ft. # Emergency Terminal Speed Limiting Device Tested R] Was The Test Satisfactory: Yes Z1 No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present attest MECHANIC'S SIGNATURE (indicate Name and Title) Copy of this Report Given to Customer: Yes Q No ❑ *Acceptance Test Only Dc -W -GS WHITE - BRANCH COPY SUPT. SIGNATURE CUSTOMER'S SIGNATURE ELEVATORS DOVER ELEVATOR COMPANY ANNUAL TEST HYDRAULIC INSPECTION & TEST ' (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE ❑ ACCEPTANCE TEST OFFICE c}. s �d NAME OF BUILDING ( "I X1 1M At J 4 4 6f LOCATION 5 ELEVATOR SERIAL NO. CITY & STATE '� '> ' i r t > >" ' _ r'o (IF NONE, USE MOTOR OR :CONTROL SERIAL NO.) DOVER. SERVICE CONTRACT NO BUILDING EL EVATOR N '77 CUS P. NO. JOB NO. MAKE OF ELEVATOR Y1�UC'`7 RATED CAR SPEED 06 F.P.M. RATED CAPACITY . x' LBS. TYPE OF ELEVATOR fi.A RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETYCODEANSI Al 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 I 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 270 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 P.S.I. No Load Car Speed: Up 16 0 F.P.M. Down /0 F.P.M. Relief Valve Sealed: P ee <- 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 Tank Oil Temperature At Start of Standing Test After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. - Length of Time Car. Standing -Empty J A't�d Amount Car Settled During Standing Period yf?' " Oil Temperature At End of Standing Period i'' / %" t7. �. Tank Oil Level At End of Standing Period f Amount of Leakage At Packing During Test F�'�'+'� Condition of Piston Packing r� 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 Ir`'E -5 Standby (Emergency Battery Lowering) Power Operation Tested 7ti`t Power Door :System Tested: Torque @ e5 # Kinetic Ft # .:Emergency Terminal Speed Limiting Device Tested 1 Was The Test Satisfactory: Yes I0 No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner; Present at test P MECHANIC'S SIGNATURE aiI t� "` ✓n°2ra1. SUPT. SIGNATURE Copy of this Report Given to Customer: Yes(] No ❑ CUSTOMER'S SIGNATURE -i - - - Acceptance Test Only DC-so-GS 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 2500 lbs. Inspector: Randy Pabst LOCATION 3655 Lutheran Parkway Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 SAFETY ID NUMBER TYPE INSPECTION DATE ON1= HP X4/6/1998 Inspection Issue Expiration Date Date Date Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue 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 2500 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Parkway TWO HP 41611998 Lutheran Med.Ctr. Engnrg Dept Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 2/16/00 2/28/00 1/31/01 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue 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 2500 lbs. Inspector: Randy Pabst LOCATION 3655 Lutheran Parkway Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 ID NUMBER TYPE SAFETY INSPECTION DATE TWO HP 41611998 Inspection Issue Expiration Date Date Date 2/16/00 2/28/00 1/31/01 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 2/28100 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 3655 Lutheran Parkway J Total Cost 120.00 ' ,,b ��&, 6:� 4 �4L 9 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 2/28/00 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description Total Cost 1 Elevator inspection for: 120.0 3655 Lutheran Parkwa}� Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 2/28/00 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description Total Cost 1 Elevator inspection for: $120.00 3655 Lutheran Parkway _sJ YS1.