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HomeMy WebLinkAbout8300 W. 38th Avenue• k c " No one available for inspection Time AM/PM • 1 . , 0 • 0 MAMMA IMM A* #*. Inspected by 68t6'*o Code Consulting LLC - .3nammgm Safety Inspection Date 1013112012 Elevator Inspection Date: 10/31/2012 Certificate Issue Date: 3/13/2013 Expiration D. 2/112014 PUM 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C6i o Code Consulting LLC EMMIM= 16111190 • MOOMMME rMSEPORW Expiration Date: 2/1/2014 7 8300 W. 38th 7Ave, Wheat Ridge, CO 80033 0 1*1 1 0 # Inspected by 666*o Code Consulting LLC Own mill NIPTITI EMMBM= Location: 83040 EMBEUM MIKUM91W r_xpiration Date 211/2014 MTN - ­ - - - ­ A I ' . 8300 W. 38th Ave. Wheat Ridge, CO 80033 N _7770 ATWITT-Tyl m- Inspected by 68" o Code Consulting LLC MEMEB= I • SEIEKH� mmumumm LTpiration Date* 2/1/201Q Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 rft Tj MIT TIA. 470 m#- Z�� m. � �Ot 0 - m Inspected by CO'b*o Code Consulting LLC fflm • = IMS amum Emmumm MMUMUME mmmffm� Expiration Date: 2/1/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 11 t - . mmummm am # »: <<2 d Expiration Date 2/112014 Lutheran Medical Center Engin. Dept. 8300 W. < ; <, Ave. Wheat Ridge, CO 80033 insped by C. cte *o Code Consulting LLC Inspected by 60 6*o Code Consulting LLC Ralvikom" MOSPIRTO-Tim mmm�� Expiration Date: 2/1/2014 MUM 8300 W. 38th Ave. Wheat Ridge, CO 80033 NOWUMU 0.10MMW Expiration D. 211/2014 8300 W. 38th Ave, Wheat Ridge, CO 80033 Inspected by Code Consulting LLC so _71ITTEVITT-7-TIM M#- N 11 0 1 000fifi m I I Expiration Date: 21/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Code Consulting LLC Inspected by C61"o Code Consulting LLC MEMO= INEMN ml, mofflum mmumam Expiration Date: 21112014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 4 ZINUMT -. 0 . ~ > \ # :< 1 MR MM. Inspected by CO Code Consulting LLC ammim= mmm I [MR MMUMOM Expiration Date: 2/1/2014 AL MMUMOM Expiration D. 2/1/2014 T " Arm. s. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected b pi e Code Consulting LLC IL Inspected by 66160o Code Consulting LLC IMMMINHOM =#- ME== i - MMUMUM Expiration Date: 2/112014 8300 W. 38th Ave. Wheat Ridge, CO 80033 it-7 Inspected by 68i6*o Code consulting LLC 111■41-N Mm f9m, =M EK*f y i mmumffigm Expiration Date: 2/1/2014 Lutheran Medical Center Engin, Dept. 8300 W. 38th Ave. Wheat Ridge, 2 O 80033 N t -, ' • ........ . Inspected by o Code Consulting LLC A # I i MOSIMPF11w mmumm2m Expiration Date: 2/112014 RROMMIAMOM, itorim M- 8300 W. 38th Ave. Wheat Ridge, CO 80033 IN Im 00- Inspected by t6 Code Consulting LLC mmmum= i MOUREME Expiration Date: 2/1/2012 MM 8300 W. 382 h Ave. 22 heat Ridge, CO 80033 # j ' . 0 • • Emu ,&" I ' L a # - MMUMUMM mmumamm r . Expiration Date: 2/1/2014 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by ci t Code Consulting LLC Inspected by 6Q o Code Consulting LLC ME323= I I I r• a mmmt 1 mmum9mm Expiration Date: 2/1/2014 Exempla Lutheran Med, Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 •• -1I Inspected by d o Code Consulting LLC MEM38= I 1013myNtw- MEHEMOM OEM= *Tkw#w1#mm= I gV17pA 8300 8th Ave. Wheat Ridge, CO 80033 "111 111111111111111111 q mmumaum MIKErglynt m Expiration Date: 2/1/2014 Lutheran Medical 2 - °© Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 8■■33 Inspected by C Code Consulting LLC Building 1),ppartment k A All, A gr This is to certify"that the ek%tor as indicate, 6 this certificate has been n mmumamm MOLUEOM Expiration Date: 2/11/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Cd 6i """""o Code Consulting LLC I :Mro I Safety Inspection Date 11/1412012 mmummm ONEXPUMP Expiration Date: 2/1/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Coot o Code Consulting LLC 0 1 1 -. A' Inspected by Cd' o Code Consulting LLC mmmsm= A g- NEEMUM mmmlzma� .Expiration Date: 2/11/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 1111 11111�!l 111111 11 11111111q�1111111 0 1 * * i # # offt"Flyw4ja - IM MT A* 00 ;I Inspected by C § d Code Consulting LLC MONT �01 Zkmj"11 MEMSM= ■ ft . FA MVIT M* MOUNUM 4© #w ° °+m Expiration Date: 2/1/2014 8300 W. 38th Ave. Wheat Ridge, CO 003 3 Inspected by o Code Consulting LLC ME= 11wfm"P1 1 - . 0 'SIN mmumu3m mmuAmm Expiration Date: 2/11/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by 6ol" Code Consulting LLC WORT m# mm•�� mmumm2m MOUBEME Expiration Date 2/1/2014 Lutheran Medical Center Engin. Dept. 8300 W 38th Ave. Wheat Ridge, CO 80033 # •• Inspected by 61" o Code Consulting LLC MEM�� I INSEMEBUI m Expiration Date: 2/11/2014 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 PH I=-UmGzrE= ME Inspected by C66" o Code Consulting LLC NEE38= i NIS �#� NNIZEEM MOUSEMM Expiration Date: 2/11/20114 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 # Jf, - . Mumma Insped by id cte "o Code Consulting LLC MEH�� ffolmm= A IM 11 MEMEM MOLUEOM Expiration at 2/112■ 14 "MIMMUll 8300 W. 38th Ave. Wheat Ridge, CO 80033 City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 303-237-8929 To: Lutheran Medical Cent rein. pt. 8300 W. 38th ve, Wheat Ridge 0033 Please feel free to invoice. Ut • 21"0 0 w Location #: 35 Address: 8300 W. 38th Ave. Elevator IN City of Wheat Ridge Building Division 7500 W. 29th Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 V I FMA. 261or. tea at MIUM17 Sm HE= ��� I =-M 3-E= Location M 35 Address: 8300 W. 38th Ave, Elevator ID. 28 m City of Wheat Ridge Building Division 7500 W. 29 th Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 Fax* 303-237-8929 To Lutheran Medical Cent In gin. pt. 8300 W. 38 ve. W V 8 Wh et Ridge, 0033 4 li U U�+► [2ml== =7 V1nVmT#= Location Address: 8300 W. 38th Ave. Elevator ID* 29 City • Wheat Ridge Building Division 7500 W. 29th AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin. pt. W 8300 . 38t ve' 4 Wheat Ridge",VO033 441( ease ree'i a=e invoice. UIMM m Im Location #: 35 Address. 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 I g M-EE 1 11 0 1 Location #: 35 Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 29th AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 Fax: 303-237-8929 — --- - ------- - ----- - ------ To: Lutheran Medical Cent ngin. pt. 8300 W. 38th ve. g ' f Wheat Rid e V 0033 • HEM= [a ggjm Location Address: 8300 W. 38th Ave, Elevator ID: 32 City of Wheat Ridge Building Division 7500 W. 2q Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin pt. 8300 W. 38t ve. Wheat Ridge, 0033 Please feel free to invoice. Ur � ii U170 Location Address: 8300 W. 38th Ave. Elevator ID: 33 City of Wheat Ridge Building Division 7500 W. 29th AVO. Wheat Ridge, CO $0033 Office: 303-235-2856 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin pt. 8300 W. 38th ve, Wheat Ridge 0033 U�s 1111111 111111 11�11111111111 III Jill • Location Address: 8300 W. 38th Ave. Elevator ID: 34 m City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303w237.8929 To: Lutheran Medical Cent right, pt. 3300 .33t ve. Wheat Rid � V 0033 m H�• 3-m= 4:i I I R Location Address. 8300 W. 38th Ave. Elevator ID 35 m !j 1111111 111 1111111 i� M E W I 11��11!1!1 11 1119A HE= Location Address 8300 W. 38th Ave. Elevator ID: 36 City • Wheat Ridge Building Division 7500 W. 2e Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 • UM•' �iiii 1 "11111711 IFITIVIIIII � 11111123MO= Location M 35 Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To Exempla Lutheran Mad tr. En ept. 8300 W. 38th ve. 4 Wheat Ridge,�V 0033 • MA W , - 1 0 # 0 • . # I P.M. invoice. wmmm 1w Em E� 11111 1 23MI= Location Address: 8300 W. 38th Ave. Elevator ID: 25 City of Wheat Ridge Building Division 7500 W. 29 1h Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 •. - M# To: Exempla Lutheran Med tr. En ept. 8300 W. 38th' 4 Wheat Ridge, V 0033 4e Your annual elevaltinspection fee of $210 35 k • wt Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 26 10 0 A* MiM M M mmr�� MEHUM Expiration Date: 2/11/2013 8300 W. 38th Ave. Wheat Ridge, CO 80033 (10 Inspected by C AP to Code Consulting LLC • t . . 0 • 0 INUFAU"F mmmzm Expiration Date: 2/1/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C@8wo Code Consulting LL.0 r - T?ZTA W - M m#- NOMME mmmzm Expiration Date: 2/11/20113 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 v W1 Inspected by 0 Code Consulting LLC N _717#71"11TTWOM m- * I., w mmmzm mmaumm Expiration Date: 2/1/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 00 111 "' , Inspected by 68 "Wo Code Consulting LLC VP P11, t Ak mmc�� mmumm 8300 W. 38th Ave, Wheat Ridge, CO 80033 Inspected by C61800 Code Consulting LLC " ' ##- IMM k m Emmumm Expiration Date: 2/1/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C'4* r io Code Consulting LLC NOWEEM igm• ♦- s Expiration Date: 2/1/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C'6%4#`o Code Consulting LLC f 14 • 0 . . 0 0 0 tt Inspected by CMipo Code Consulting LLC NMMBM= mm •� a ^ Z # •. ME&SNUF mmoam ]Expiration Date: 2/1/2013 8300 W. 38th Ave. Wheat Ridge, CO 80033 • 1 . 40 lilt "ll ilm 7=01 Cade Con suiting LLC Inspected by C'olS* Im ai • � TO FXMVVM�I! MORUM mmumm lg! • E 8300 W. 38th Ave. Wheat Ridge, CO 80033 [ 11 1111111111 IIIIIIIIJJIII��IIJI III # \\\ ^1 1* 0 0 or" Am - INEEM w ° #!« » #» IEUM Expiration Date* 211/2013 8300 W. 38th Ave. ?©a Ridge, CO 80033 1 14 Inspected by C8ffi*,,o Code Consulting LLC Immimm MERMV-4 noriloq#TF Expiration Date* 21112013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspect 0' "o Code Consulting LLC R Inspected by C16*0 1 L M 0 IN m#- om" Am Mum NNU3HK#wA Expiration Date: 2/1/2013 Luthe .M d ©» Center Engin. Dept. 8300 W 38th Ave. Wheat Ridge, CO 80033 Inspected by 6168Y# Code consuiting LLC ?? +2 "11177-M. T9.007#7 -3 MMMMA I - ONEEM mmumm Expiration Date: 2/1/2013 8300 W. 38th Ave. 2 heat Ridge, CO 0 033 Inspected by C6M4*fo Code consuiting LLC 0 M A * MOM■E M-MOURTim Expiration Date: 21112013 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C8'18*'b Code consuiting LLC RF I AL MUPITSTlytTIM.M. 0 M#- too 8300 W. 38th Ave. Wheat Ridge, CO 80033 0 1 . . a, 0 # MUMMA 1� « :t IMSEEM < t . he L TOM RTIMM m Elevator I N "I #n sue: I Date: /1 lam 2/11201 partment 14" .� * »_ < .. It �Mffl Lutheran Medical Center Engin. Dept. 8300 W 38th Ave. Wheat Ridge, CO 80033 0 1 . w . mmumm imp-rommm= Expiration Date: 2/1/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C81;*,"o Code Consulting LLC 5 1117-duffmT111111111111l 111 111��111 111I�j q i������� � 1, 1 I I TO W m m mmamm Expiration Date: 2/112013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 N OW" Inspected by C a Code Consulting LLC F117 M#- ElAu"A'am I ^ �- ms EEMMME r-JEWNP wi mi 98��� Lutheran Medical Center Engin, Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by C'11-601'� Code Consulting LLC 0 1 1 • t . . a • 0 mmumm! Ak NOMMO 1 9=mmz_ • zs .'-� Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave, Wheat Ridge, CO 80033 Inspected by C'O%*O Code Consulting LLC M 0 # EEM� MEEMERM Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 4�'O- Inspected by C890 Code Consulting LLC • 8300 W. 38th Ave. Wheat Ridge, CO 0 033 • � NI 0=11m Im m W OW 0 ' IPP" Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 111 VT No UW-7 0 A * 0 0 mmum" - ImmEm • MOMM Expiration Date 2/1/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Cot Code Consulting LLC NOWUM mmmzm Expiration Date: 2/1/2013 8300 W. 38th Ave. Wheat Ridge, CO 0 033 o o Code Consulting LLC Inspected by C i • mmmzm MEOZOE 4 19303 ! 111 E Lutheran M`: Center Engin. Dept, 8300 W. 38th Ave, Wheat Ridge, CO 80033 Inspected by C'33 Code Consulting LLC Loma NX mo- molawKiw- MEMME Expiration Date 2/1/2013 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by CA * 116 Code Consulting LLC A ir MEPTAKIw- Expiration Date: 2/11/20113 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by 68" %0 o Code Consulting LLC Q , "I MNQ Alma Inspected by Code Consulting LLC mmumm Expiration Date: 211/2013 'I m I #^ z . LYNIUMMUS - # . R lilt dwir NOMM MOPT-ITMI N Expiration Date: 2/1/2013 Lutheran Medical Center Engin. Dept. i.00§< 38th Ave. Wheat Ridge, CO 80033 0 Inspected by d"" Code Consulting LLC ro - 71PITTAT171177F. - RX M#- mommu NIMPTARW .-xpiration Date: 2/1/2013 Lutheran Medical Center Engin. De 8300 W. 38th Ave. Wheat Ridge, CO 81 033 NOW Code Consulting LLB V Inspected by Co 0 NEREM Expiration Date: 211/2013 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave, Wheat Ridge, CO 80033 Inspected by two "O'o Code Consulting LLC ME&SUPTOW MMEEM Expiration Date', 211/2013 Lutheran Medical Center Engin. De 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by CM06 Code Consulting LLC Insped by 6 > d Code Consulting LLC cte 0 " ME22mum NEREEM mmumm �- I Lutheran Medical Center Engin, Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80 033 moffam Lqm•= • Expiration Date: 2/11/2013 Exempla Lutheran Med. Ctr. Eng, Dept. 8300 8th Ave. Wheat Ridge, CO 80033 Inspected by 6,01"."o Code Consulting L reffrIMATI NTT., TOW M- H&Q 1 4 1 mm * # . I « « -> *° Inspected by 601 0 Code Consulting LLC 3-MEMNIM yo =.# ffi-1#1 W TT i mmumm mmumm Expiration Date: 2/11/2013 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 ON r ff� �1�10 # �#- MoRam mmr�� Expiration Date: 211/2013 twomm-WATPIT "R 8300 W. 38th Ave. Wheat Ridge, CO 0 033 IF IF IFF Inspected by Cra Code Consulting LLC City of Wheat Ridge Building Division 7500 W. ° ®^ Ave. Wheat Ridge ' CO 80033 Office: 303-235-2855 * Fax* 303-237-8929 EST-MMEEVININ I 2§i:<: 0 p 11111�fj:jjj+ 2 © Location #: 35 Address: 8300 W 38th Ave. Elevator ID: I rom I City of Wheat Ridge Building Division 7500 W. : ©~ Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * 2 ax: 303-237-8929 170 %� �# K ME invoice. Hamm Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 2 U� w 2 r� EEO Ffll M 1 1 1 1 � I rprorn I �� 11 11111111 � I I I , 1 MIM= Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 3 10 ME City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80■33 Office: 303-235-2855 Fax: 303-237-8929 ME , itm�" invoice. U4«�<a« Q Location #-. 35 Address: ■ 300 W. 38th Ave. Elevator ID: 4 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2856 303-237-8929 Mw,�Q MO. WFIFT �nvoice. 11�• �Illll! jll� I'll'! 11 llillmIll I Location #* 35 Address 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 2W Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 ImJ #K Your annual elevaffins ection fee f I Im 1 11 invoice. <! < ; »» ule U��< y ,«. Location #: 35 Address 830■ W. 38th Ave. Elevator 1D. 8 Im City of Wheat Ridge Building Division 7500 W. 29 th Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 - --- ---------- To: Lutheran Medical Cent ngin pt. 8300 W. 38t ve. V Wheat Ridge, 0033 ea am-am Ave. i 14 JOC t at 5300 30th Rim M= ree m invoice. UY i 10 Location #: 35 Address: 8300 W. 38th Ave. Elevator ID* 14 City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * F2x: 303-237-8929 U42. 3-m= 1 !13 � e Location #: 35 Address: 8300 W. 38th Ave, Elevator ID: 15 m City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To Lutheran Medical Cent ngin pt. 00 W 83 . 38t ve. .4 Wheat Ridge, V 0033 4e 15 tea at 8 wTT9U76m7= invoice, U w � Rt Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: • City • Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 1 . To: Lutheran Medical Cent ngin pt. 3300 .38t ve. Wheat Ridge �V 0033 Your annual elemvat inspection fee of $210 is 1 1M. I. lrewewml invoice. OEM= ft 9 iiiiiiiiiij�ililillllii IIIIIIIIIIIIIII • • 111111111+� Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 17 10 in City of Wheat Ridge Building Division 7500 W. 2• Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 1117F !!1 1111111 1 1 11 115TEM ® 01!11- "9 i i I I ; ��� 2 HEM= Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 18A ]a City • Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 Fax* 303-237-8929 mcnffii To Exempla Lutheran Me d t j r. En4ept. Wheat Ridge 800 G! I I FrTMTMT�M invoice. m Location Address: 8300 W. 38th Ave. Elevator ID: 18B 9EM r - 3 mill Ak L II muzomm To Lutheran Medical Cent ngin pt. 8300 W, 38th ve. .4 Wheat Ridge �V 0033 41( �# [9 rrF77F=ryr9= invoice. U�• to [a Ist I IT 1 11; 1 1 1! 11 1 � I 1 1 1 1 1 � 1 7 1 1 111 2 1 �1 Location A: 35 Address: 8300 W. 38th Ave. Elevator ID: 19 City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 ��` ._. L_~.~~a^. .,~~_.~~, Cent ���.g�. 8300 W. 38th ve, Wheat Ridge,�V 0033 , I i no HOEM Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 20 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 mEnwaim To: Lutheran Medical Cent ngin pt. 8300 W. 38th ve. Wheat Rid V 0033 Your annual i 21 located at I Atem. a UY � ME= ; Ili pin 11111 i : Location #* 35 Address* 8300 W. 38th Ave. Elevator D 21 m 0 viii 0 w*- '* 0 ♦ - w ♦ I # W111111 0 MI To. Lutheran Medical Bent in pt. 80 W Wheat Ridge, 0033 30. 38t",ve. t ir . 4 4 Please feet free to invoice. 9 IN Location #: 35 Address 8300 W. 38th Ave. Elevator City • Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin pt. 8300 W. 38t",ve, c Wheat Ridge, 0033 16 invoice. U« �► rr q I I I � I • Location Address: 8300 W. 38th Ave. Elevator ELMC ELEVATOR DETAILS DATA CURRENT AS OF 2116/2012 ELEVATOR # LOCATION FLOORS TYPE MACHINE ROOM PRUSEC 1. PUBLIC WEST P. CORE B, 1-6 CP WEST P. PENTHOUSE 1/2 2. PUBLIC WEST P. CORE 5, 1-6 CP WEST P. PENTHOUSE 1/2 3. PUBLIC WEST P. CORE B, 1-6 CP WEST P. PENTHOUSE 1/2 4. PUBLIC WEST P. CORE B, 1-6 CP WEST P. PENTHOUSE 1/2 7. SERVICE WEST P. CORE B,1-6 CP WEST P. PENTHOUSE 1/2 $. SERVICE WEST P. NORTH B, 1-4 CP WEST P 5TH FLOOR N 1/2 14. D WAITER KOCK P. (OPS) B-1 DW MAIN PHARMACY 15. SERVICE KOCK P. CORE 16, PUBLIC KOCK P. S/WEST 17. SERVICE KOCK P. DOCK 18. SERVICE RCVING. DOCK 1-9. SERVICE RCVING. DOCK 20. SERVICE RCVING. DOCK 2C SERVICE OLD SPD 22. SERVICE OLD SPD 23. SERIPUB OLD L&O 24. PUBLIC KOCK P. MAIN 25. PUBLIC KOCK P. MAIN �6. PUBLIC KOCK P. SOUTH 27. PUBLIC NORTH PJSOUTH 28. PUBLIC NORTH P./SOUTH Pl,�' 29. PUBLIC NORTH PJWEST 30. PUBLIC NORTH P./WEST 31. PUBLIC NORTH P./WEST 32. PUBLIC NORTH P./WEST 33. SERVIDIRTY NORTH PPD 34, SERV/CLEAN NORTH PO :16. DUMBWAITER NORTH P. SPD/08 30. CHAPEIJSERV CHAPEL 37. PUBLIC NORTH P. L&D/FBC MOB 1, #1 MOB I CORE MOB 1, #2 MOB I CORE B, 1-6, P CP KOCK P. PENTHOUSE 1/3 B, 1-3 HP B, 1-2 HP B-D HP B-D HP B-D HP B, 1-2 HP B, 1-2 HP B, 1-2 HP B, -6 CP B, -6 CID 1 - 6 (DBL) CP 8,1,2-6 CP 8,1,2-5 CP 8, 1-516W CP B, 1-516W CP B, 1-5/6W CID B, 1-5/6W CP B,1 -2 HP B, 1-2 HP DW B/1 /CHAPEL HP 2N - 3N HP 1-4 HP 1-4 HP KOCK P. BASEMENT/ADJ. 1/8 KOCK P. BASEMENT/ADJ. 1/8 BASEMENT/ADJ. 0/8 BASEMENT/ADJ. D/B BASEMENT/ADJ. E/B WEST P. BASEMENT/ADJ. 1/B WEST P. BASEMENT/AOJ. 1/8 WEST P. BASEMENT/ADJ. 1/8 KOCK P. PENTHOUSE 1/2 KOCK P. PENTHOUSE 1/2 KOCK P. PENTHOUSE 1/2 NORTH P. PENTHOUSE 1/2N NORTH P. PENTHOUSE 1/2N NORTH P. PENTHOUSE 1/2W NORTH P. PENTHOUSE 1/2W NORTH P. PENTHOUSE 1/2W NORTH P. PENTHOUSE 1/2W NORTH P. BASEMENT/ADJ 1/2N NORTH P. BASEMENT/ADJ 1/2N NORTH P. BASEMENT/ADJ a, I NORTH P. P/P BASEMENT I - CHAPEL NORTH P. BASEMENT/ADJ 2N/3N I ST FLA, WEST HALLWAY "2 1 ST FLA, WEST HALLWAY 112 a If you have any questions feel free to contact the office at (303)235-2855. John C. Schumacher, Jr., CBO Chief Building Official 7500 W, 29th Avenue Wheat Ridge, Colorado 80033 Office Phone: 303-235-2853 I'ax: 303-237-8929 www.ci.Nvjiea LAjdd& www.d.wheatridge.coms PMFIN��: Inspected by Dd gional Council of Govemm _COG) MEMEM= H #^ i mmf d? 2f <* MMUMM Expiration Date: 2/l/201E ) r2 M 8300 W. 38th Ave. Wheat Ridge, CO 80033 I III IIIIIIIIIIIIIIIq 11 111111111l IIIIIIIII 111111111qii��l�111 • gx g Inspected by J eri Regional Council of Governm . . . . . . RCOG) NOT.Mmmull, ME== I - I mmmumm mm1FTFwx#w Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 r ow 0 � 1 .07 A' M#- mIt""A'am I - I sm Inspected by D6hwRegional Council of Govemme6 , QDRCOG) mzmum 106= Elm= Elevator Inspection Date: 9/23/2010 Expiration Date: 2/1/2012 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 • This is to at the e Bator as certify th Ifidicatedi;o n this certificate has been , inspected on the d hown below and wd un d safe to carry 5000 lb s. Inspected by D6 egional Council of Governmeh"DRCOG) 2 Location: 83qla A . Smamm mmoamm Expiration Date: 2/11201E Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 -74C mo 11 A T.M. — ONO mo- TAVI.. �Mmffi I - BM Emma2daf SmEm2m Emmumm Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 ht'(DRCOG) rrr d y De""'n"V"""'q"'� R egi on aI C o unc it of G overn me Inspecte b " Morla =# 1 -5 B?ilding Department 1 "N 1111,11"111- J111, This is to certify "that the egGtor as dicatq,,,don this certificate has been inspected on the""I shown bel nd vv"und safe to carry 50 It sr Inspected by Council of Govemmeff DRCOG) •. I # # MEHOOM Expiration Date: 2/1/2015 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 R �#- . �:P# M This is to certify'tat the e&t►r as ifidicateo. n this certificate has been inspected on the " below and w und safe to carry 2700 lbs. 0 0 OF14 =## mmudgm ENUUME Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 :R egional Council of Governmeh"it'(DRCOG) Inspected by 4""""'�1k1 0 t . . 0 0 WEERMUM '000a Location: 83 Elevator Type: CP Safety Inspection Date: 9123/2010 Elevator Inspection Date: 912312010 Expiration Date: 211/2012 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 ffw.Trj-r# Mm, ii �11111111� il�pii 111111111 11111111111 1 !!1- - 0 "TIM Inspected by De'fivi '"'"Regional Council 10TO Mot NOW OEM= 9�•� 0 0 . fT7rTT7dr(TfT"w7 7M 8300 W. 38th Ave. Wheat Ridge, CO 80033 I '�7 This is to certify'lb-at the e 4914A Akommi W�e?Mn below nd un safe to carry 4000 lbs. Inspected by D6hV"egional Council of Governm RCOG) V 1"I"I"', 1,11 t 1- 0 1 " MEMNM= I EMOMME MUM= 9��: Y& MEMO 4 TAMP 8300 W. 38th Ave. Wheat Ridge, CO 80033 MORE= Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DA egional Council of Governm RCOG) M MEMO= mmimm= Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 111 h Inspected by 64WOegionai council of Govemmerif" RCOG) I 's mill 11111pliq 511 0 1 =0 "m ?MOV FV" 11,01"amp mmtmml Inspected by Def"'Y'O""J"' egional Council of GovemmeKQDRCOG) mmmm= I I # yr I • . Elevator Type: DW Safety Inspection Date: 3112/2010 Elevator Inspection Date: 3/12/2010 m Expiration Date: 211/201E 77MM ► 8300 W. 38th Ave. Wheat Ridge, CO 80033 11111111q� 1111q 0 0-5 a • of "I Mm Building Dopartment This is to certify "tha the el' Vator a s this certificate has been inspected on the shown below and w fbund safe to carry 500 lbs. o d" Inspected by Ddffi"egional Council of Govemm RCOG) MA 1�- mmmm� MOMEM Expiration Date: 2/1/2012 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 MOZOTITIVIM-Mrs. mt- Building Dppartment This is to certify that the el6vator as ifidicatp,4" an this certificate has been inspected on the hown below and wd§jf6und safe to carry 4500 lbs. 102202m MOU22m ENHUME Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by be " n , *kegional Council of Governme' DRCOG) alt Inspect on al Council of Governme"' (DRCOG) .. . . ....... .... MSERMUM MEM MOMEM MORUMM Expiration Date: 2/l/201E 8300 W. 38th Ave. Wheat Ridge, CO 80033 1MV. Inspected by DdhV"eg ion al Council of Gov emmeht'(DRCOG) MEMSH= If ON momamm Expiration Date: 2/11/201P J r m"f 8300 W. 38th Ave. Wheat Ridge, CO 80033 11111 1111 1 !''11111 lillillilliq I , pilliliq IIIIIIIII III Pill 111��1111 Mr. M-TOM". I ; "All a- 0 0 1 mwj"'mm - imspecte• • the d Inspected by De 4f, Council of Govemmeff'(DRCOG) mms�� I I TTM a I ME= Expiration Date: 211/2012 Lutheran • Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 B gilding Department 10 'ag This is to certify "thpt the e' ator as iddicatp, n this certificate has been inspected on the d hown below and w si -"T'I'und safe to carry 12000 lbs. MOMM monumm Expiration Date: 2/112012 Exempla Lutheran Med. Ctr. Eng De Wheat Ridge, CO 80033 1 1- 0 Inspected by be""'N"egional Council of GovernrneN {DRCOG) Inspected by De"'r"i'v" e'Regional Council of GovernmeANDRCOG) ME= is f- i MMUMME Expiration Date: 2/11/2012 8300 W. 38th Ave. Wheat Ridge, CO 80033 0 rr mmmE= On OF-wim Expiration Date: 2/1/201U Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Council of GovernrneW DRCOG) E ff "I Mm t dicateil' n this certificate has been This is to certif t t e eleva or as Inspected by D46V"' eg ion al Council of Government . (DRCOG) NEE SE= • +r I Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 0 t . v • ♦ mmummm m i� moff"m Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by I envvifRegional Council of Govemmeht'(DRCOG) [Or A• I* "�DRCOG) Inspected by Den"'v""""' egional Council of Governmea' mms�� A . I . - 0 mmawmu Expiration Date: 2/l/201E 91 111 8300 W. 38th Ave. Wheat Ridge, CO 0 033 o ff "I Mm Inspected by Council of Govemmeht"(DRCOG) t4 WOTOPUMMIZ. • vm rommam I • I # Expiration Date: 2/1/2012 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 • a f 0 WITOMMI ffi-M 11 Ly a Elevator Type: CP Safety Inspection Date 9/2312010 . 0 # Expiration Date. 2/1/2012 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 mmumm mmaumm 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Deh �egional Council of Governmeff g(DRCOG) • a � 1111111q JII1111111111111�111 1111111111111111111 � iiiiiiiiiii 111��l - - • oh"t "WITT-MMMMITM @ 1 5 This is to certify "that the ei tor n this certificate has been inspected on the d . s hown below and w found safe to carry 4000 lb s. Inspected by be"n"W"'t Regional Council of Gov err meif'{DRCOG) ammuMm I 1161INVII, SmOmEm mmumEm Expiration Date: 2/1/2012 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 I i q IIII iiiiiiii IIIIIIIIq IIII��11111 III ailj� liwii ' I iilllllllll I 1 7 111111 0 ^ 0 Moku AIM" =1'1�# 0 - U�Mm B4ilding Department 1 1 S This is to certify'th_ at the eldVator as indicated `�' this certificate has been inspected on the dbj shown below and w und safe to carry 4000 lbs. Inspected by DOM q(fie gional Council of Governrneift'�DRCOG) MMH�� jm•; MMUMEM MOGMEM MONYMMU Expiration Date: 2/l/201E 8300 W. 38th Ave. Wheat Ridge, CO 80033 oak" 1 4 11 mm ' IS This is to certify "that the e"tor ri is t an this certificate has been ' d e 4000 inspected on the hown below and was loun saf to carry lbs. e DRCOG) Inspected by De' Mhkh Regional Council of Governm 2-mm s .: #2 • mmumlam mmumaim Expiration Date: 2/1/2012 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DenVe'r."'Regional Council of Governme6 DRCOG) . ..... . . . . 0 • All . mmumu2m rdm9wEF7K#Tr1 002UME Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 0 MUM Mm • 0 Inspected by J er e l e lentil Council of Governmerw"'("DRCOG) NBEEMUM Location 83qqU HIM= MOMEME MEMEME Expiration Date: 2/1/2012 8300 W. 38th Ave. Wheat Ridge, CO 80033 ! I 11111111pi���111 1j 1 MR" ism M Ct This is to certify that the e eVator djcatQ, can this certificate has been Inspected on the shown beleaw and w und safe to carry 4000 Ibs. mmm� �1 MMUMOM Expiration Date: 2/1/2012 8300 W. 38th Ave. Wheat Ridge, CO 0 033 Inspected by C errs Regional Council of GovernmeAQDRCOG) EM Building Department This is to certify"th that the e %: for as dicatqd,'1, n this certificate has been inspected on the dal"hown below an w6Wund safe to carry 4000 lbs. Inspected by D i 'M"egional Council of Governme W MEMSMMM mm. a I 10113�= Expiration Date: 2/1/201S 8300 W. it Ave. Wheat Ridge, CO 80033 tInffm* v Building D as indicate This is to certify ,,,p,t the of for this certificate has been inspected on the OPVshown below and wc is` , bund safe to carry 4000 lbs. MENEME ONEEEM Lutheran Medical Center Engin, Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 RCOG) Inspected by D&H"gional Council of Gov ern m I # it .. 0 0 0 �Mmm 11 - ##- « /I Building Department This is to certify "that the of 6tor as indicated this certificate has been inspected on the d shown below and wd and safe to carry 4000 lbs. Inspected by D6RegionaI Council of GovernmeR , QDRCOG) I L- 0 2KOMMUM I • I I I PO M i ll mmumEm mmlfflmR Lutheran Medical Center Engin. Dept. 8300 W 38. h Ave. Wheat Ridge, CO 80033 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin. pt. 3300 . 38t h ve. 00" Wheat Rid 0033 M ease 111111piIIIIIIII: invoice. MEMO 1� -�� 11 lim 1111 14:jnm-J;I =WHISEE�� Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: I City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent gin pt. 8300 W. 38th' Sve. i , I V - A , " I I "I' Wheat Ridge, 00033 P* N.. *911 1110MFMI� IfItILTAIKIII No is invoice. U�• re Location Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 5000 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 7 m HE N�I= U» - »« < #° '''i I 1 11111 1 C IM1111111 I I gligill � 23 : * Location #: 35 Address: 8300 W 38th Ave, Elevator 113 3 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To* Lutheran Medical Cent ngin pt. 8300 W. 38th Wheat Ridgellj00033 Your annual ele fee of $210 d lo located at 8300 W. 38th Ave. in Wboot Ri 0111 1 1 Ile Ely invoice. U�a ra 111!11111pij�I�mii 11 111 7p!!I111 11111 II!!IIIII!IIjI 11111111 • IF 111 74111 1 • Location #- 35 Address: 8300 W. 38th Ave. Elevator ID: 4 City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 4� MM m ME ease Tee invoice. Uw # 1 0 11 I ! M111: � I llflllzl�lli gimir'' i i 1 i Mr� Location Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Im I M e = t o it <41111 invoice. U<»2? Location #-. 35 Address 8300 W. 38th Ave. Elevator ID: 6 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 Your annual ele fee ♦ $210 is located at 8300 W. 38th Ave. in Wheat Ridat Im invoice. am mm rr - 0.'• • • 1 1 11 1 i 1 : 1 1 IfFi I � ITI MIT! I , 23 , � Location Address: 8300 W. 38th Ave. Elevator ID: 7 0 im ` 0 # 1 0 To: Lutheran Medical Cent gin. 'Apt. 8300 W. 38th ve. Wheat Ridge SO0033 r 011111111 • ffiIIIF!?1 H'' 71 USE= r n i I � � r � I i � I � I Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 8 City of Wheat Ridge Building Division 7,500 W. 291hAVe. Wheat Ridge, CO 80033 Office: 303-235-2855 -*-Fax: 303-237-8929__________ To: Lutheran Medical Cent ngin. pt. 8300 W. 33t ve. Wheat Ridge, 0033 mw�R • rz._ � • U�s 14W , , , ,,, Location Address: 8300 W. 38th Ave. Elevator ID 9 City of Wheat Ridge Building Division 7500 W. 29 Ih AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 303-237-8929 To: Lutheran Medical Cent ngin. pt. 8300 W. 38th ve. Wheat Ridge, 0033 invoice. Im WEB= rr 12T=;mIjrrIr#r=I 'F=mm-3m3m== VAIL3 old g— • g , . Building Division 7500 W. 2WhAVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 OM 1 H To Lutheran Medical Cent ngin. pt. 8300 W. 38 t" ve. Wheat Ridge, 0033 -.AL, Please feel free to invoice. UN [a Location #- 35 Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Offi ce: 303-235-2855 * Fax: 303-237-8929 76M. ��# 4 rol I r III tions regarding your invoice. MIM< 1 1 1 �i 1111 711111M I SMS= Location #: 35 Address: 830■ W. 38th Ave. Elevator ID: 12 City of Wheat Ridge Building Division 7500 W. 2W Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 303-237-8929 To. Lutheran Medical Cent ngin- pt. 8300 W. 38t",ve, Wheat Ridge, 0033 • lit ♦ 0 # In 1w ree Yo co • invoice. Um= rr Location Address: 8300 W. 38th Ave. Elevator To: Lutheran Medical Cent ngin pt. 8300 W. 38 h j 0 '; Wheat Rid P0033 ' 14" rue 1W invoice. II BB M# UM� Location Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 2Wh AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 »w! ?2?[M Your annual el nspection fee of $210 is d location # 35 15 located at 8300 W. 38th ijpppm 11pill Sm 1 1 2 1 11 1 1 i i 1 � I : I HIM U?w » \«« Location #: 35 Address: 8300 W. 38th Ave. Elevator ID 15 m City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 mvoice. U�• tr Location Address: 8300 W. 38th Ave. Elevator ID 16 m Noun SHHi4 To: Lutheran Medical Cent y ngin pt. 8300 W. 3 8' h ve. Wheat Ridge 0033 Your annual 1 17 located at WMEW re 3-m= Location Address: 8300 W. 38th Ave. Elevator ID: 17 m City of Wheat Ridge Building Division 7500 W. 29 th Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin pt. 8300 W. 3 8t" v e. W ,heat Ridge, 0033 I q �1111 11 11! 1 111 11 111 1 1 ; 1 1 �i p m i '' Kill ll�`;11 tions regarding your invoice. I i I � Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 18A City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 To: Exempla Lutheran Med tr. En Wheat Ridge, C f8 00 Please remit p"A ease T ree To invoice. Urt� M 03 EZMI= Location Address: 8300 W. 38th Ave. Elevator ID: 18B City of Wheat Ridge Building Division 7500 W. 2Wh AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To Lutheran Medical Cent ngin. pt. 8300 W. 38 , e. Wheat Ridge, 0033 in 11211911111;11 11 1111'm 11!111p ,I rly 11 F 11" 11 11 1 0 1 ''If !1 1 11 1 1! T M - # • U�• qp 11�ppjqji�i ���� 1 Location Address: 8300 W. 38th Ave. Elevator ID: 19 City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge,C # 80033 Office: 303-235-2855 * Fax: 303-237-8929 Your annual el vat f inspection fee of $210 is 20 located at 8300 W. 38th Ave. inAbeaLM M* 3B I MEWN U:» » y t. 23MS= Location #* 35 Address: 8300 W. 38th Ave. Elevator ID: 20 City of Wheat Ridge Building Division 7500 W. 29 th Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 303-237-8929 To: Lutheran Medical Cent ngin. pt. 8300 W. 38t Sve, Rid 4 Wheat Rid 0033 # # wo 1-83 I it lr-76=6 invoice. U�#' US: Location #: 35 Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin. pt. 8300 W. 381h ve. Wheat Rid ge, � 0033 invoice. U1Y� xx rj. F PI m rZ .• N • ��Igj� I q I � I! 11�1111 11 1 1 1 � 111 1 1 1 1 1 1 1 1 •= Location Address: 8300 W, 38th Ave. Elevator Koji 1 To: Lutheran Medical Cent , ngin- pt. 8300 W. 38t"ve. Wheat Ridge, *0033 ftltl IMF 71 11 invoice. U.� �► ra 1 ? 11 Irrinill • mzM .� Location #: 35 Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 29th AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Exempla Lutheran Med tr. En ept. 8300 W. 38th ve. Wheat Ridge, 0033 am M 11 1 1 11 11 1 1! UIMa Location M 35 Address: 8300 W. 38th Ave, Elevator ID: 24 IMMM rf��� To Exempla Lutheran Med tr. En ept. 8300 th W. 38 "' * 14 Ife" ' Wheat Ridge, +0033 r , IMI invoice. do 11 1 � 111 � �: III Iff I FIT! 111 1: 1 1 1 111 1� Location #: 35 Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 29 Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 w omllm-3��� 11 1 I Now= 7 invo ce. M»i «<�< 1 11 11111111' 111111111;1111 111111 !111 11111 !11111 !!111111111111111 " 11111 q rp 11�p :I 1� I � I 1� 11 U1 I, � E= I I 13MS= Location #* 35 Address: 8300 W. 38th Ave. Elevator ID: 26 m mamm3mm City • Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin pt. 8300 W. 38t 4 g Ij Wheat Rid 00033 No F a NIII.F. Me 11 NrArowyroi UTTj=zjrq 0 16 Please feel free to COWEND U�• Location Address: 8300 W. 38th Ave. Elevator To. Lutheran Medical Cent Ingin. pt. 8300 W. 38t ve. W V heat Ridge, 0033 Please feel free to colmmwmfffim����� invoice. U�r III 11 1 , 7111 1 1 1 11 , 1 1 1 1 1 , T1 1 ii E�� Location Address: 8300 W. 38th Ave. Elevator ID: 28 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 m z f� M, Please feel free to co invoice. U17EMM ra Location #* 35 Address* 8300 W. 38th Ave. Elevator ID: 29 MUMEMMMM'[41" City of Wheat Ridge Building Division I << 29th Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 IN, Pat F. 1. ".0 1 01101-3101 MIN U«» ? § ,w. -ME= M �,z«w.� Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 30 m City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 I I 111;;�Ii�111 rM 'IIQIUU,��#Ijk ons regarding your U�# rr IgIllyl 11 11 Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 31 City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cen gin. pt, 8300 W. 38th,;; ', V i, 1 1 11 Wheat Ridge 0033 invoice. am= � � 1 : 1 111 1 1 11 1 1 1 11 FIRIZ�� Location Address: 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 PI 1� To: Lutheran Medical Cent ngin. t. 8300 W. 38t e, Wheat Ridge, 0033 In 0 r I I P111111 1 11 li'�l 1 1 , flons regarding your U,. • rr Location Address 8300 W. 38th Ave. Elevator City of Wheat Ridge Building Division 7500 W. 29th AVe. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To: Lutheran Medical Cent ngin. t. 8300 W. 38h ve. Wheat Rid g e ' 0033 410( Your annual el 4 • inspection fee o o f $210 is • lcati I Z, WM , &g,r bw_ 34 located at 8300 W. 38th Ave. in4 I EWE Location #-. 35 Address: 8300 W. 38th Ave. Elevator ID: 34 City • Wheat Ridge Building Division 7500 W. 29' Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 To Lutheran Medical Cent ngin pt. 8300 W. 38th" Wheat Ridge, V0033 Your annual i 35 located at • Ig mmm 3-m= Location #: 35 Address: 8300 W. 38th Ave, Elevator ID: 35 m City • Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 . ... . ... .. -,", To Lutheran Medical Cent ngin pt. 8300 W 38th,4 Wheat Ridge, A0033 10 UE= fit Location #: 35 Address: 8300 W. 38th Ave. Elevator 11): 36 City of Wheat Ridge Building Division 7500 W. 291h AVe. Wheat Ridge, CO $0033 Office: 303-235-2855 * Fax: 303-237-8929 M To: Lutheran Medical Cent gin. pt. t j 003 8300 W. 38 ve. V A V 3 Wheat Ridge, 14(1 ## Please feet free to c invoice. Location Address: 8300 W. 38th Ave, Elevator ID: 36 9A Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Building Dgpartment s I. d This is to certify hat the el ator as indicated Hon this certificate has been inspected on the da shown below and wash ound safe to carry 5000 lbs. Inspected by D6NOVRegional Council of Governme�DRCOG) Location Number: Building Name: Location: ID Number: Elevator"t voe: CP Safety Inspection Date: 31212010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 3/112010 Expiration Date: 12:00:00 AM Lutheran Medical Center Engin. 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 Department This is to certify the elevator as indicated&n this certificate has been inspected on the daffi's�`shown below and wd and safe to carry 5000 lbs. Inspected by Denv" gRegional Council of Governme ( RCOG) Location Number: Building Name: Location: ID Number: Elevator"Tvoe: CP Safety Inspection Date: 3/212010 Elevator Inspection Date: 31212010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 BVilding Department n This is to certify'ttq t the elevator as indicated n this certificate has been inspected on the cafe shown below and wasound safe to carry 5000 lbs. Safety Inspection Date: 3/2/2010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 u Inspected by De1n , 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 t#aat the ek asindicatedn this certificate has been inspected on the d shown below and waHound safe to carry 5000 lbs. Inspected by Derr 2egional Council of Governme� (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Tvoe: CP Safety Inspection Date: 3/2/2010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 311/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department A This is to certify %pt the el'�Vator asindicat on this certificate has been inspected on the cfa! shown below and wg§Tbund safe to carry 1500 lbs. Safety Inspection Date: 3/12/2010 Elevator Inspection Date: 3112/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Defi�e�egional Council of Govern men7f(DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 "' Ave. Wheat Ridge, CO 80033 B ?ilding Department {mss This is to certify t)at the e ° ator as indicateo n this certificate has been inspected on the 0 shown below and N found safe to carry 50 lbs. Inspected by Den Regional Council of GovernmeKt(DRCOG) Location Number: 35 Building Name: Lgtherospi Location: 830 .38- ID Number: ElevatorType: DW Safety Inspection Date: 3/1212010 Elevator Inspection Date: 3/12/2010 Certificate Issue Date: 3/112010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department This is to certifyt ,t the JR66 as indicate bn this certificate has been inspected on the c) &Ishown below and was ound safe to carry 2700 lbs. Safety Inspection Date: 3/12/2010 Elevator Inspection Date: 3/12/2010 Certificate Issue Date: 31112010 Expiration Date: 12:00:00 AM Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Denv� -� egional Council of Governmei(DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department gwg This is to certif 'that the elevator as indicat d y n this certificate has been inspected on the 'shown below and wad -Tound safe to carry 2700 lbs. Inspected by De16% Regional Council of GovernmeVDRCOG) Location Number: Building Name: Location: ID Number: ElevatorTvoe: CID Safety Inspection Date: 3/1212010 Elevator Inspection Date: 3/12/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 B�Ilding Department A m This is to certify t at the e. "e ator a dicat da= n this certificate has been inspected on the ate, hown below and wa& ound safe to carry 4000 lbs. Inspected by DeFiv rRegional Council of Governme(DRCOG) Location Number: Building Name: Location: ID Number: Elevator'rype: HP Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/1912009 Certificate Issue Date: 3/1/2010 Expiration Date: Lutheran Medical Center Engin. 