�9 40 � Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 2/28/00 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 3655 Lutheran Parkway Total Cost $120.00 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 214/99 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description Elevator inspection for: 3655 Lutheran Parkway Total Cost $90.00 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at cam I:have this day inspectedthis- struetire- and - these - premises and have found the following violations of City and/or State laws gov- erning same: °-�r- 0� As .,.n t , ` You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. t° 4 f. Date2 -M Inspector for Building Dept. DO NOT REMOVE THIS TAG -.FORM WRS -22 BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at zsa'�5 LuA I have this day inspected tgis- -stwsture -add Obese- prenuses and have found the following violations of City and/or State laws gov- erning same: l s 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 50 lbs. Inspector: Jack Bultman SAFETY LOCATION ID NUMBER TYPE INSPECTION DATE 3655 Lutheran Parkway ONE HP 4/8/96 Lutheran Med.Ctr. Engnrg Dept Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 1/30/98 2/9/98 4/15/98 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 50 lbs. Inspector: Jack Bultman SAFETY LOCATION ID NUMBER TYPE INSPECTION DATE 3655 Lutheran Parkway TWO HP 418/97 Lutheran Med.Ctr. Engnrg Dept 8300 W. 38th Avenue Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 1/30/98 219/98 4/15/98 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2500 lbs. Inspector: Jack Bultman LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Parkway ONE HP 4/8/97 Lutheran Medical Office Bldg Inspection Issue Expiration 3655 Lutheran Pkwy Date Date Date Wheat Ridge, CO 80033 1/28/97 3/14/97 1/31/98 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2500 lbs. Inspector: Jack Bultman LOCATION 3655 Lutheran Parkway Lutheran Medical Office Bldg 3655 Lutheran Parkway Wheat Ridge, CO 80033 ID NUMBER TYPE SAFETY INSPECTION DATE TWO HP 4/8/97 Inspection Issue Expiration Date Date Date 1/28197 3/14/97 1/31/98 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2500 lbs. Inspector: Jack Bultman LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 3655 Lutheran Parkway ONE HP 2/22/96 Lutheran Medical Office Bldg 3655 Lutheran Pkwy Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/96 3/28/96 3/31/97 Certificate of Inspection City of Wheat Ridge, Colorado BUILDING DEPARTMENT This is to certify thatthe elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 2500 lbs. Inspector: Jack Bultman LOCATION 3655 Lutheran Parkway Lutheran. Medical Office Bldg 3655 Lutheran Parkway Wheat Ridge, CO 80033 ID NUMBER TYPE SAFETY INSPECTION DATE TWO HP 3/22/96 Inspection Issue Expiration Date Date Date 3/22/96 3/28/96 3/31/97 Cnertificate Prtopr eq of Med ridge, & BUILDING DEPARTME This is to .certify that the Elevator has been inspected on the date shown below and was foul Inspector — LOCATION ID NUI FLutheran Medical Office Bldg 3655 Lutheran Pkwy Wheat Ridge, CO 80033 L Certi of ( 3n spe. City killed 74e1 Ca BUILDING DEPARTMEI ,. This is to certify that the Elevator �} has been inspected on the date shown below and was four i % Inspector 0" LOCATION ID NOD 3655 Lutheran Pkwy #2 )l F Lutheran Medical Office Bldg. 3655 Lutheran Pkwy.. 3/14/95 Wheat Ridge, CO 80033 DATE C t // - OF INSPECTIO! '°am .0 " 'Rm� �o1P wY yy" ufr 'Rim aY' '"' ' •" '4pm t"u y� Y Wp' � 1'i`w`X"Nn dpi' x .R '''+. ..x" '+,w .g c�m w' ^+w. �.�✓„9 v «. ✓'#i .»" x; V.. Ww �e,` �f"a .w^ 'u s '' `�� (nEr#if utt #e of rins�sectiv �;�" o Wlceat e, �olauu BUILDING DEPAR�`MEN,7 y This is to certify that the `elevator s" >. as " � T e� ®1 has been inspected on the date shown below and�was saf Inspector l `� t LOCATION _x IpxNi7MBER 3655 Lutheran P'arkwa3 - T `4 `Lutheran 140B Bldg. Ma agar ti 3655 Lutheran Park " . � "� 3 feat Ridge, CO 80033 DATE L OF INSPECTION Ter#ifirate of &Svrrtin BUILDING DEPART This is to certify that ther' _ Blevattor „'a`s has been inspected on the date shown below aril was found rs`at Inspector LOCATION - _ 'ID NUMBtR 3655 Lutheran Parkwa3r - 1 Lutheran MOB Bldg, Manager, _ r . 3655 Lutheran Parkway Mieat Ridge, CO 80033 DATE L OF INSPECTION «, .r! {.*., a, •'+..." ,.+4h^. fir.