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 Department a� y= This is to certiO pt the a itor as'ndicate n this certificate has been inspected on the shown below and was ound safe to carry 4000 lbs. Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 3/1/2010 Expiration Date: Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by D 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 fiat the e vator as ihdicat ion this certificate has been inspected on the da shown below and wound safe to carry 3500 lbs. Safety Inspection Date: 3119/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 3/1/2010 Expiration Date: Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De v Regional Council of Governme'DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certify hat the JaVator as indicat loon this certificate has been inspected on the #b- shown below and found safe to carry 50 lbs. Inspected by DeAN 17Regional Council of GovemmenY(DRCOG) Location Number: 3 re Building Name: L O W therans ` ospi I RIP Location: 830QI1. 38 ID Number: 1 0 Elevator DW Safety Inspection Date: 3/12/2010 Elevator Inspection Date: 3/12/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department This is to certify'toat the el`ehtor as ks indicat di this certificate has been inspected on the Y2 shown below and W found safe to carry 50 Ibs. Safety Inspection Date: 3/1212010 Elevator Inspection Date: 3112/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 w ... Inspected by 6A Regional Council of Government (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29t Ave. Wheat Ridge, CO 80033 Building Department This is to certify ". t the a evator as it dicat -n this certificate has been inspected on the shown below and w"'11 ound safe to carry 500 lbs. Safety Inspection Date: 3/12/2010 Elevator Inspection Date: 3/12/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 211/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 v.� Inspected by Denv- Regional Council of Governmer (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certifytbat the elitor adicaten this certificate has been inspected on the "W'shown below and w99 bund safe to carry 4500 lbs. Safety Inspection Date: 3/2/2010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 3/112010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 M - Inspected by De V, egional Council of Govern mA (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certiOpgt the elevator as indicat n this certificate has been inspected on the die ='shown below and wasound safe to carry 4000 lbs. - 6 - - � Inspected by eft Regional Council of Governmer� (DRCOG) Location Number 3" Building Name: L ospital Location: ID Number: fill Safety Inspection Date: 312/2010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 311/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department h mae� This is to certify the elevator as ndicate n this certificate has been inspected on the daSePshown below and was ound safe to carry 4000 lbs. Inspected by Denv r= Regional Council of Governmei, (DRCOG) Location Number: Building Name: Location: ID Number: Elevator'Tvpe: HP Safety Inspection Date: 31212010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 211/2011 Lutheran Medical Center Engin. 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 Department w1 A This is to certifyt t the elevator as iiidicated n this certificate has been inspected on the "shown below and waH�ound safe to carry 4000 lbs. Inspected by De A Regional Council of Governmehff DRCOG) Location Number: Building Name: Location: ID Number: ElevatorTvae: HP Safety Inspection Date: 3110/2010 Elevator Inspection Date: 3110/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department AN AN ARM This is to certify�tat the elevator as indicatect n this certificate has been inspected on the d'a 1 shown below and wasund safe to carry 12000 lbs. Inspected by DenverRegional Council of Governmen (DRCOG) Location Number: Building Name: EMC : Location: ID Number: , 18B -4 ElevatorTvpe: HF Safety Inspection Date: 3/10/2010 Elevator Inspection Date: 3110/2010 Certificate Issue Date: 3/112010 Expiration Date: 2/1/2011 Exempla Lutheran Med. Ctr. Eng Dept. 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'thpt the elehtor as ndicat do this certificate has been inspected on the A-0-shown below and was�found safe to carry 4000 lbs. Inspected by Dew- egional Council of GovernmeIDRCOG) Location Number: Building Name: Location: ID Number: Elevator Tvpe: HP Safety Inspection Date: 3110/2010 Elevator Inspection Date: 3/10/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 21112011 Lutheran Medical Center Engin. 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 Department Ebb fi This is to certify'that the elevator a'sTriclicat4o this certificate has been inspected on the df hown below and wadund safe to carry 20000 lbs. Safety Inspection Date: 3110/2010 Elevator Inspection Date: 3110/2010 Certificate Issue Date: 31112010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 -. Inspected by De v . egional Council of Governmer (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building D�ppartment This is to certi0hat the eVator as indicated on this certificate has been inspected on the daPshown below and waound safe to carry 2500 Ibs. Inspected by Deli ORP egional Council of Governmeg( Safety Inspection Date: 3/10/2010 Elevator Inspection Date: 3/1012010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department This is to certify't the elevator as dicated on this certificate has been inspected on the c) I&Shown below and was found safe to carry 2500 lbs. ^4 MOP- Inspected by De4f _ Regional Council of Governmeht (DRCOG) Location Number: 3W Building Name: Location: ID Number: Elevator"T pe: HP Safety Inspection Date: 3/10/2010 Elevator Inspection Date: 3/10/2010 Certificate Issue Date: 311/2010 Expiration Date: 211/2011 Lutheran Medical Center Engin. 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 Department L This is to certify .at the eeitor as indicate4io this certificate has been inspected on the shown below and wa bund safe to carry 5500 lbs. OF Inspected by Derive egional Council of Governmeiff RCOG) Location Number: Z Building Name: Location: 83( ID Number: 2 R Elevator7ype: HP Safety Inspection Date: 3/1012010 Elevator Inspection Date: 3/1012010 Certificate Issue Date: 311/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department A This is to certify et the e ator as mdicat ion this certificate has been inspected on the d'shown below and waound safe to carry 4500 lbs. Safety Inspection Date: 3/212010 Elevator Inspection Date: 31212010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DeRegional Council of Governmen (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave Wheat Ridge, CO 80033 Building Department This is to certifytbat the elovator as 'ndicat� this certificate has been inspected on the c)a a shown below and wa1 4 ound safe to carry 4500 lbs. V u Inspected by 6Ve egional Council of GovernmeiW(DRCOG) Location Number: 3 4n Building Name: E C Location: 830,QiM. 3$tl ID Number: 25 " Elevator levatorType:. CP Safety Inspection Date: 3/2/2010 Elevator Inspection Date: 312/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Exempla Lutheran Med. Ctr. Eng. 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 Bilding Department This is to certify ,t the elator asSdicatedn this certificate has been inspected on the hown below and wa ound safe to carry 4500 lbs. IV Safety Inspection Date: 3/2/2010 Elevator Inspection Date: 3/2/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 - G,n ;0- Inspected by Deny g Regional Council of Governme(DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Building Department This is to certify�at the elevator as iridicat do this certificate has been inspected on the dtshown below and waound safe to carry 4000 lbs. Inspected by Deilu r egional Council of Governmerf'(DRCOG) Location Number: Building Name: Location: 8300MV. 38tt Ak ID Number: CP Safety Inspection Date: 3/28/2010 Elevator Inspection Date: 3128/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department L R This is to certify fat the elevator as ndicate n this certificate has been inspected on the d- mshown below and waound safe to carry 4000 lbs. Inspected by 64KV Regional Council of GovernmeKf- (DRCOG) Location Number: Building Name: Location: ID Number: CP Safety Inspection Date: 3129/2010 Elevator Inspection Date: 3/29/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department This is to certify t t the elevator as indicat #bn this certificate has been inspected on the d�a# shown below and waound safe to carry 4000 lbs. Inspected by Derma egional Council of Governme?,V�DRCOG) Location Number: 7X Building Name: LIE U Location: 831 ID Number: 2 Elevator T oe: CP Safety Inspection Date: 3/30/2010 Elevator Inspection Date: 3/30/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department This is to certify °tbat the A for as indicat�ed�n this certificate has been inspected on the awoshown below and wa° Aund safe to carry 4000 lbs. Inspected by DesaRegional Council of Governme (DRCOG) Location Number: 7; =aK mi � ° 1 Building Name: L bspi Location: 8300® P URMP ID Number: "3 Og ElevatorType: CP Safety Inspection Date: 3/30/2010 Elevator Inspection Date: 313012010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Bpilding Department This is to certify at the el vator as iridicatedon this certificate has been inspected on the ';fie "'shown below and waound safe to carry 4000 lbs. Safety Inspection Date: 3/31/2010 Elevator Inspection Date: 3/31/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De ` OiRegional Council of GovernmeDRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Building Department AN m: This is to certify t the e�ator as indicate on this certificate has been inspected on the d shown below and wa`F" ound safe to carry 4000 lbs. Inspected by De1Qb, egional Council of Governme (DRCOG) Location Number 7 ' ' Building Name: L�ithere ospit- Location: ID Number: 99 Safety Inspection Date: 3/31/2010 Elevator Inspection Date: 3/3112010 Certificate Issue Date: 311/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department This is to certifytliat the e' for as indicat1on this certificate has been inspected on the r� shown below and wav ound safe to carry 4000 lbs. Inspected by De ier °Regional Council of Government (DRCOG) Location Number 7�, 9V POF Afflt .- O N 011215 Building Name: QV thera&- Mal M—'ospita I 9' cac Location: 600 38 ID Number: 33 Elevator7ype: CP Safety Inspection Date: 4/5/2010 Elevator Inspection Date: 4/5/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department This is to certify t: , t the ei v for as rri dicat n this certificate has been lo inspected on the ti, below and wa%ound safe to carry 4000 lbs. Inspected by Deriv Regional Council of Governmel'(DRCOG) fe r Location Number W A. r Building Name: e =bspita a 0' Location: 830. .3 , ID Number: ElevatorType: CP Safety Inspection Date: 4/18/2010 Elevator Inspection Date: 4118/2010 Certificate Issue Date: 3/112010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department This is to certify�lt�at the a ator as indicated n this certificate has been inspected on the c�atshown below and wa � ound safe to carry 4000 lbs. Safety Inspection Date: 3/31/2010 Elevator Inspection Date: 3/31/2010 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 w Inspected by D = egional Council of Governmeif'(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: 12/4/2009 4a To: Lutheran Medical Center Engin. Opt. '%),pt. 8300 W. 38thtAve. Wheat Ridge, 63Q< 01 , Your annual elevafff inspection fee of $210 is dqqJorjocation # 35 elevator ID: 1 located at 8300 W. 38th Ave. in Wheat Rid _g TO -ANEW =H BE 4 TO Please remit paymentb bter than , 4 . O, A j A"�ry 1, 20, _W7 ARM- NOV A 151. A-MIN IN' 20�_ Please feel free to comact ouill ce if yQ0' ff�' ­nm­ "6- ­tr regarding your invoice. T -Tv gp r Thank you, --moo vw Z da# Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 1 Amount due: $21 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 Medical Cent(% ,�gngin. 8300 W. 38th Wheat Ridge, 0033 A y by C� y J Your annual elevator inspection fee of $210 is, due ,,fo.r_location # 35 elevator ID: 2 located at 8300 W. 38th Ave. in Whe - t Rjdgle 'Ma Please remit payment no later thqrf'?,, 7 211- 0 ' a r y 1 2 1 NE P" 99W �411 F " M 2 p-0 - "pmg 'T "M L A-1021.0 Please feel free to contact ou'610 14ce if yogi l"fia" V ti C tons regarding your invoice. JIM Awaffiismw� WW� Thank you, -PROV Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 2 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: 12/4/2009 To: Lutheran Medical Centej KEngin.ALept. 8300 W. 38th FEW "WR Wheat Ridge,60 Your annual elevatoi inspection fee of $210 is due f Qr_location # 35 eleva located at 8300 W. 38th Ave. in W11go Rid Please remit payment 6ter tharfl A NOISE Please feel free to coakt 0 f%frice if yo�u 0, re garding your invoice. Thank you, = 41 � Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 3 Amount due: $21 r ID: 3 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 Medical Cent(RgEngin. 9_), 8300 W. 38th-Ave. Wheat Ridge, , ONO 0033 P" I Your annual elevator inspection fee of $210 is duej. ,p,.,Ejocation # 35 elevator ID: 4 located at 8300 W. 38th Ave. in Wheat Ridge - 'gaffisp� - uw - - p --e-n -ti MW rpv Please remit payment A Nier thp N ru -W. q - hl - AVE, d"U A-MEN IN fl, Ur Am ME , Please feel free to contact ou j,'L� ffice if yo re garding your invoice. AWi t.. ALP' Thank you, 60"� j Please detach and send this stub in with your payment. Location 35 Address: 8300 W. 38th Ave. Elevator ID: 4 Amount due: $21 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: Lutheran Medical Cent6_hEngin. Dept. 8300 W. 38thAve. Wheat Ridge 60- 80033 vm Your annual elevator inspection fee of $210 is duefar location # 35 elevai located at 8300 W. 38th Ave. in Wheat Ridg0 09 m _ h- Eli Please remit payment aterthanJU Firuary 1, 2Q _ m: iS AV °nii::i'nec¢onniuu: Please feel free to contact our.ofice if youhaue questions regarding your invoice. — Thank you, a 90"6 y �ic�i¢ioc� ID: 5 Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 5 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: 12/4/2009 J To: Lutheran Medical Cent&Engin. ept. J 8300 W. 38th M Aff - �e. Wheat Ridge, , COaO033 Your annual elevatdf inspection fee of $210 is duejo-r-location # 35 elevator ID: 6 located at 8300 W. 38th Ave. in Wheat Ri Us AIM- 0 1 2 M®R A9 MR91, �'Z -01 Please remit payment rats later than eti iary 1, 2 0 4 W 1 I W" M 5''' E IM Mr-10TV Please feel f iions regarding your invoice. A � ffl Thank you, 0 M NO- va"ffl* Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 6 Amount due: $21 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: Lutheran Medical Cent6ruEngin. Mpt. 8300 W. 38th Wheat Ridge, �- oT.800:3 E _ .. «„ � IN" 4R �s�"o'i Your annual elevator inspection fee of $210 is d.ue,for „location # 35 eleva1 located at 8300 W. 38th Ave. in Wig 't Rid e frO ° -_- "NOV Please remit paymentA6.3ater than 7 ruary 1, 204 @YR�iNg MEW m; a Please feel free to contact our,nffice if yo A`Sq �urestions regarding your invoice. - = y ld µmain Alp Thank you, - -- o �� L/ cvca.7act Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 7 Amount due: $210 ID: 7 INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-235-2857 Date: 12/412009 To: Lutheran Medical Cent Engin.06-pt. 4 . 8300 W. 38th%Ave Wheat Ridge, 00 ,80033 Vq mss- Your annual elevat6f inspection fee of $210 is clue-for -location # 35 elevator ID: 8 located at 8300 W. 38th Ave in W Rid RT I 'm 80 V Elm AM-90. U.10MV, Please remit payment ,68A er qn' ar 1, 20... 0 '--- --- INN y lb NINE P V t th N � , , ,gggpygmp- 01. - go- til p Please feel free to CoRact oulr if % regarding your invoice. Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 8 Amount d ue: $21 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 Medical CentaFrigin. bbpt. 8300 W. 38thA MEW , ve. 6-f" Wheat Ridge, IF _J0033 Your annual elevat6f inspection fee of $Shut Downli m e� P�M- elevator ID: 9 located at 8300 W. 3hr'Av - Y 0_t " r v - Affiffiffi WPI AMR Please remit 1 201t . paymentp' 4 4 'Wary later thanT % ffir TO.M."W ARM A M R I E 4 .7 A740 Please feel free to coRtact o -'(-�.Wce if yoAfi invoice. 1- '�ff.—HMGHF 'A' i-- T -A� ap Apr 0 - Thank you, -A due for location # 35 regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 9 Amount due: $Shut Down!!! 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: Lutheran Medical Cent&Fngin. [%pt. ft 8300 W. 38Ave. WZM. =t Wheat Ridge, ; 80033 Your annual elevaf Finspection fee of $Shut Dow elevator ID: 10 located at 8300 W. -38-th fte- Please remit payment Ater than —if ry 1 201X C' zgm&gyp MHE Please feel free to contact 041 , 01 ice if Yom' ON 0 990es invoice. A Thank you, 96 " 6 y due for location # 35 regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 10 Amount due: $Shut Down!!! 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: Lutheran Medical Cent grigin. QQpt. 8300 W. 38th:Ave. _ Wheat Ridge, MI. 00033 Your annual elevator inspection fee of $Shut Down,' j,' is due for location # 35 elevator ID: 11 located at 8300 W. 381# AveR7ffiW 2idge� C&O -02-0' .. -- NMI RYq ry Please remit payment flM er than rua 1, 20 �. alffi _. IF 4 OF -,- Please feel free to cor3tact )yr like i estions regarding your invoice. '= = m Thank you,' va"4� �u�iaca� Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 11 Amount due: $Shut Downff! 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 Medical Cent"ngin. , m-pt- 8300 W. 38th-,Ave. Wheat Ridge, i-- , 80033 Your annual elevaf r inspection fee of $210 is dqq JoLlpcation # 35 eleval 12 located at 8300 W. 38th Ave. irl,.W ... MOM N Please remit paymentto later tha. 010 10 U HIP- -9 NUM Please feel free to con if bttions regarding your ,ta invoice. Thank you, vu";v Please detach and send this stub in with your payment. Location 35 Address: 8300 W. 38th Ave. Elevator ID: 12 Amount due: $210 M 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 J ' Lutheran Medical Centd ngin.P1 To: – pt. 8300 W. 38th'I,.Ave. Wheat Ridge, CM-11 0033 Your annual elevator inspection fee of $210 is due for -location # 35 eleva 13 located at 8300 W. 38th Ave. in W '-Mam a l. ( ,heat -1, M W � M -17 "a-Ma-M EPP Please remit payment A'M,6ter tha 1 , 201pR s Please feel free to con tact oaf 4 ice if i ns regarding your invoice. ON— Thank you, FA Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 13 Amount d ue: $21 I7 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 M To: Lutheran Medical Centkgngin. pt. 8300 W. 38MTA_ve. S Wheat Ridge, 602480033 I R IMM IMP Your annual elevator inspection fee of $210 is due .or_location # 35 eleval 14 located at 8300 W. 38th Ave. in UUtieat C n` _ Please remit paymentd Peter tharbYiaary 1, 20 - Please feel free to cottact oul— fice d yo��gtions regarding your ow invoice. ��- �_� M Thank you, " I -=�� $'w"4vg L/ cuc¢ioc� Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 14 Amount due: $210 In 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 Medical Cent"ngin. _Dept. 8300 W. 38th r�@ Affl -019 Wheat Ridge,b 003 U Your annual elevator inspection fee of $210 is duej,,Q ' .,r, location # 35 elevator ID: -Sb 15 located at 8300 W. 38th Ave. "i.WheatRAde �AL EMMA Please remit payment too ter that filary 1, 2 A A AS U" Please feel free to contact oq p�ffice if y ions regarding your mvF W invoice. - 9 n IN,-` --E 943V Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 15 Amount due: $21 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: Lutheran Medical Cent Ungin. d R 8300 W. 38th-xQve. —' Wheat Ridge, , , 80033 Your annual elevator inspection fee of $210 is due: for w location # 35 elevai 16 located at 8300 W. 38th Ave. in Wthea g 2 M US AN Please remit payment fio ater than-As ary 1, 24 Please feel free to contact our afice if yptatdstions regarding your invoice. Thank you, r S'u�t?duuy �iv�2ioc� Al Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 16 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: 12/4/2009 To: Lutheran Medical Cent&Engin.F pt. 8300 W. 38th%Ave. - °- v Wheat Ridge, 00 =$0033 Your annual elevator inspection fee of $210 is duefor location # 35 elevai 17 located at 8300 W. 38th Ave. in Wheatidge�3 t x e . Please remit paymentf41ater th�rs Feuary 1, 200 y w A NET f:.. m Please feel free to contact obiffiice if yg ivq[5esfions regarding your invoice. is 5 Mme "i a " Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 17 Amount due: $210 in 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 A 465 To: Lutheran Medical Cent&Engin. LD r " ..- Pt. - 8300 W. 38thkAve' AR � Wheat Ridge, '0 0033 1 -1 'Pho — 7 9 Your annual elevaRF inspection fee of $210 isd-u-e.io-r.-location#35elevaI 18A located at 8300 W. 38th Ave. Jr.-h 1 . 'eat-23 Udw- Oft - �p " -- , - RR Please remit payment"A titer th r'l E�W 2 iruary 1, 2,Q. NMEF A -. M-011 P 0M., A — Please feel free to co -Fou ti ns regarding your h e if you 1.9 invoice. - -4 'A A7 Thank you, awr Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 18A Amount due: $210 To] 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: Exempla Lutheran Med;!Ctr. Eng ept Wheat Ridge",mQO 800$3 A# q% Your annual elevaUNinspection fee of $210 is due foraf ation #35 elevator ID: 18B located at 830 38th Ave. in Wheat Ridge,j Afil- Please remit payft triq$M than 1 201 0-0 9 OF' A.-M Please feel free t # P ct our', r 4;� , , , if u invoice. Thank you, 01 A4T MAP regarding your Please detach and send this stub in with your payment. Location M 35 Address: 8300 W. 38th Ave. Elevator ID: 18B Your annual elevaUNinspection fee of $210 is due foraf ation #35 elevator ID: 18B located at 830 38th Ave. in Wheat Ridge,j Afil- Please remit payft triq$M than 1 201 0-0 9 OF' A.-M Please feel free t # P ct our', r 4;� , , , if u invoice. Thank you, 01 A4T MAP regarding your Please detach and send this stub in with your payment. Location M 35 Address: 8300 W. 38th Ave. Elevator ID: 18B Amount d ue: $21 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: Lutheran Medical Centa ngin. pt. 8300 W. 38th+Ave MI Wheat Ridge, C0;80033 MEN Your annual elevk inspection fee of $210 is due..for location # 35 elevator — "MN 19 located at 8300 W. 38th Ave. in-W iheat,.Rj' M .— Please remit paymentfi" ter than # -xr ASON U AMMER g ou"k , H EW ANN "UN Please feel free to cofi1tact o .&,� - i ions regarding your ­ M11 invoice. IS ME— �iV AV . . . . . . . . . . Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 19 Amount due: $21 M 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: Lutheran Medical CentC.Engin. Apt. 8300 W. 38ftAve. Wheat Ridge, G-L? „$0033 'w -'�,; G,NO z� Your annual elevat'6f inspection fee of $210 is 4uq..fo.[,location # 35 elevator ID: 20 located at 8300 W. 38th Ave. in wIUf�eat a . - n u° Please remit paymentAaater thanetlrary �F ; TV � mg j 5h I� RS Please feel free to contact our office if yogagpestions regarding your an invoice. as >. ;I FA IMF Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 20 Amount due: $210 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: 12/412009 To: Lutheran Medical Centq, .01 8300 W. 38ft&e. F -1-0 1 'Aly iff Wheat Ridge, 01Z r I N V Your annual elevator inspection fee of $210 is due.10-r-location # 35 eleval 21 located at 8300 W. 38th Ave. Please remit payment<noater th Please feel free to corafact ou ice if y ions regarding your invoice. P; AM — ;�o M M . Thank you, IBM M Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 21 Amount due: $21 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 »M To: Lutheran Medical Cent6fEngin. Dept. 8300 W. 38th Ave. F 04 - 1 1 - F Wheat Ridge, -80033 2 ,, r v U P u « Your annual elevator inspection fee of $210 is due for locati 22 located at 8300 W. 38th Ave. in MI— = Please remit payment noater thanfiriiary 1, 2UOs maw AUW # 35 elevator ID: Please feel free to contact ouffif", fice if yo ions regarding your invoice. = _ �vr _ -ttim APP Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 22 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: 12/4/2009 JT A To: Lutheran Medical Cent"ngin. Dept. 8300 W. 38 th Ave. >' Wheat Ridge, I N 4 0033 - IF 46 Your annual elevator inspection fee of $210 is dp.#jq09pation # 35 eleval 23 located at 8300 W. 38th Ave. in _{heat AS 5 A-EffifflPF SO Al A- 2 0 1 b' - -0 0 Please remit paymen N l ater thanN R bhjary 1 M --p-p t" ; i -- fl.—fflul m�m gpgw Uri f'SURNIFF AN , � In g IN ." T, rK'. i regarding your Pl ease f e e I f ree t o c o d1a c t oul"ER6 invoice. t. Thank you, n w OW&& 16 Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 23 Amount due: $21 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 A To: Exempla Lutheran Med ..,,tr. Eng, 44, ept. 1 AMR 8300 W. 38th-,A.ve. OR Wheat Ridge, 6.0- 0033 Your annual elevatdf inspection fee of $210 is due-for location # 35 elevator ID: P� � � r 24 located at 8300 W. 38th Ave. in-M, - eat,R f O W _ftM -h _ REM- AM — MEN- M Please remit payment .010 thapffl 1, 20-1A3 ME - ,4 ME- i5 - Myo A AM R-1 W Please feel free to co AW - Mppp +MM J­ h 5 co oQgpjf e if yoU - 7y M mot i ons regarding your H M , 0 'MM invoice. Thank you, va" Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 24 Amount due: $21 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: Exempla Lutheran Medfi r. Engj ept. _0 8300 W. 38th-Ave. AMM Wheat Ridgejbw 80033 11V 'r Your annual elevator inspection fee of $210 is djue.for location # 35 eleval 25 located at 8300 W. 38th Ave. �%W-heat e 5N 11V imp M... 5 1 payment @4 ary 2044@ Please remit pay @4 ter thazTj MHI AMEM nary MIF ANIMP111P ' glm - - - 4go— Please feel free to contact o Ja �Ice if you y Veiestions regarding your invoice. as Thank you, up Please detach and send this stub in with your payment. Location M 35 Address: 8300 W. 38th Ave. Elevator ID: 25 Amount d ue: $21 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: Exempla Lutheran Med0::';Q-tr. Enqfflept. 8300 W. 38th-Ave FIJI wo f r , Wheat Ridge, 60., G V ---w UP ' Your annual elevator inspection fee of $210 is ,[@,,f,p_r_location # 35 26 located at 8300 W. 38th Ave. in- h e Please remit payment fib'15ter thc0, 'F_d0Mary 1, ZQ-14 Please feel free to invoice. Thank you, I U1 if regarding your 11111 Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 26 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 ID: 1 located at 8300 W. 38th Ave. in Wb - t Ri F Please remit payment, rater tha _ _; ary 1, Please feel free to invoice. if regarding your Thank you, r' I , a �r r ` �I Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. 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 Please feel free to coact o ice if y tions regarding your invoice. Thank you, Please detach and send this stub in with your payment. Location M 35 Address: 8300 W. 38th Ave. Elevator ID: 2 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 # 35 elevator ID: 3 Please feel free to invoice. if regarding your Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 3 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 To: Lutheran Medical Cent ngin. pt. 8300 W. 38th ve. 3. Wheat Ridge, IT 0033 4 Your annual elevat , inspection fee of $210 is located at 8300 W. 38th Ave. in ftV Ri '6 Please remit Please feel free to invoice. Thank you, I U1 if -, W- . or location # 35 elevator ID: 4 regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 4 ry 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 ID: 5 Please feel free to invoice. Thank you, /- I . , if ns regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 5 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 M Please feel free to invoice. Thank you, if regarding your Please detach and send this stub in with your payment. Location M 35 Address: 8300 W. 38th Ave. Elevator ID: 6 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 ID: 7 located at 8300 W. 38th Ave. in Whe®Rig Please remit payment ter thqd4WM ary 1, Please feel free to invoice. if regarding your Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 7 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 Your annual elevator inspection fee of $210 is located at 8300 W. 38th Ave. in Wheaf Ridgd Please remit Please feel free to coact o ° ice if invoice. Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 8 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 due for location # 35 Please feel free to coact o ice if invoice. . Thank you, regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 9 Amount due: $Shut Down!!! INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 - 235 -2857 M I Your annual elevato inspection fee of $Shut elevator ID: 10 located at 8300 W. Vh Avg n Please remit Please feel free to invoice. Thank you, 1, if due for location # 35 regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 10 Amount due: $Shut Down!!! 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: Lutheran Medical Cent- ngin. I pt. 8300 W. 38th' ve. Wheat Ridge, 0033 Your annual elevat @inspection fee of $Shut elevator ID: 11 located at 8300 W. 8th Aval Ao Please remit Please feel free to invoice. Thank you, t� if if due for location # 35 regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 11 Amount due: $Shut Down!!! INVOICE City of Wheat Ridge Building Division 7500 W. 29 Ave. Wheat Ridge, CO 80033 Office: 303 - 235 -2855 * Fax: 303 - 235 -2857 Date: 12/1512008 rID: 12 located at 8300 W. 38th Ave. in ea 0 - j" I Please remit payment ter tha„r ary 1, Please feel free to invoice. if regarding your Thank you, t• Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 12 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 # 35 elevator ID: Please remit payment Mliter tha _ _ " ih`i"iary 1, 2 Please feel free to invoice. if regarding your Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 13 Amount due: $210 INVOICE Please feel free to coact o i if ce y °' tions regarding your invoice. ° Thank you, bur. &9u 9"de" ¢ta# Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 14 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 coyact 0 lwiceif y tions regarding your invoice. X Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 15 Amount due: $210 INVOICE Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 16 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 am 17 located at 8300 W. 38th Ave. i - - - eatal Please remit payment ter tha rt ruary 1, „ Please feel free to invoice. if ns regarding your Thank you, ., 1� Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 17 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 # 35 elevator ID: Please feel free to invoice. if regarding your Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 18A 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 Your annual el t inspection fee of $210 is due 18B located at 830 . 38th Ave. in Wheat RidDe Please remit pa'it Please feel free to invoice. Thank you, if you # 35 elevator ID: regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 18B than _ "` 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 M Please feel free to invoice. Thank you, if ns regarding your Please detach and send this stub in with your payment. Location M 35 Address: 8300 W. 38th Ave. Elevator ID: 19 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 coact o ice if y E tions regarding your invoice. Thank you, 1� Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 20 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: 12/1512008 Please feel free to coact o ice if ytions regarding your invoice. Thank you, m Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 21 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 To: Lutheran Medical Cent ngin. pt. 8300 W. 38th Vve.. Wheat Ridge0033 Your annual elevato' inspection fee of $210 is 22 located at 8300 W. 38th Ave. itiea Please remit Please feel free to coact o ice if invoice. Thank you, s tions regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 22 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 Ell Please feel free to invoice. if regarding your Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 23 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 To: Exempla Lutheran MedWtr. En ept. 8300 W. 38th' Wheat Ridge, -MA 0033 Nq=;; Your annual elevates inspection fee of $210 is d or location # 35 go 24 located at 8300 W. 38th Ave. in eat. 01 r Please remit payment.;m; m t ary m _ er tha 1, Please feel free to invoice. regarding your if Thank you, Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 24 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 0 J I Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 25 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 # 35 elevator ID: Please feel free to coact o = ice if invoice. ,a Thank you, ° . . t• regarding your Please detach and send this stub in with your payment. Location #: 35 Address: 8300 W. 38th Ave. Elevator ID: 26 Amount due: $210 ,. q1 , I cj �s 53 ✓t -li 97 io8y� G�o9sg� f O 0 Ckftl Sa ,. Inspections Page 1 of 1 zf inme Correctio Vi nit Notices Plan Reviews PW IMCI /Edit Us Synchr Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may viewledit a previous inspection by clicking the "Select" hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection' button. Address 8300 W 38th AVE Jurisdiction WHEAT RIDGE Building Assigned #: 27 Bar code #: 05501 Unit Type Electric passenger Elevator (aka Cable) Start New:: Inspection Edit this Unit Safety Tests ' M— k—. T- N.... s.... LL:.. . Date i Insp Typ of In Status Select Delete 03 -28 -2010 1 Bill Chouinard Acceptance Inspection Finished Select Delete Safet Test Histo Date Type 03 -01 -2010 I 5 -year full load test Version 4.2.3 07229 I Bill Chouinard I Copyright 2006 -09 Denver Regional Council of Governments hap:// localhost/tablet /Inspections.aspx ?UnitID =DL72 4/5/2010 Inspections Page 1 of 1 Home Correct Notices Plan Reviews View AddJEdit Units Synchronize Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below Is a list of previous inspections for this unit. You may viewledit a previous inspection by clicking the "Select' hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection" button. Address 8300 W 38th AVE Jurisdiction WHEAT RIDGE Building Assigned #: 28 Bar code #: 05502 Unit Type Electric passenger Elevator (aka Cable) Safe tv Test Histo : Date I Type 03 -01 -2010 1 5 -year full load test Version 42.3.07229 1 Bill Chouinard 1 Copyright 2006 -09 Denver Regional Council of Governments http: //Iocalhost/ tablet /Inspections.aspx ?UnitlD =DL73 4/5/2010 Inspections Page 1 of 1 Home Co rrection Notice Plan Reviews Wiew.[Add/ Units Synchronize Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may view /edit a previous inspection by clicking the "Select' hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection" button. Address 8 W 38th AVE Jurisdiction WHEAT RIDGE Building Assigned #: 23 Bar code #: 05503 Unit Type Electric passenger Elevator (aka Cable ) . Safet Test Histo Date Type 03 -01 -2010 1 5 -year full load test Version 4.2.3.07229 1 Bill Chouinard j Copyright 2006 -09 Denver Regional Council of Governments http:// Iocalhost/tablet /Inspections.aspx ?UnitID =DL74 4/5/2010 Inspections Page 1 of 1 Home Correction N otices Plan Reviews Vi d / e /AdEdit Units Synchronize Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may viewledit a previous inspection by clicking the "Select' hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection" button. Address 8300 W 38th AVE Jurisdiction _ WHEAT RIDGE Building Assigned #: 30 Bar code #: 05504 Unit Type Electric Passenger Elevator (aka Cable) Edit this Unit Safe Test Histo Date Type 03 -01 -2010 1 5 -year full load test Version 4.2.3.07229 1 Bill Chouinard I Copyright 2006 -09 Denver Regional Council of Governments http:// Iocalhost/tablet /Inspections.aspx ?UnitlD =DL75 4/5/2010 Inspections ._..._.... Page 1 of 1 ....% Home Correc Notic Plan Reviews View/Add/E dit-Units Synchronize Dat Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may viewledit a previous inspection by clicking the "Select" hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection" button. Address 8300 W 38th AVE 3urisdiction _ WHEAT RIDGE Building Assigned #: 31 Bar code #: 05505 Unit Type Electric Passenger Elevator (aka Cable) Safety Tests_ Safet Test Histo Date Type 03 -01 -2010 1 5 -year full load test Version 4.2.3.07229 ] Bill Choumard I Copyo ht 2006 -09 Oenvcr Regional Council of Governments http: //Iocalhost/ tablet /Inspections.aspx ?UnitlD =DL68 4/5/2010 Inspections Page 1 of l Home C Notices Plan Reviews View /Add /Edit Units Synchronize_ Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may viewfedit a previous inspection by clicking the "Select' hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection' button. Address 8300 W 38th AVE Jurisdiction WHEAT RIDGE Building Assigned #: 32 Bar code #: 05506 Unit Type Electric Passenger Elevator (aka Cable) Edit.this Unit f F Safety : Tests - S Select I Delete Sa etv Test Histor Date Type IF 03 -01 -2010 5 -year full load test Veralon 3.2.:.07229 HIII Chou,ma -1 I Cgpynght 2006 0 0 Dcniver Regional Council of Governments http:// Iocalhost/tablet /Inspections.aspx ?UnitlD =DL77 4/5/2010 Inspections It/ Page I of 1 Home Correction Notices Plan Reviews ViewJAddLEgI t Units Sy_nc -Data Reports Administration Log out - Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may viewledit a previous inspection by clicking the "Select`' hyperlink to the right of the inspection. To start a new inspection, click the "Stan New Inspection' button. Address 8300 W 38th. AVE Jurisdiction WHEAT RIDGE Building Assigned #: 33 Bar code #: 05503 Unit Type Hydraulic passenger Elevator Edit this Unit Safety.7ests Droarinuc Pncnnniinnc fns fhic 1Inif- Date Inspector Tvpe_o Inspe Status Select Delete 04 -05 -2010 Bill Chouinard Acceptance Inspection Finished Select I Delete SlfetV Test Histor Date Type 03 -01 -2010 1 5 -Year full load test Version 423.0,229 I Dili Chouinurd ; Copyright 2008 -09 Denver Region! Council of Govemmern http: //Iocalhost/ tablet /Inspections.aspx ?UnitID =DL79 4/5/2010 Inspections Page 1 of 1 Home Correc Notices Plan Reviews ViewJ /Etlit Units Synchron Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may viewledit a previous inspection by clicking the "Select" hyperlink to the right of the inspection. To start a new inspection, click the "Start New Inspection" button. Address 8300 w 38 AVE Jurisdiction _ WHEAT RIDGE Building Assigned #: 34 Bar code #: 05508 Unit Type Hydraulic passenger Elevator Select I Delete Sa etv Test History: Date Type 08 -01 -2009 5 -year full load test Version 4.2.107229 1 Bill Choumard I Ceprighl 2005 09 Denva Regional Council of Gmvernmcnm http: //Iocalhost/ tablet /Inspections.aspx ?UiiitlD =BG303 4/5/2010 Inspections Page I of 1 Home Correction._ Notices Plan Reviews View /Add /Edit Units Synchronize Data Reports Administration Log out Specific Unit Information You have chosen to inspect this unit. Below is a list of previous inspections for this unit. You may view /edit a previous inspection by clicking the "Select" hyperlink to the right of the inspection. To start anew inspection, click the "Start New Inspection" button. Address 8300 W 38th AVE Jurisdiction WHEAT RIDGE Building Assigned #: 36 Bar code #: 05507 Unit Type Hydraulic Passenger Elevator Edit: this Unit Safety7ests i4)•�3111 Select I Delete Safe Test Histo Date Type 03 -01 -2010 1 5 -year full load test Yetrsian 423.07229 I Bill Chouina;tl I DopydWit 200609 Denveridegional Council of Govemments http: //Iocalhost/ tablet /Inspections.aspx ?UnitlD =DL80 4/5/2010 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Building Department ° m a This is to certifyltlat the elevator as mdica teen this certificate has been inspected on the dale shown below and wd and safe to carry 5000 lbs. g' . Inspected by De�}°Regional Council of Governme� "(DRCOG) Safety Inspection Date: 9/18/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 12:00:00 AM Lutheran Medical Center Engin. 