- yv*.... ,.0 "«... r S^«�..../r5 ;( Fa 1�n (�erfifirntr of �Jnspier io BUILDING DEPAR`TME`NT N" � N ` r 1i ` This is to certify that the > evator ati has been inspected on the'date below a`n'1 was, found saf h ®. "inspector. x , I � L:_OCATION' - ID x.LL - MEER !t 3655 Lutheran P" rkwa s yy —' LggL ' 4 h Si �n��ll"�" i.At Y{. G Lutheran Medical Medical Office Bids 3655 Lutheran Parkway Wheat Ridge, CO 80033 -" ATE OF INSPECTION 3 ".^w�, .✓^ ✓^ s 'xrv . mf+ny. �r .v�* "gym .wF.'x IM '"T '�e.,..w9 'C 1 ,,. k+. a \. . t .' � =3lg x <` %Uerfifirate of �Jnsper# n fYju a 7 w "BUILDING DEPART ME NT ",,` This is to certify that theA El vat or , as has been inspected on the= and a `" ��, p date shown below wa$ rfound sat - Inspector" u w L OCATION- - �- - ,�[)�ftp{y�BER 3655 Uutheran Parkway. #= - -' �< r Lutheran Medical Office Bl�g - � ��,, 3655 Lutheran Parkway X13, Wheat Ridge, CO 80033 8f95 r " g u'OATE *'! OF INSPECTION u. a I�f b 1 - f & � Tat of City o� tWkeat B1J11DING DEP This is to certify That the 7evator has been inspected on the'date shown below an Inspector ns�ettin eli ZTNIENT Y'W Y, z L E as IV LOCATION. - 'C NUMBER 3655 Lutheran P�rkwa ,; Inuit #2 o Lutheran MOB ° 3655 Lutheran <Parkway x /ZI /2a E Wheat Ridge, CO 80013 "DATE fir{ OF INSPECTION E a'Jft`*"u: ,.r "+'^i"$`"`' 4 ✓' "+w, �v"'u c ..' �.. !°n ....'a q �... a °'lr -i w� .d 4.. y \ mjt \„✓ g �.. 33 `4v � ' , s 9 � �, 1�,�.w�p n fia ,,,!!! ems• %!.�Prfif of C ns ec#in o e, BUILDING DEPARYAINT w h This is to certify that the Elevator as u has been inspected on th'eada2e Shown below and was found sat ' In5pector LOCATION _ ID,NUMB €R 555 Lutheran Paklcway'I�i�i� t V_ ti FLutheraa MOB 3655 Lutheran Parkway Wheat Ridge, CO 80033 F6� 11-, CATE I - OF INSPECTION Ttr#ifirate of ;41nspertia City o� Wit �idye, Colouu BUILDING DEPARTMENT This is to certify that the ' ELEMATOR as has been inspected on the, date shown below and -'was found saf inspector -� LOCATION - ;ID NUMBER 8 W. .iti Y' nt'G:li2 L%it'. 4i't. 8350 W. 38th Avernxe, Stp— 7'105 '61 e r P DAT at i re�.� to d CO r:.FG:'�3 DATE - OF INSPECTION %utdifira e of �Jnspertim �/ o� w>keat. ridge; COlo�c BUILDING DEPARTMENT This is to certify that the E, a VATOt as has been inspected on the; date shown below and was, found 'safi Inspector ' =' LOCATION - - =JD NUNSBER 4370 W. 38E A eruie t+�=3_€: a s W! 33 1?'z7a ue ffi at Riielge, CO 8003 ( 'DA OF INSPECTION 'Wmn :a9' ' �'b'�w i,r > mom' '" f rom `�i .w# ^" a , ' ""3 "'4'nn .mw +' ' ""' �,�j �:�w... ..✓d� Ta... ° '+v.. .; u�^ < v. .f} +fYw,.. .✓� ^ "w.. �"4... F �y -q'bA \ 1J�"^__c4 Ridge, G O ZsiiV.'. .'DATE J} OF INSPECTION E(Q ff L qty„ 5�`C F,: r ,, ,, i @ ^41 I.... � _ °.;✓ .�� 3"+° '!?6 ,b�°' ^An. . +d'� � �., .a""'4.., "�v, •fin �„am qq, C�Prtifirafr of ;llnsper#io W C City o� Wkeat �Zcclye, �ilo�u "-BUILDING DEPARTMENT,'; � T This is to certify that the as has been inspected on th�e d�ate shown below and was:foundsaf Inspector y� a I ,r ,LOCATION I ID NUINgER q3 {t W. 33L1 Ave nue, aA- _ C C.5 X50 W. 38th Aver-me, W�?u,5 Cher #i #irate of ;Ntopertiu B AbiNG DEPAR This is to certify that the` EEEV O R'Q. . has been inspected on t shown below ajw! Inspector' - -r'�1 n � . as: n d saf LOCATION ;IONUMBER L8370 W. 38th AKpue, }4 ( \S2 3350 Vk .SOLD+ Avenue, Ste ; r /.3, M i • 'J 80 033 I OF INSPECTION %urr#ifira of ;Wnspatio �`��, City o� Wtizat ��lye, Colour .BUILDING DEPARTMENT.. 1' This is to certify that the" s,} �� '?$�' = "as- has been inspected on the shown below and was found saf Inspector �� `LOCATION IDNUM�ER - 8370. 38tk 1 'vonuc , !Unit at V 101 ti 4 e 2 °l Medical Off W U c , p � y 3 `�n W. 30th Aven V Y "�Vr`' 800 2 �f Ridge, r�L 11fiNg ;anet, E iE .�rie1 [ %f "YN wlA' "M'x ;� r "Ab wNy'�' � � Wp} m 6✓ tbv` aa\��q y�f � .,� � 'v � �� /^'� x 4 ✓ '.wrv✓ � M ^� V:' §A�a�3 � ��\ "Tatifirate of ;3jnsyntio `��, G o� Wlceat �clye, ° �ilouu BUILDING DEPARTMENT " ". I . This is to certify that the he 3 sq �'I (? as< iii: • , has been inspected on the date shown below and was found °saf Inspector `LOCATkON - ID NUKABER yy ' A ove St 0. , 0 e yi Cf pv - "tt „f v.:,i J,s v r DATE L � d 0 1 44 I��S Cz;. OF INSPECTION J t^8-r ��a� cif ,,��,,� ..��. ?�`^•.'*� ��' .,� ' ` �