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 Department 2.1 A A I I 499%5 - M -41 This is to certify the el tor as i dicated- this certificate has been inspected on the `shown below and wd und safe to carry 5000 lbs. Inspected by egional Council of Govern me Location Number: FROF P-H- w Building Name: ther ospi Location: 830,0k'L-A 3q_,tftX-& 1, -A"P ID Number: -.-1zNM Elevator CP Safety Inspection Date: 9/18/2009 Elevator Inspection Date: 9/18/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 211/2011 Lutheran Medical Center Engin. 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 Department L M& — IM � WNR This is to certify 1 ? the el—e-Gtor a All, s iridicatedl6n this certificate has been inspected on the 9f"hown below and was und safe to carry 5000 lbs. Inspected by 687 egional Council of GovernmeW DRCOG) Location Number: Building Name: Location: ID Number: ElevatorTvr)e: CP Safety Inspection Date: 9/18/2009 Elevator Inspection Date: 9118/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/11/20111 Lutheran Medical Center Engin. 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 Department 11 - Z 11 Ink This is to certifj!#qt the elevator as ihdicate6o this certificate has been inspected on the d s hown below and W und safe to carry 5000 lbs. 'V1- Safety Inspection Date: 9/18/2009 Elevator Inspection Date: 9/18/2009 Certificate Issue Date: 31112010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 - — F"'- M� Inspected by De Council of Governme RCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department 4 This is to certify th he efvator as iiidicadaon this certificate has been inspected on the dAMPshown below and wa"Jound safe to carry 1500 lbs. Inspected by Derr --, Regional Council of Governmei t (DRCOG) Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 D.ppartment L This is to certify"tpat the el adicatq J %,n this certificate has been inspected on the W6 s in shown below and ­ Hound safe to carry 50 lbs. Inspected by D60' Regional Council of GovemmeYn(DRCOG) MP IiH - IV Location Number: Building Name: Location: ID Number: Elevator DW Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 3/11/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department A This is to certify �)hat the e ator as indica on this certificate has been inspected on the 89& shown below and waTlifound safe to carry 2700 lbs. IF Safety Inspection Date: 9/18/2009 Elevator Inspection Date: 9/18/2009 Certificate Issue Date: 3/11/2010 Expiration Date: 12:00:00 AM Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Ddhift t DRCOG) ,ty!Regional Council of Governmehl Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 B911ding Department ArK -M AMR This is to certify that lb" aisli6ca tor q the e tqc[,bn this certificate has been inspected on the akPshown below and w und safe to carry 2700 lbs. Ins 3 A Q pected by D - HVQ� - egional Council of Governrnefff Safety Inspection Date: 9/23/2009 Elevator Inspection Date: 9123/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/11/2011 Lutheran Medical Center Engin. 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 Department m This is to certifyI4 t the elevator as ndicated n this certificate has been inspected on the dates shown below and wasound safe to carry 4000 lbs. t r° " Inspected by Derti% Regional Council of GovernmerirtPDRCOG) Location Number: Building Name: Location: ID Number: ElevatorType: HP Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 311/2010 Expiration Date: Lutheran Medical Center Engin. 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 Department N� This is to certiO.Oat the elevator as indicate, 4 o p o`n this certificate has been inspected on the e shown below and wasound safe to carry 4000 lbs. Inspected by D4fiV"egional Council of GovemmeKQDRCOG) Location Number: Building Name: Location: ID Number: Elevator'Tvpe: HP Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 3/112010 Expiration Date: Lutheran Medical Center Engin. 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 Department & k A This is to certify*h at the el ator as ­ Hdicated26n this certificate has been inspected on the die shown below and wasound safe to carry 3500 lbs. I Safety Inspection Date: 3119/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 3/1/2010 Expiration Date: Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 VNRF' Inspected by Denver _rRegional Council of GovernmeiW(DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Byilding Department AM This is to certify'that the efevator as indicated-�,6n this certificate has been inspected on the fe shown below and was found safe to carry 50 lbs. Inspected by Deny% - egional Council of Govern me (DRCOG) Safety Inspection Date: Elevator Inspection Date: Certificate Issue Date: Expiration Date: Lutheran Medical Center E 8300 W. 38th Ave. Wheat Ridge, CO 80033 3/19/2009 3/19/2009 3/1/2010 2/11/20111 -ngin. Dept. Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department G4- y This is to certify the elevator as indicated46n this certificate has been inspected on the' '"t shown below and w�found safe to carry 50 lbs. Inspected by DenV,- Regional Council of Governme (DRCOG) Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department a. 'e This is to certify as in th the a evator dicatedn this certificate has been inspected on the -fie shown below and m and safe to carry 500 lbs. IF 0"- Inspected by 66M6 Council of Govemme tf Location Number: Building Name: Location: ID Number: Elevator l ype: DW Safety Inspection Date: 3/1912009 Elevator Inspection Date: 311912009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. 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 Department A A Aw - M This is to certify�toat the elevator as indicate din this certificate has been inspected on the dg&8hown below and A' and safe to carry 4500 lbs. W N-20-HP Inspected by Council of Governme ( DRCOG) Safety Inspection Date: 9/22/2009 Elevator Inspection Date: 912212009 Certificate Issue Date: 3/112010 Expiration Date: 211/2011 Lutheran Medical Center Engin. 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 Department A , �n " This is to certify'that the elevator as indicated -bn this certificate has been inspected on the c'- hown below and was found safe to carry 4000 lbs. TOY Inspected by bah - `Regional Council of Govern mei;rf "(DRCOG) Safety Inspection Date: 9122/2009 Elevator Inspection Date: 9/22/2009 Certificate Issue Date: 311/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department All a.- —1 This is to certifylopt the i tor andicat%,F16n this certificate has been inspected on the 8917 5shown below and wasbund safe to carry 4000 lbs. 'm Inspected by D&N' Regional Council of Govemme Location Number: W & � j Ow a AH AMN-0 A M Building Name: Lutheran iospit 71 at A-01. ma Location: a " M 830,Q,.UM-- A A _Oaaal ID Number: `'j 7a .0 ' OR Elevator Type: HIP Safety Inspection Date: 912212009 Elevator Inspection Date: 9122/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Lutheran Medical Center Engin. 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 Department 1 1., L 199 A This is to certify 1 10 AIR .,pt the el6i6tor as'iridicatpo this certificate has been inspected on the dloPshown below and waso und safe to carry 4000 lbs. - la Inspected by DOWWRegional Council of GovernmeM RCOG) 7�kll Location Number 3�15--V' fO MEW Building Name: Luthe raospi l Location: 830Q X11. t ID Number: rN Elevator HIP Safety Inspection Date: 9/23/2009 Elevator Inspection Date: 912312009 Certificate Issue Date: 311/2010 Expiration Date: 2/11/20111 Lutheran Medical Center Engin. 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 Department This is to certify'%at the el@Vator a qlg iridicate,�jlbn this certificate has been 74 inspected on the da"hown below and was safe to carry 12000 lbs. Inspected by Iia—ffl— egional Council of Governme I Location Number: Building Name: Location: ID Number: ElevatorTvr)e: HIF Safety Inspection Date: 9/23/2009 Elevator Inspection Date: 9/23/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/112011 Exempla Lutheran Med. Ctr. Eng Dept. 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'tt the dwator as mdicateon this certificate has been IM inspected on the do Yshown below and was�ound safe to carry 4000 lbs. Inspected by De WO Regional Council of Governmerf (DRCOG) Location Number: 3 e 10 1 10M` li ' �, ,::E" HT AN,- >. Building Name: Luthegh- spi Location: 830W 38.t1v ID Number: 1 " ElevatorType: HP Safety Inspection Date: 9/2312009 Elevator Inspection Date: 9/23/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 211/2011 Lutheran Medical Center Engin. 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 Department I R mmkk AIN This is to certify he er as indicatedffion this certificate has been inspected on the dl.%N below and wa ound safe to carry 20000 Ibs. Inspected by DeftVtffRegional Council of GovernmetW(DRCOG) Safety Inspection Date: 9/23/2009 Elevator Inspection Date: 9/23/2009 Certificate Issue Date: 3/11/2010 Expiration Date: 2/11/2011 Lutheran Medical Center Engin. 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 Department Sk -.K This is to certifythat the el a`sl� this certificate has been inspected on the Qb�shown below and was und safe to carry 2500 lbs. V Safety Inspection Date: 9/23/2009 Elevator Inspection Date: 9/23/2009 Certificate Issue Date: 3/11/2010 Expiration Date: 2/112011 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by 6ei egional Council of Governme RCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department IrM This is to certify�tbqt the eF tor as indicated this certificate has been inspected on the d&yshown below and way � and safe to carry 2500 lbs. Inspected by DOVibl egional Council of GovernmerffQDRCOG) ri R Location Number: Building Name: Location: ID Number: Elevator7ype: HP Safety Inspection Date: 9123/2009 Elevator Inspection Date: 9/2312009 Certificate Issue Date: 311/2010 Expiration Date: 2/11/2011 Lutheran Medical Center Engin. 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 Department A This is to certify"that the elbVator as Fhdicate __q[ on this certificate has been k�r-s inspected on the d ­ ehown below and wd9klbund safe to carry 5500 lbs. Inspected by Den -" Regional Council of Govern ment'(D RCOG) Location Number: Building Name: Location: ID Number: ­ 23 g Elevator7ype: ~ HP Safety Inspection Date: 9/23/2009 Elevator Inspection Date: 9/2312009 Certificate Issue Date: 3/112010 Expiration Date: 211/2011 Lutheran Medical Center Engin. 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 Bpilding Department M ROOM This is to certify1bat the ef4vator as indicat@d$on this certificate has been inspected on the dWshown below and was safe to carry 4500 Ibs. A Inspected by bVe' Council of GovernmehflDRCOG) Safety Inspection Date: Elevator Inspection Date Certificate Issue Date: Expiration Date: Exempla Lutheran Med. C 8300 W. 38th Ave. Wheat Ridge, CO 80033 9122/2009 9/2212009 3/11/2010 2/11/2011 :tr. Eng. Dept. Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Byliding Department This is to certify , 1phgat the elevator a's indicate n this certificate has been inspected on the J14 &khown below and waound safe to carry 4500 lbs. Inspected by Denv Regional Council of Governmeift(DRCOG) Location Number 3" M 10 IS , P AMIN Building Name: fMC Location: 83 F ID Number: Elevator Type: CIP Safety Inspection Date: 9/22/2009 Elevator Inspection Date: 9/22/2009 Certificate Issue Date: 3/1/2010 Expiration Date: 2/1/2011 Exempla Lutheran Med. Ctr. Eng. 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 Department AM This is to certify �% the e 9Vato r ars icated-2. n this certificate has been inspected on the. I ishown below and =nd safe to carry 4500 lbs. bi V - Safety Inspection Date: 9/22/2009 Elevator Inspection Date: 9/22/2009 Certificate Issue Date: 311/2010 Expiration Date: 2/11/2011 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DAVRegional Council of Governmeiit'(DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building D: partment This is to certify t the a 'vator as indicat n this certificate has been inspected on thee- °shown below and wa our safe to carry 5000 lbs. Safety Inspection Date: 3119/2009 Elevator Inspection Date: 311912009 Certificate Issue Date: 5/112009 Expiration Date: 2/112010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De �Regional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Building Department This is to certify t the a vator asndicate n this certificate has been inspected on the hown below and wa ound safe to carry 5000 lbs. Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 21112010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by 68%W-Regional Council of Governme°= (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Inspected by De ffi egional Council of Governme (DRCOG) Location Number: Building Name: Location: ID Number: ElevatorTvoe: CP Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 5/112009 Expiration Date: 21112010 Lutheran Medical Center Engin. 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 Safety Inspection Date: 3/1912009 Elevator Inspection Date: 311912009 Certificate Issue Date: 5/112009 Expiration Date: 211/2010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DeY3 egional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29"' Ave. Wheat Ridge, CO 80033 Location Number: Lutheran Medical Center Engin. 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 Lutheran Medical Center Engin. 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 Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 511/2009 Expiration Date: 211/2010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DeTn egional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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: 3/1912009 Elevator Inspection Date: 3/1912009 Certificate Issue Date: 511/2009 Expiration Date: 2/112010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De WRegional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building D ' epartment This is to certify'- at the a ator as indicatedon this certificate has been inspected on the - hown below and wasound safe to carry 4000 lbs. Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De kegional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave, Wheat Ridge, CO 80033 Safety Inspection Date: 311912009 Elevator Inspection Date: 311912009 Certificate Issue Date: 5/112009 Expiration Date: 211/2010 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De R egional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Inspected by De egional Council of Governme (DRCOG) Location Number: Building Name: Location: ID Number: M1 Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Safety Inspection Date: 3119/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Department This is to Ce rtify t the e ator as indicat this certificate has been inspected on the shown below and wound safe to carry 500 lbs. Inspected by De - Regional Council of Governme (DRCOG) Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Biding Department This is to certify t the aviator as ndicat n this certificate has been inspected on the shown below and wa flund safe to carry 4500 lbs. Inspected by De egional Council of Governmen (DRCOG) Safety Inspection Date: 311912009 Elevator Inspection Date: 3/1912009 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Inspected by De m egional Council of Governme (DRCOG) Location Number: Building Name: Location: ID Number: Elevator'Type: HP Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 311912009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Safety Inspection Date: 311912009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/112009 Expiration Date: 211/2010 Lutheran Medical Center Engin. 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 Department u This is to certifyat the a ator a ndicat n this certificate has been inspected on the d *shown below and wa ound safe to carry 4000 lbs. - Inspected by De ; ,Regional Council of Governme (DRCOG) Location Number: Building Name: Location: ID Number: ElevatorTvoe: HP Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Department This is to certify`t t the e vator as indicat n this certificate has been inspected on the dshown below and wa and safe to carry 12000 lbs. Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/1912009 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Exempla Lutheran Med. Ctr. Eng Dept. Wheat Ridge, CO 80033 Inspected by De Regional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Bilding D partment This is to certify t the e e ator Ai A ndicat, n this certificate has been inspected on the shown below and wa . safe to carry 4000 lbs. Inspected by De Regional Council of Governmer(DRCOG) Location Number: Building Name: Location: ID Number: Elevator Tvae: HP Safety Inspection Date: 311912009 Elevator Inspection Date: 311912009 Certificate Issue Date: 511/2009 Expiration Date: 2/112010 Lutheran Medical Center Engin. 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 Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/112009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Inspected by De egional Council of Governme 0 (DRCOG) Location Number: Building Name: Location: ID Number: Elevator - TVDe: HP Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/1912009 Certificate Issue Date: 51112009 Expiration Date: 211/2010 Lutheran Medical Center Engin. 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 Safety Inspection Date: 3/1912009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/112010 Lutheran Medical Center Engin. 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 Bpilding Department x This is to certify > t the a ator as mdicat n this certificate has been inspected on the. below and wa ound safe to carry 5500 lbs. Inspected by De egional Council of Governme (D Location Number: Building Name: Location: ID Number: ElevatorTvr)e: HP Safety Inspection Date: 311912009 Elevator Inspection Date: 3119/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Lutheran Medical Center Engin. 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 Inspected by De , egional Council of Governme (DRCOG) 0 Location Number: Building Name: Location: ID Number: Elevator?voe: CP Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Exempla Lutheran Med. Ctr. Eng. 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 Department This is to certify t the elevator as indicat this certificate has been inspected on the d gshown below and wa ound safe to carry 4500 lbs. Safety Inspection Date: 3/19/2009 Elevator Inspection Date: 311912009 Certificate Issue Date: 5/112009 Expiration Date: 211/2010 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De Regional Council of Governme (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29� Ave. Wheat Ridge, CO 80033 Safety Inspection Date: 3119/2009 Elevator Inspection Date: 3/19/2009 Certificate Issue Date: 5/1/2009 Expiration Date: 2/1/2010 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by De - egional Council of Governme (DRCOG) '�* � City of W h6a - tP s z d e g COMMUNITY DEVELOPMENT July 9, 2008 Lutheran Medical Center Engin. Dept. Attn: Elevator /Escalator Owner or Managing Agent 8300 W. 38th Ave. Wheat Ridge, CO 80033 Re: Elevator and Escalator Registration Dear Elevator /Escalator Owner or Managing Agent: The Division of Oil and Public Safety (OPS) is the implementing agency for The Elevator and Escalator Certification Act (Title 9, Article 5.5, Sections 101 through 120 Colorado Revised Statutes [CRS]) ( "the Act'). Pursuant to this Act ( §9 -5.5 -111 (1) CRS), all existing and newly installed conveyances must be registered with the OPS by August 1, 2008. Conveyances that are regulated by the Act include any commercial conveyance, accessible to the public, that is an elevator, escalator, moving walk, dumbwaiter, platform lift, personnel hoist, or stairway chair lift, and excluding those listed under §9 -5.5 -104 (2) CRS. The OPS is requesting that you complete this one -time registration for regulated conveyances located in Colorado that you own or operate by one of the following methods: 1) Access the website at http: / /oif.cdle.state.co.us and select the Conveyance Section link, then the Conveyance Registration Procedures link. Follow the instructions provided to register the conveyance. Submit the completed registration form and registration fee payment ($200.00 per conveyance, payable to CDLE, Division of Oil and Public Safety) to the address listed below: CDLE, Division of Oil and Public Safety Conveyance Section 633 Street, Suite 500 Denver, CO 80202 -3660 2) If you do not have internet access, contact Michael Stewart or Greg Johnson with OPS. A Registration Notice form will be faxed or mailed to you. The completed form and registration fee payment must be submitted to the address in 1) above. The OPS conveyance identification number or the facility address must be included on the fee payment check. The City of Wheat Ridge appreciates your cooperation in registering your conveyances. Please address correspondence to the OPS Conveyance Section contacts listed below. Michael Stewart Conveyance Technical Specialist 303 -318 -8530 michael.stewart(a)state.co.us Greg Johnson Conveyance Program Manager 303 - 318 -8536 greg.johnson(a Sincerely, City of Wheat Ridge Building Division 7500 W. 29" Ave. Wheat Ridge, CO 80033 303 - 235 -2855 Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Department This is to certif t at the elevator as indicated bn this certificate has been inspected on the d shown below and wb§,fbund safe to carry 5000 lbs. Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/112008 Expiration Date: 211/2009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Denuer Regional Council of Government (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 th Ave. Wheat Ridge, CO 80033 Building Department r 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 5000 lbs. Inspected by Denver` Regional Council of Government "(DRCOG) 3 } . i}. Location Number: Building Name: Littherart Hospi Location: 8300.0 38th'! A1, ID Number: fl ' EIevatorType C Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicated on this certificate has been inspected on the dat shown below and wa5",found safe to carry 5000 lbs. Inspected by DehVbrRegional Council of Government ° (DRCOG) Location Number: Building Name: i ` Location: ID Number: Elevator'Type: CP Safety Inspection Date: 411712006 Elevator Inspection Date: 3/3112008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicated on this certificate has been inspected on the d' shown below and was found safe to carry 5000 lbs. Inspected by Denver Regional Council of Government (DRCOG) Location Number: Building Name: Location: ID Number: ElevatorType: CP Safety Inspection Date: 4117/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/112008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department f ±. This is to certify that the elevator as i'rdicated this certificate has been inspected on the dbf, & below and was':found safe to carry 1500 lbs. Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 21112009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Devi er''Regional Council of Governme4 (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 d�tb shown below and wia'�°found safe to carry 50 lbs. Inspected by Denver Regional Council of Government'(DRCOG) Safety Inspection Date: N/A Elevator Inspection Date: 3131/2008 Certificate Issue Date: 211/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator Type: DW 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 irdicated;on this certificate has been inspected on the da` #,e shown below and wasfound safe to carry 2700 lbs. Inspected by Denver Council of Government (DRCOG) Location Number: Building Name: Lutheran Hospital Location: ID Number: Elevator Type: CP Safety Inspection Date: 4/1712006 Elevator Inspection Date: 3/3112008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/112009 Lutheran Medical Center Engin. 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 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 2700 lbs. Safety Inspection Date: 4/1712006 Elevator Inspection Date: 313112008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Denver 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 d i' shown below and wasJound safe to carry 4000 lbs. Inspected by Denver:'Regional Council of GovernmenY(DRCOG) ,f Location Number: Building Name: Location: ID Number: Elevator Type: HP Safety Inspection Date: 4/1712006 Elevator Inspection Date: 313112008 Certificate Issue Date: 211/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicated,' n this certificate has been inspected on the dat'W�shown below and was;fbund safe to carry 4000 lbs. 3 , . Inspected by De' Regional Council of Government (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Type: HP Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify 'th ' at the elevator as iridicatedbn this certificate has been inspected on the d$ shown below and wA4ound safe to carry 3500 lbs. Inspected by Denvpr, I Regional Council of Gover nmen (DRCOG) Location Number: Building Name: Location: ID Number: Elevator'TviDe: CP Safety Inspection Date: 4117/2006 Elevator Inspection Date: 3/3112008 Certificate Issue Date: 2/11/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicateq :,on this certificate has been inspected on the date shown below and wasfound safe to carry 50 lbs. Inspected by Denver Regional Council of Government (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Type: DW Safety Inspection Date: N/A Elevator Inspection Date: 3131/2008 Certificate Issue Date: 21112008 Expiration Date: 2/112009 Lutheran Medical Center Engin. 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 Department s This is to certify that the elevator as indicated,pn this certificate has been inspected on the date shown below and wa'`s "found safe to carry 50 lbs. Inspected by Deriaier'Regional Council of Government' (DRCOG) Location Number: 35 a n a Building Name: Luther}ospii Location: 8300 Ili/ 38,th A ID Number: 13 Elevator Type: DW Safety Inspection Date: N/A Elevator Inspection Date: 3131/2008 Certificate Issue Date: 21112008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 By, ilding Department 3k A This is to certify that the elevator as indicated,on this certificate has been inspected on the date shown below and was'Jound safe to carry 500 lbs. Inspected by Denveri`Regional Council of Government (DRCOG) u Location Number: Building Name: Location: ID Number: ElevatorTGoe: DW Safety Inspection Date: N/A Elevator Inspection Date: 313112008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicategon this certificate has been inspected on the date shown below and was :found safe to carry 4500 lbs. Inspected by De five r,` "Reg ion al Council of Government (DRCOG) Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/3112008 Certificate Issue Date: 211/2008 Expiration Date: 211/2009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator Type: hP 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, this certificate has been inspected on the d' a'te`shown below and way I and safe to carry 4000 lbs. Inspected by Denver` Regional Council of Government (DRCOG) Location Number: Building Name: Location: 8 ID Number: ElevatorTvoe: HP Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/3112008 Certificate Issue Date: 211/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 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 4000 lbs. Safety Inspection Date: 4/17/2006 Elevator Inspection Date: 3/3112008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Derv' r Regional Council of Governnneht'(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 datd�'shown below and wa's;fiound safe to carry 4000 lbs. Safety Inspection Date: 4/1712006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 21112008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Den'vs 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 this certificate has been inspected on the date!shown below and was found safe to carry 12000 lbs. D A" as i< Inspected by Deh�rort:�Regional Council of Government (DRCOG) Location Number: 35 Building Name: E Location: 8300` -, i ID Number: 1 v4 �� .. B ocG.lyte. Elevator Type: HF Safety Inspection Date: Elevator Inspection Date Certificate Issue Date: Expiration Date: 4/15/2006 3/3112008 2/1/2008 2/1/2009 Exempla Lutheran Med. Ctr. Eng Dept. 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 that the elevator as indicated on this certificate has been inspected on the date shown below and was found safe to carry 4000 lbs. Inspected by DehV r:Regional Council of Govern men (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Type: HP Safety Inspection Date: 412012006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/112008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicated on this certificate has been inspected on the d4,t i8hown below and was found safe to carry 20000 lbs. Safety Inspection Date: 4120/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/112009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by DdhVoRegional Council of Govern men' f (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 i "ndicated'on this certificate has been inspected on the da'ke shown below and was:found safe to carry 2500 lbs. Inspected by Den er'Regional Council of Government (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Type: HP Safety Inspection Date: 4120/2006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/112008 Expiration Date: 2/1/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator as indicatedon this certificate has been inspected on the date shown below and was =found safe to carry 2500 lbs. Safety Inspection Date: 4/20/2006 Elevator Inspection Date: 3131/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/112009 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Dehver ;Regional Council of Government (DRCOG) Certificate of Elevator Inspection City of Wheat Ridge 7500 W. 29 Ave. Wheat Ridge, CO 80033 Building Dppartment This is to certify that the elevator as in`dicated,!6n this certificate has been inspected on the date'shown below and wa�und safe to carry 5500 lbs. Inspected by Denver- Regional Council of Government (DRCOG) Location Number: Building Name: Location: ID Number: ElevatorTvoe: HP Safety Inspection Date: 412012006 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 211/2009 Lutheran Medical Center Engin. 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 Department This is to certify that the elevator a s indicatedIbn this certificate has been inspected on the date shown below and was found safe to carry 4500 lbs. Inspected by Denver Regional Council of Government (DRCOG) Safety Inspection Date: 817/2002 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 21112009 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator Type: CP 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 ihdicated�on this certificate has been inspected on the d te shown below and was found safe to carry 4500 lbs. Inspected by Deriver Regional Council of Government (DRCOG) Location Number: Building Name: Location: ID Number: Elevator Tvpe: CID Safety Inspection Date: 817/2002 Elevator Inspection Date: 313112008 Certificate Issue Date: 21112008 Expiration Date: 2/1/2009 Exempla Lutheran Med. Ctr. Eng. 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 Department s„ This is to certify that the elevator as indicated; >on this certificate has been inspected on the date shown below and wgiound safe to carry 4500 lbs. Safety Inspection Date: 8/7/2002 Elevator Inspection Date: 3/31/2008 Certificate Issue Date: 2/1/2008 Expiration Date: 2/112009 Exempla Lutheran Med. Ctr. Eng. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspected by Den' ver!`Regional Council of Government (DRCOG) 1* � City of -All V� Wheat�id1ge COMMUNITY DEVELOPMENT July 9, 2008 Exempla Lutheran Mad Ctr. Engineering dept Attn: Elevator /Escalator Owner or Managing Agent 8300 W. 38th Ave Wheat Ridge, CO 80033 Re: Elevator and Escalator Registration Dear Elevator /Escalator Owner or Managing Agent: The Division of Oil and Public Safety (OPS) is the implementing agency for The Elevator and Escalator Certification Act (Title 9, Article 5.5, Sections 101 through 120 Colorado Revised Statutes [CRS]) ( "the Act "). Pursuant to this Act ( §9 -5.5 -111 (1) CRS), all existing and newly installed conveyances must be registered with the OPS by August 1, 2008. Conveyances that are regulated by the Act include any commercial conveyance, accessible to the public, that is an elevator, escalator, moving walk, dumbwaiter, platform lift, personnel hoist, or stairway chair lift, and excluding those listed under §9 -5.5 -104 (2) CRS. The OPS is requesting that you complete this one -time registration for regulated conveyances located in Colorado that you own or operate by one of the following methods: 1) Access the website at http: / /oil.cdle.state.co.us and select the Conveyance Section link, then the Conveyance Registration Procedures link. Follow the instructions provided to register the conveyance. Submit the completed registration form and registration fee payment ($200.00 per conveyance, payable to CDLE, Division of Oil and Public Safety) to the address listed below: CDLE, Division of Oil and Public Safety Conveyance Section 633 Street, Suite 500 Denver, CO 80202 -3660 2) If you do not have internet access, contact Michael Stewart or Greg Johnson with OPS. A Registration Notice form will be faxed or mailed to you. The completed form and registration fee payment must be submitted to the address in 1) above. The OPS conveyance identification number or the facility address must be included on the fee payment check. The City of Wheat Ridge appreciates your cooperation in registering your conveyances. Please address correspondence to the OPS Conveyance Section contacts listed below. Michael Stewart Conveyance Technical Specialist 303 - 318 -8530 michael.stewart(cDstate.co.us Greg Johnson Conveyance Program Manager 303 - 318 -8536 greo.]ohnson state.co.us Sincerely, City of Wheat Ridge Building Division 7500 W. 29"" Ave. Wheat Ridge, CO 80033 303 - 235 -2855 ThyssenKrupp Elevator ❑ 5 A YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST DATE ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE 1)70 NAME OF BUILDING r t tf 1 ( & te e LOCATION 8 CO ELEVATOR SERIAL NO. CITY &STATE (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT N0. ! c� �9�dJ4` BUILDING ELEVATOR NO. :L CUSTOMER P.O. N0. JOB NO. MAKE OF ELEVATOR P1CV "f A- RATE CAR SPEED '-Iey F,P.M. BUFFER MFG. �`�Llk'r — NUMBER OF BUFFERS CAR CWT. TYPE OF MOUNTING CAR: CHANNEL FLOOR `A TYPE 0 MMOUNTING CWT: CHANNEL � FLOOR Y CONDITION OF CAR BUFFERS 4666 CONDITION OF CAR BUFFER PLUNGERS deed CONDITION OF CWT. BUFFERS levee CONDITION OF CWT. BUFFER PLUNGERS F c 3 CONTACT ON: BUFFER SWITCH Po RATED CAP, OF BUFFER: MIN. � , "fits MAX. 64)W RATED BUFFER SPEED F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS F� To Comply with ANSUASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes 0 No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and yhen released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds - (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds 3 Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ No❑ -4' Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. 15° Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ No❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Yes`. No❑ 7. Was the test satisfactory: ig.,Yes ❑ No If not, explain B. Representatives of the Insurance Company, City or State Inspector or Owner, presentattest (Indicate name and title) �� .MECHANIC'S SIGNATURE i - rN- SUPT. SIGNATURE Copy of this report given to customer: YES p, NO ❑ CUSTOMER'S SIGNATURE MATOBT0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) )III ANNUAL TEST 0 5 YEAR TEST 0 NEW ELEVATOR NAME OF BUILDING Lf/)erP6j LOCATION �m g ELEVATOR SERIAL N0. ; t®q CITY & STATE !J! (IF NONE, USE MOTOR OR CONT L SERIAL. NO.) THYSSENKRUPP SERVICE CONTRACT N0 �`' V BUILDING ELEVATOR NO. CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR U�'a RATE CAR SPEED F.P.M. RAT CAPACITY 6 �0 LES. SAFETY MFG. 0 6 & 1 L. GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL BRONZE V GOVERNOR ROPE: ]RON STEEL 8X90 6X19' SIZE (DIAJ RATED ULTIMATE STRENGTH/—Z" CONDITION OF ROPE Aft CONDITION OF JAWS 4 TYPE OF SAFETY: INSTANT U WEDGE CLAMP} FLEX. GUIDE N OTHER (TYPE) CONDITION 6L `Mel CONTACT ON: GOVERNOR%, RELEASING CARRIER U SAFETY 0 RATED CAP. OF SAFETY —# CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: ' ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes)9 No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intendeclZ -(3) Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) 44) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load`9... 4 Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: YesA No 0 How much out of level D.B.G. Max. 3/8" per ft.) (4) Length of cable pulled off the drum . Number of turns of cable left on the drum -" Governor and safety reset, safety drum rewound evenly: Safety jaw clearance 44.9) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes( No 0 (12) Was it necessary to readjust the governor? Yes 0 Nod' (13) Condition of governor rope after test 4 �4. (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yesx No 0 Was the test satisfactory: YesA No O If not, explain. (15) Normal and Final Terminal stopping devices tested;9 4-6) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque _V-/J # Kinetic ft. # (19) Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's .lowest terminal with 125°/% of Rated Load:. 4 Emergency Terminal Speed Limiting Devices tested 0 epresentatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 (Indicate name and title) MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this report given to customer: Yes No 0 CUSTOMER'S SIGNATURE 1 MASGTRO301 ThyssenKrupp Elevator * ANNUALTEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR TRACTION ELEVATOR OIL BUFFER TES' (F(LL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING V��OI GI 1 t41U �$ �r e -Ji ✓e ELEVATOR SERIAL NO. $ >° _ L- -) (IF NONE, USE MOTOR OR CONTPOL SERIAL NO.) THYSSENKRUPP SERA BUILDING ELEVATOR NO. CUSTOMER P.O. NO. MAKE OF ELEVAT R �r€�C - RATE CAR SPEED f �L F.P.M. BUFFER MFG. ��pv'f o'er.. NUMBER OF BUFFERS CAR - CWT. TYPE OF MOUNTING CAR: CHANNEL FLOOR � TYPE OF MOUNTING CWT: CHANNEL FLOOR CONDITION OF CAR BUFFERS o t n CONDITION OF CAR BUFFER PLUNGERS €SG CONDITION OF CWT. BUFFERS do f, CONDITION OF CWT. BUFFER PLUNGERS f e CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. v 5Lt� . 9000 RATED BUFFER SPEED F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes4 No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and en released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the we' ht resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds , .&n Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ No❑ -4T Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. m5:° Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ Non In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Ye Non 7. Was the test satisfactory: 'WYes ❑ No If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, present attest Copy of this report given to customer: CUSTOMER'S YESY NO ❑ r MATOBT0301 (Indicate name and 5tle) ( ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUAL TEST 0 5 YEAR TEST 0 NEW ELEVATOR C'I NAME OF BUILDING f Y'2/A/1 64 L /4e4 C rA LOCATION �? Z'V• ELEVATOR SERIAL N g - lx CITY & STATET (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. BUILDING ELEVATOR NO. CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR vL��L RATE CAR SPEED ��� F.P.M. RAT. CAPACITY .6�ff LES. SAFETY MFG. -- >!/S(>yG GOVERNOR MFG. r TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL BRONZE GOVERNOR ROPE: IRON :)L STEEL 8X90 6X1°a SIZE (DIA.) 3 40 ' 0 RATED ULTIMATE STRENGTH '€ CONDITION OF ROPE /=cYJd7 CONDITION OF JOS 'c22%'� TYPE OF SAFETY: INSTANT 0 WEDGE CLAMP)®- FLEX.. GUIDE 0 OTHER (TYPE) CONDITION (rocs CONTACT ON: GOVERNOR RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY /d �� # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: ` ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes %_ No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intendedz 43) Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) 44 Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no loam, 46) Safety checked and tested with rated cap. bs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Ye No 0 How much out of level D.B.G. Max. 3/8" per ft.) 48} Length of cable pulled o the drum . Number of turns of cable left on the drum (9) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance 4&) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: YesA No 0 (12) Was it necessary to readjust the governor? Ye$0 Nod!]" (13) Condition of governor rope after test �e (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes No 0 Was the test satisfactory: Yeg No 0 If not, explain. (15) Normal and Final Terminal stopping devices testeciz (46) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque # Kinetic I/ # 48) Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. (19 Emergency Terminal Speed Limiting Devices tested 0 1 5 I d4f Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes No 0 (Indicate name and title) MECHANIC'S SIGNATUR r/ SUPT. SIGNATURE Copy of this report given to customer: Yes A- No 0 CUSTOMER'S SIGNATUR MASGTR0301 ThyssenKrupp Elevator ANNUAL TEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR TRACTION ELEVATOR OIL BUFFER TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING t" eA4 f to 161 1W /AP,; C e _ LOCATIOl' ELEVATOR SERIAL NO. 1I '16Il CITY & ST (IF NONE, USE MOTOR OR CONa SERIAL N0.) THYSSENKRUPP SERVICE CONT BUILDING ELEVATOR N0. _ CUSTOMER P.O. NO. DATE r� OFFICE 6 ZZ •: 0� MAKE OF ELEVAT9R . 4 fe- RATE CAR SPEED L l l t'� F.P.M. BUFFER MFG. G9f'e� — NUMBER OF BUFFERS .'4 CAR '92— CWT. I TYPE OF MOUNTING CAR: CHANNEL 'u". FLOOR < TYPE OF MOUNTING CWT: CHANNEL FLOOR 4 x CONDITION OF CAR BUFFERS e�.%e� CONDITION OF CAR BUFFER PLUNGERS CONDITION OF CWT. BUFFERS c „ CONDITION OF CWT. BUFFER PLUNGERS /Poo ,' CONTACT ON: BUFFER SWITCH ry RATED CAP. OF BUFFER: MIN. �0 MAX. ROL " RATED BUFFER SPEED F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yest No[] (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and ohen released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds ° 9 (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds �? -3w. Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes 0 NOD -4. Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. -rs.' Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ NOD In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with th final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Ye.59 NOD 7. Was the test satisfactory: 1dYes ❑ No If not, explain S. Representatives of the Insurance Company, City or State Inspector or Owner, present attest (Indicate name and title) MECHANIC'S SIGNATURE SUPT. SIGNATURE —r ffi Copy of this report given to customer: YES }i NO ❑ CUSTOMER'S SIGNATURE MATOST0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT Col (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUALTEST 5 YEAR TEST D NEW ELEVATOR NAME OF BUILDING V' �jY PIA C�`jy- J 1" LOCATION r 76-9 W. , 39P Al/e SERIAL NO. r R 16y CITY & STATF b ✓)� e (IF NONE, USE MOTOR OR CONTROL, SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO a BUILDING ELEVATOR NO. i CUSTOMER P.O. NO.. JOB NO. MAKE OF ELEVATOR. �..- RATE CAR SPEED tIP6 F.P.M. RAT �fJ CAPACITY S LBS. SAFETY MFG. 4/1rsliP✓ GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT :4 TYPE GRIP JAWS: STEEL BRONZE X GOVERNOR ROPE: IRON Z STEEL 8X9U 6X19]: SIZE (DIA.) '/ U RATE 9 ULTIMATE STRENGTH ...CONDITION OF ROPE 0 CONDITION OF J WS tt,7 TYPE OF SAFETY: INSTANT N WEDGE CLAMP`.. FLEX. GUIDE f] OCHER (TYPE) CONDITION /:PsG CONTACT ON: GOVERNOR`%. RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY AQ, ,00 # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: " ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: YesX, No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intende(t ..R Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) 44 Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) -H Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load` 46•)• Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Yes,0 No U How much out of level D.B.G. Max. 3/8" per ft.) (8a- Length of cable pulled off the drum . Number of turns of cable left on the drum - ft Governor and safety reset, safety drum rewound evenly: Safety jaw clearance (19) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: YesX. No (12) Was it necessary to readjust the governor? Yes U No; (13) Condition of governor rope after test /)1C' (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes.' No 0 Was the test satisfactory: YesJd No U If not, explain. (15) Normal and Final Terminal stopping devices testedE. (.16) Standby (Emergency) Power Operations tested (with 125%0. Rated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque # Kineticft. # (3.8) Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125°/% of Rated Load. l Emergency Terminal Speed Limiting Devices tested 0 l /LP owC Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0. (Indicate name and title) MECHANIC'S SIGNATURE ✓/ms`s"✓ SUPT. SIGNATURE Copy of this report given to customer: Yes X- No D_ CUSTOMER'S SIGNATURE N MASGTRO301 ThyssenKrupp Elevator ANNUACTEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR TRACTION ELEVATOR OIL BUFFER TES' (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING +AAA � /,1W ELEVATOR SERIAL NO. L16Y4? (IF NONE, USE MOTOR OR CON ROL SERIAL NO.) THYSSENKRUPP SERV BUILDING ELEVATOR NO. CUSTOMER P.O. NO. MAKE OF ELEVAT R &IC'F�.- RATE CAR SPEED L e r70 F.P.M. BUFFER MFG. s✓ia ./ NUMBER OF BUFFERS "> CAR `•- CWT. ,d TYPE OF MOUNTING CAR: CHANNEL �� FLOOR `-?- TYPE OF MOUNTING CWT: CHANNEL -J FLOOR X CONDITION OF CAR BUFFERS 1lsia',�` CONDITION OF CAR BUFFER PLUNGERS «fa CONDITION OF CWT. BUFFERS ld t od CONDITION OF CWT. BUFFER PLUNGERS � voO CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. CO0 MAX. P460 RATED BUFFER SPEED .5'7S F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. YeS9 No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and �when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds f -3,- Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes C No ❑No❑ .4.- Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. -5r- Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ No❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with tho final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. YesA No❑ 7. Was the test satisfactory: iZYes ❑ No If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, present attest /j (Indicate name and title) MECHANIC'S SIGNATURE �� �"� SUPT. SIGNATURE Copy of this report given to customer: YES $ NO ❑ CUSTOMER'S SIGNATURE MATOBT0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT �. (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUAL TEST DATE L I' n -0 D 5 YEAR TEST OFFIC O 0 NEW ELEVATOR NAME OF BUILDING C WAUlsO tt sJ /t L !bL LOCATION OFI �• � ELEVATOR. SERIAL N 9d CITY & STATE GG ✓uP_� - `ll ! [T1 (IF. NONE, USE MOTOR OR CONTRO SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT. NO U BUILDING ELEVATOR NO. CUSTOMER RO NO. JOB NO. MAKE OF ELEVATORRt✓Clk RATE CAR SPEED F.P.M. RAT¢ CAPACITY LO LBS. SAFETY MFG. 0LI GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT ' TYPE qRIP JAWS: STEEL BRONZE GOVERNOR ROPE: ]RON STEEL 8X90 6X19 SIZE.(DIA.) ORAT D ULTIMATE STRENGTH CONDITION OF ROPE 06 CONDITION OF AW o TYPE OF SAFETY: INSTANT 0 WEDGE CLAMP FLEX. GUIDE 0 OTHER (TYPE) CONDITION n6® CONTACT ON: GOVERNOR$_ RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY ZJ,i 260 # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: ' ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS - To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208,� 2�09, 1002, & 1003. V (1) Governor & safety free of excessive lubrication, lint and dirt: Yes b No 0 (2) Hand test made of safety & governor to insure all bearing and ru bing surfaces, including rope grip -jaws operate freely as intended, 44 Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) , (4-) — Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load9 (£r1r Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: YeV. No 0 How much out of level D.B.G. Max. 3/8" per ft.) .(8b Length of cable pulled off the drum . Number of turns of cable left on the drum •(9) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance ( -M Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail (11) Rails inspected and filed where necessary: Yes No 0 (12) Was it necessary to readjust the governor? 0 Noll° (13) Condition of governor rope after test a y- (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes)(( No 0 Was the test satisfactory: Vend_ No 0 If not, explain. inches. (15) Normal and Final Terminal stopping devices testedR 0.6). Standby (Emergency) Power OperatioJs tested (with 125% f Rated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque ��'�. 0 # Kinetic!ft. # (48) Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. (.b9) V rgency Terminal Speed Limiting Devices tested 0 Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 - (Indicate name and title) MECHANIC'S SIGNATURE .SUPT. SIGNATUR Copy: of this report given to customer: Yes9 No 0 CUSTOMER'S SIGNATURE MASGTRO301 ThyssenKrupp Elevator ANNUALTEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR TRACTION ELEVATOR OIL BUFFER TES' (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING 4( OG ELEVATOR SERIAL NO. t IVA A E (IF NONE, USE MOTOR OR 00 TR�L SERIAL NO.) THYSSENKRUPP SERV BUILDING ELEVATOR NO. fifi��,?? CUSTOMER P.O. NO a MAKE OF ELEVAyOR Y ) l ou r f 4�RT CAR SPEED F.P.M ` BUFFER MFG. Y t78 ' `,d _ �— NUMBER OF BUFFERS ,:3 CAR CWT. TYPE OF MOUNTING CAR: CHANNEL Y FLOOR )! TYPE OF MOUNTING CWT: CHANNEL X FLOOR CONDITION OF CAR BUFFERS s� G CONDITION OF CAR BUFFER PLUNGERS X4 7 CONDITION OF CWT. BUFFERS T , c6l CONDITION OF CWT. BUFFER PLUNGERS CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. ` 500 MAX. 6 7 "4,m3 RATED BUFFER SPEED F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yeso No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weig resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds e% a-3- Examine the buffer nameplates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ No❑ m4-- Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. -Err' Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ No❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Yesp No[] 7. Was the test satisfactory: 10-Yes ❑ No If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, presentattest (Indicate name and title) MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this report given to customer: YES !7, NO ❑ CUSTOMER'S SIGNATURE MATOBT0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUALTEST DATE Lj `� 10 - 7 5 YEAR TEST OFFIC NEW ELEVATOR r ,� ' l(>P NAME OF BUILDING c-�PmAdL"s k C t LOCATION d 6 / t✓� ELEVATOR SERIAL N CITY & STATE (IF NONE, USE MOTOR OR CON �'�' n ' T jjj�� IT � T � T �jjj ROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO Q!t✓/ 2 � BUILDING ELEVATOR NO. CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR RATE CAR SPEED 5d F.P.M. RA -D CAPACITY c LBS. SAFETY MFG. (� GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL BRONZE GOVERNOR ROPE: IRON STEEL 8X90 6X19)[. SIZE (DIAJ 3 E1 U RA �T q ED ULTIMATE STRENGTH LNS CONDITION OF ROPE (one CONDITION OF JAWS KA 0/ TYPE OF SAFETY: INSTANT 0 WEDGE CLAMP, FLEX. GUIDE OTHER (TYPE) CONDITION 4,7U CONTACT ON: GOVERNORA RELEASING CARRIER H SAFETY P RATED CAP. OF SAFETY / <i4 # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: * ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) - 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes)Z No H (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intendedv 43), Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) 4* Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no loadg. 46- Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Yesd No H How much out of level D.B.G. Max. 3/8" per ft.) ,($U., Length of cable pulled off the drum . Number of turns of cable left on the drum .4)- Governor and safety reset, safety drum rewound evenly: Safety jaw clearance 440) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yesfl No 0 (12) Was it necessary to readjust the governor? Yes H No)Z (13) Condition of governor rope after test dK (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yeg No 0 Was the test satisfactory: Yes Z No 0 If not, explain. (15) Normal and Final Terminal stopping devices testeg (46) Standby (Emergency) Power Operation tested (with 125% of Rated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque # Kinetic # ,(J.8) Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. lU ergency Terminal Speed Limiting Devices tested 0 I Em Z `e'e(/ /Cg-dC Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes H No 0 (Indicate name and title) MECHANIC'S SIGNATUR / ��' ^� SUPT. SIGNATURE V Copy of this report given to customer: Yes No D CUSTOMER'S SIGNATURE 4 MASGTRO301 ThyssenKrupp Elevator •�t ANNUAL TEST ❑ 5 YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DAT OFFICE NAME OF BUILDING ✓ b y t - '� e�'s LOCATION 0 3 R- Ak ELEVATOR SERIAL N C Al I,lf` ' CITY & STATE (IF NONE, USE MOTOR OR CO TROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. 4%',f `ssX­63 & 7 BUILDING ELEVATOR NO. CUSTOMER P.O. NO. JOB NO. p MAKE OF ELEVATOR RATE CAR SPEED - 0 F.P.M. BUFFER MFG. _ f" IlV4 �* A./ NUMBER OF BUFFERS CAR I CWT. TYPE OF MOUNTING R: CHANNEL FLOOR TYPE OF MOUNTING CWT: CHANNEL FLOOR_ CONDITION OF CAR BUFFERS or}� CONDITION OF CAR BUFFER PLUNGERS 6 CONDITION OF CWT, BUFFERS A n o/) CONDITION OF CWT. BUFFER PLUNGERS 1 r?o 0 CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. / ( 1,2 " MAX, a'/ t C'-00 RATED BUFFER SPEED �` � F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSUASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes ❑ No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and en released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds (b) Place a fifty (50) pound weight on the plunger,'depress two (2) inches and then release. When released with the wei ht resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds , ir' Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ No❑ -4-- Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. -5 Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ No❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Yes)4 No[] 7. Was the test satisfactory: 1Nes ❑ No If not, explain 8. Representatives of the Insurance Company, City orState Inspector or Owner, presentattest (Indicate name and title) MECHANIC'S SIGNATURE .Z�/'L SUPT. SIGNATURE Copy of this report given to customer: YES T NO ❑ CUSTOMER'S SIGNATURE MATOBT0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ' ANNUAL TEST DATE D 5 YEAR TEST OFFIC D NEW ELEVATOR NAME OF BUILDING $ �'��'��'�>•°' C7 LOCATION =•° �� �"✓•( ELEVATOR SERIAL NO. C 3 CITY & STA (IF NONE, USE MOTOR OR CON T 2 OL S ERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. O 3 t /�_ YA� 6" BUILDING ELEVATOR NO. , p' CUSTOMER P.O. NO. JOB N0. MAKE OF ELEVATO RATE CAR SPEED F.P.M. RAT APACITY 0 LBS. SAFETY MFG. GOVERN MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL BRONZE G O C PE: IRON STEEL 8X90 6X19' CON (DI F JAJ VJ 0 RA D ULTIMATE STRENGTH C O ND I TI ON � TYPE OF SAFETY: INSTANT 0 WEDGE CLAMP` FLEX. GUIDE 0 OVER (TYPE) CONDITION CONTACT ON: GOVERNOR It RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY # CONDITION OF SAFETY DR M ROPE. SIZE INSTRUCTIONS: " ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes V— No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intendev , F34° Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) {4p —Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no loads, kR— Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Ye9 No 0 How much out of level D.B.G. Max. 3/8" per ft.) 448) Length of cable pulled off the drum . Number of turns of cable left on the drum -F9)- Governor and safety reset, safety drum rewound evenly: Safety jaw clearance 4- Windicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes,[, No 0 (12) Was it necessary to readjust the governor? Yes U NOY (13) Condition of governor rope after test /& (14) Governor adjustments sealed and tagged and Release Carrier tagged: Ye,46 No 0 Was the test satisfactory: Yes} No 0 If not, explain. (15) Normal and Final Terminal stopping devices testedjd (U) Standby (Emergency) Power Operation tested (with 125% o Rated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque_# Kinetic # (18)- Brake tested with 125 of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. (k9) Emergency Terminal Speed Limiting Devices tested p r/ /W seleVt( ? o�_- Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes -0 No 0 (Indicate name and title) i v /�i @� SUPT. SIGNATURE k e MECHANIC'S SIGNATURE :, r r ✓' ,*-_- _- x •. Copy of this report given YO customer: Yes. No D . CUSTOMER'S SIGNATURE MASGTR0301 ThyssenKrupp Elevator ANNUALTEST ❑ 5 YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) 0 DATE OFFICE ✓ >d NAME OF BUILDING " '• Lr e' !%J d' b� . LOCATION 6 .�CC' "v • ,J�€ "V AWE. ELEVATOR SERIAL NO v✓t CITY & STATE fnw +reF/�> (IF NONE, USE MOTOR OR C OL TRSERIAL N0.) THYSSENKRUPP SERVICE CONTRACT BUILDING ELEVATOR NO. pi CUSTOMER P.O. N0. JOB NO. MAKE OF ELEVATOR "I V f12%'A/ RATE CAR SPEED ,%1 � F.P.M. BUFFER MFG. NUMBER OF BUFFERS 6Z.- CAR f CWT. I TYPE OF MOUNTING ° CAR: CHANNEL_ FLOORTYPE OF MOUNTING CWT: CHANNEL FLOOR_ CONDITION OF CAR BUFFERS ire >t' CONDITION OF CAR BUFFER PLUNGERS trek CONDITION OF CWT. BUFFERS 3' ✓� CONDITION OF CWT. BUFFER PLUNGERS e? -fez CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. ` Ld:? C' MAX. /h r 6 0 RATED BUFFER SPEED t 1 / 0 F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes1 No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds ;.. .. (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds _ ...3:_ Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ No❑ -4- Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. .5, Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ No❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. YesX No❑ 7. Was the test satisfactory: ,Yes ❑ No If not, explain 8. Representatives of the Insu ance Company, City or State Inspector or Owner, presentattest (Indicate name and title) Copy of this report given to customer: CUSTOMER'S SIGNATURE MATOBT0301 YES V NO ❑ ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) `,ANNUAL TEST U 5 YEAR TEST U NEW ELEVATOR NAME OF BUILDING - 1' Ptl) /.( t, l l 1L 4 C - rALLOCATION 00 - .79 e ELEVATOR SERIAL N e f CITY &STATE �..i �© (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO 6 3V , - 4 Z'7 BUILDING ELEVATOR NO. �V & CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR RATE CAR SPEED it F.P.M. RAT APACITY /g�JCJ LBS. SAFETY MFG. GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL -.. FLYWEIGHT ' TYPE GRIP JAWS: STEEL BRONZE - GOVERNOR ROPE: IRON � TEEL SX90 6)h SIZE (DIAJ�0 RAT D ULTIMATE STRENGTH CONDITION OF ROPE � oGd CONDITION OF JAS 166 TYPE OF SAFETY: INSTANT U WEDGE CLAMP- FLEX. GUIDE ,j 0 QTHER (TYPE) CONDITION /PGG CONTACT ON: GOVERNOR J Id RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: `ANNUAL TEST ---- OMIT ITEM (3-4-6-18-19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes$' No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended .,(3) Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) 44)- Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no loav - (67' Safety checked and tested with rated cap. Ibs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Yes" No 0 How much out of level D.B.G. Max. 3/8" per ft.; -(% Length of cable pulled off the drum . Number of turns of cable left on the drum -(9) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance J-1-0) the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yesg No 0 (12) Was it necessary to readjust the governor? U NoX (13) Condition of governor rope after test r% (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes" No 0 Was the test satisfactory: YesX No U If not, explain. (15) Normal and Final Terminal stopping devices testedJ0 (ddb Standby (Emergency) Power Operati ns t stetj.(with 120 of Rated Load on Acceptance and 5 Year Tests) 0. (17) Power Door System tested: Torqu 1W Kineti # (d- &)-Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125°/% of Rated Load. (449) Emergency Terminal Speed Limiting Devices tested p / - / 1^0/1111 ems` Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 (Indicate name and title) MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this report given to customer: Ye4f No D CUSTOMER'S SIGNATURE MASGTR0301 ThyssenKrupp Elevator ANNUAL TEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR TRACTION ELEVATOR OIL BUFFER TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING e- 0 �4 / l., a' I t i � L L( ELEVATOR SERIAL NO. 1".fvlk s q Cl (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVI( BUILDING ELEVATOR NO. ; CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR Ff/}l✓ RATE CAR SPEED -� F.P.M. BUFFER MFG. NUMBER OF BUFFERS CAR CWT. TYPE OF MOUNTING CAR: CHANNEL _ FLOOR TYPE OF MOUNTING CWT: CHANNEL FLOOR _ CONDITION OF CAR BUFFERS K! c +� CONDITION OF CAR BUFFER PLUNGERS e5�„ CONDITION OF CWT. BUFFERS f r 1 r1 CONDITION OF CWT. BUFFER PLUNGERS e Og CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. / - - MAX. `M C 0 RATED BUFFER SPEED F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSUASME A17.1 Section 1000 and Section 201. 1. Oil. Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. YeAX Non (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds ,-. _ (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds —3...- Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ Non _4� Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes 0 No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. -5:` Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes 0 Non In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Ye4 Non 7. Was the test satisfactory: ;G°tYes ❑ No If not, explain B. Representatives of the Insurance Company, City or State Inspector or Owner, present attest (Indicate name MECHANIC'S SIGNATURE Copy of this report given to customer: YES X' NO ❑ CUSTOMER'S SIGNATURE MATOBT0301 ThyssenKrupp Elevator Vt ANNUAL TEST ❑ 5 YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) 0 DATE C d OFFICE rE J NAME OF BUILDIN 1 �`fI4 A a C" lx LOCATION ,7e 6 ELEVATOR SERIAL NO. - /dt3 - f cf CITY & STATE L'`fi l4 i, (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. el.:: BUILDING ELEVATOR NO. # � CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR d r'`L` (i40` '. RATE CAR SPEED )" �` F.P.M. BUFFER MFG. L4 11,14t0n� NUMBER OF BUFFERS <2- CAR 1 CWT. f TYPE OF MOUNTING CAR: CHANNEL FLOOR TYPE OF MOUNTING CWT: CHANNEL FLOOR CONDITION OF CAR BUFFERS 4r ;ao7 CONDITION OF CAR BUFFER PLUNGERS 4ir CONDITION OF CWT. BUFFERS Af r _4 CONDITION OF CWT. BUFFER PLUNGERS 40cl CONTACT ON: BUFFER SWITCH e t RATED CAP. OF BUFFER: MIN. ! � 6 MAX. J i On :3 RATED BUFFER SPEED F.P.M. ANNUAL TEST - -OMIT ITEMS (3, 4 & 5) ONLY INSTRUCTIONS: 5 YEAR TEST -- COMPLETE ALL ITEMS NEW ELEVATOR TEST -- COMPLETE ALL ITEMS To Comply with ANSUASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes No❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed anfi y hen released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds f f , (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weei bt . resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds 3 Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes ❑ No❑ A Car oil buffers tested by running the car with rated load onto the buffers at rate speed. Yes ❑ No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑ No❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporary relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these test making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Yes,g No❑ 7. Was the test satisfactory: A Yes ❑ No If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, present attest name MECHANIC'S SIGNATURE 4114 ` } SUPT. SIGNATURE Copy of this report given to customer: YESK NO ❑ CUSTOMER'S MATOBT0301 Thyssenl(rupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) IAN N UAL TEST DATE v - / /'O 0 5 YEAR TEST OFFIC �l7 U NEW ELEVATOR NAME OF BUILDING U ru" to ( 0 td Iv C`d'e -- LOCATION ut 3U0 11A� 1 —5 a .1 ELEVATOR SERIAL N A ?/1 CITY & STATE &) / B (IF NONE, USE MOTOR OR CONTROJ, SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO 6+ +ti! BUILDING ELEVATOR NO. / CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATO RATE CAR SPEED - ,94o F.P.M. RATED CAPACITY ��7 co LBS. SAFETY MFG. nyg� GOVERNOR MFG. �7/VOl✓� TYPE OF GOVERNOR: FLY BALL GOVERNOR ROPE: IRON FLYWEIGHT !4 TYPE GRI JAWS: STEEL STEEL 8X90 6Xi� SIZE (DIA.) 1 F U RAID ULTIMATE BRONZE STRENGTHAV_ CONDITION OF ROPE CONDITION OF JAW TYPE OF SAFETY: INSTANT 0 WEDGE CLAMP, FLEX. GUIDE 0 HER (TYPE) CONDITION 66 K CONTACT ON: GOVERNOR - RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY ffed,0 # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: `ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes% No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intendedQ� .,( Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) _ -( Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load$ , H Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F. P.M. (7) Did the car stop level: Yes. No D How much out of level D.B.G. Max. 3/8" per ft.) 4% Length of cable pulled off the drum . Number of turns of cable left on the drum 44)- Governor and safety reset, safety drum rewound evenly: Safety jaw clearance -(3-0) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Ye9;9 _No 0 (12) Was it necessary to readjust the governor? Yes Noo (13) Condition of governor rope after test 6) (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes,` No 0 Was the test satisfactory: YesA No 0 If not, explain. (15) Normal and Final Terminal stopping devices tested (46) Standby (Emergency) Power Operations tested (with 125°`oof_Haled Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torque" Fa 1 .4 Kinetic u/ ft. # (3 Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. °(4* Emergency Terminal S eed Limiting Devices tested 0 Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 (Indicate name and title) MECHANIC'S SIGNATUR SUPT. SIGNATURE Copy of this report given to customer: Yes %, No p CUSTOMER'S SIGNATURE MASGTR0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT C °I (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) �.eJ;,ANNUAL TEST I7 5 YEAR TEST N NEW ELEVATOR OFFICE NAME OF BUILDING & eMA �- Luna -le Imo' P` - LOCATION 9 760 4&J, �i 9 0 v� ELEVATOR SERIAL NO. C d3_q� CITY & STATF Lf t 115 (IF NONE, USE MOTOR OR CONTf30L SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO 1 BUILDING ELEVATOR NO. �i CUSTOMER P.O. N0. JOB NO. MAKE OF ELEVATO GU� RATE CAR SPEED 900 F.P.M. RATE�Dp CAPA ITY ��� LES. SAFETY MFG. rU 1 _ GOVERNOR MFG. aCIA� _ TYPE OF GOVERNOR: FLY BALL FLYWEIGHT 1 ;rt — TYPE GRIP JAWS: STEEL BRONZE GOVERNOR ROPE: [RON ) STEEL 8X90 6X19)9. SIZE (DIA.) - O RATED ULTIMATE STRENGTH L r CONDITION OF ROPE 60 CONDITION OF JAWS r O TYPE OF SAFETY: INSTANT 0 WEDGE CLAMI)4- FLEX. GUIDE 0 HER (TYPE) CONDITION /AG�J CONTACT ON: GOVERNOR- RELEASING CARRIER 0 SAFETY] RATED CAP. OF SAFETY �� # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: ' ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes- No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended _0� Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) , (4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no loa�g My Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. '(7) Did the car stop level: Yeg No 0 How much out of level D.B.G. Max. 3/8" per ft.; -(8). Length of cable pulled off the drum . Number of turns of cable left on the drum -0 Governor and safety reset, safety drum rewound evenly: Safety jaw clearance -40) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes;9 No 0 (12) Was it necessary to readjust the governor? Y s U Nod' (13) Condition of governor rope after test (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes)9.. No 0 Was the test satisfactory: Yes)e No U If not, explain. (15) Normal and Final Terminal stopping devices teste '� 446) Standby (Emergency) Power Operatio s tested (with 125 ° 0 offR�ated Load on Acceptance and 5 Year Tests) 0 (17) Power Door System tested: Torqu Kinetic �ft # (4$) Brake tested with 125% of Rated Load Rule 207.8 shall lower, .stop and hold the car at it's lowest terminal with 125% of Rated Load. 4419) Emergency Terminal Speed Limiting Devices tested 0 .'Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 (Indicate name and title)°" MECHANIC'S SIGNATURE SUPT: SIGNATURE _ !: Copy of this report given.to customer: Yes'y, No p CUSTOMER'S SIGNATURE MASGTR0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) `ANNUAL TEST 0 5 YEAR TEST N NEW ELEVATOR N AME OF BUILDING 6eA t 4-1 9& 9 41tJ / .'R°2_ LOCATION . OB , ra-a A(le, ELEVATOR SERIAL N CITY & STA rlia-0 0 (IF NONE, USE MOTOR OR CONT OL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. 0 3.y4�a - )~ _.. BUILDING ELEVATOR NO. 9 CUSTOMER P.O. NO. .JOB NO. MAKE OF ELEVATO,,R � - RATE CAR SPEED "v`!IO F.P.M. RAT�p CAPACITY _�d� LES. SAFETY MFG. (Al / 1y €p- GOVERNOR MFG. G G�Ftin/� TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL BRONZE GOVERNOR ROPE: IRON — STEEL 8X9 U 6X19 SIZE (DIA.) p RATED ULTIMATE STRENGTH ��p CONDITION OF ROPE _ £s r3 CONDITION OF S JA ti oa TYPE OF SAFETY: INSTANT 0 WEDGE CLAMP)H_. FLEX. GUIDE 0 OTHER (TYPE) CONDITION 4,90 CONTACT ON: GOVERNOR>j RELEASING CARRIER N SAFETY N RATED CAP. OF SAFETY IOf�d� # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: ' ANNUAL TEST - - -- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yesg No U (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended9 463 Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) .(4). Force required to pull governor rope from the release carrier. - (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load'' T6)r Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Yes' No U How much out of level D.B.G. Max. 3/8" per ft.) (� Length of cable pulled off the drum . Number of turns of cable left on the drum Governor and safety reset, safety drum rewound evenly: Safety jaw clearance (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes`, 9. No 0 (12) Was it necessary to readjust the governol,?,YQs U Nog (13) Condition of governor rope after test -, (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes)9 No 0 Was the test satisfactory: Yes\K No U If not, explain. (15) Normal and Final Terminal stopping devices tested W&)-S tandby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) N (17) Power Door System tested: Torque `;_2a # Kinetic 15 ft. # ¢78) tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. (dam Emergency Terminal Speed Limiting Devices tested 0 Ic /!1Q f�Rv�Ge_ d Representatives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 (Indicate name and title) ♦ ,' MECHANIC'S SIGNATURE /�.f�l�" SUPT. SIGNATURE Copy of this report given to customer: Yesy No U CUSTOMER'S SIGNATURE MASGTR0301 0 HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUALTEST f DATE F" � 0 ACCEPTANCE TEST OFFICE 65q NAME OF BUILDING r l (L " rz, - rg.f ELEVATOR SERIAL NO. t G r s C• CITY & STATE' fry /t °/ t bst le; (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. /) ]1707 =' ' BUILDING ELEVATOR NO 1 CUSTOMER P.O. NO, JOB NO. MAKE OF ELEVATOR 1A - ,_ RATED CAR SPEED Z0 ti F.P.M. RATED CAPACITY � LBS. TYPE OF ELEVATOR 04 <-< RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 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 Dimension 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 Saf9V Code ANSI A17.1 Rule 1005 & 303. Relief Valve Setting , r5 tO 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 G> P.S.I. No Load Car Speed: Up frio F.P.M. Down �Z< F.P.M. Relief Valve Sealed: fr?1. 5 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 L7 t " Tank Oil Temperature At Start of Standing Test tf5�VW p After minimum of 15 minutes, note the position f t o e platform with respect to the chosen reference. Length of Time Car Standing -Empty /_f Af Amount Car Settled During Standing Period " Oil Temperature At End of Standing Period 'leU 0 Tank Oil Level At end of Standing Period f `r Amount of Leakage At Packing During Test tyr . Condition of Piston Packing 1.f 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 6se'� Standby (Emergency Battery Lowering) Power Operation ested .'✓ A Power Door System Tested: Torque Q e # Kinetic S Ft. # Emergency Terminal Speed Limiting Device Tested F W7,1 / 1 Test Satisfactory: Yes V No C If not, explain. Representative of the Insurance Company, City or State Inspector or Owner, Present at test: ndicate Name and MECHANIC'S SIGNATURE _ %''Z lady - SUPT. SIGNATURE Copy of this Report Given to Customer: Yes $ No 0 CUSTOMER'S SIGNATURE *Acceptance Test Only MAHI &T0301 WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK -ZONE COPY ThyssenKrupp Elevator HYDRAULIC INSPECTION & TEST ANNUAL TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) BATE 2 1- 11 -01 ❑ ACCEPTANCE TEST ��pp OFFICE 4)3' NAME OF BUILDING C'iel�IA,:.A 1 o /K l''J c'' ifc LOCATION ( ) I—J ' 79 -- W AV C' ELEVATOR SERIAL N0, y °Ps < C K� t! CITY & STATE E 4 r f r ?' 2 '. /,r. (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO. Q 5 a BUILDING ELEVATOR NO. /G? CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR b us fit— RATED CAR SPEED /'GO F.P.M. RATED CAPACITY - j TYPE OF ELEVATOR .A RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACI 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 tip Physical Dimension 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 e e 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 27 P.S.I. No Load Car Speed: Up le'X) F.P.M. Down q,' F.P.M. Relief Valve Sealed: !Z, 5 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 V entering the pit. Tank Oil Level At Start of Standing Test ele n Tank Oil Temperature At Start of Standing Test 6 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 Perio " Oil Temperature At End of Standing Period E7?-/6'G a Tank Oil Level At end of Standing Period cCle " Amount of Leakage At Packing During Test ✓c'LL Condition of Piston Packing .4f_ 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. M. Down - F.P.M. Normal and Final Terminal Stopping Devices Tested iI Standby (Emergency Battery Lowering) Power Operation Tested IJJf s1 Power Door System Tested: Torque �--) Fl # Kinetic ' Ft. # Emergency Terminal Speed Limiting Device Tested JT , Wks the Test Satisfactory: Yes'VJ No C If not, explain. � , . f? 17 l ode Representative of the Insurance Company, Crty or State Inspector or Owner, Present at test: Name and MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this Report Given to Customer: Yes Non CUSTOMER'S SIGNATURE_ e l vll — *Acceptance Test Only WHITE- BRANCH COPY YELLOW- CUSTOMER COPY PINK -ZONE COPY MAHI &T0301 ThyssenKrupp Elevator HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUAL TEST BATE t I- f'C1 0 ACCEPTANCE TEST OFFICE 094 NAME OF BUILDING i'_4 114 1,011 Alfili' LOCATION H 766 '­) 39 # Ave ELEVATOR SERIAL NO. Y t3 GJ� + 5 CITY & STATE In,+ s >r ,, , v r (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO: BUILDING ELEVATOR N P CUSTOMER P.O. NO, JOB NO. MAKE OF ELEVATOR n +: a?.. RATED CAR SPEED /G F.P.M. RATED CAPACITY Lg$, TYPE OF ELEVATOR _R n f RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACE 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 4:�.­ Physical Dimension of Reservoir Make (3) Round Trips Before Setting Relief Valve-3L 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 IcO 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 E-7-0 P.S.I. No Load Car Speed: Up dU F.P.M. Down 14,1) F.P.M. Relief Valve Sealed: 8 /I? f 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 V entering the pit. Tank Oil Level At Start of Standing Test �° Tank Oil Temperature At Start of Standing Test 4fl� d After a minimum of 15 minutes, note the posiSion of the platform with respect to the chosen reference. Length of Time Car Standing -Empty /' 1 Amount Car Settled During Standing Period " Oil Temperature At End of Standing Period Tank Oil Level At end of Standing Period ^r ^'" Amount of Leakage At Packing During Test e /?,l it r Condition of Piston Packing f �PAk'r 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 S *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 F G S Standby (Emergency Battery Lowering) Poor Operation Tested F t Power Door System Tested: Torque ') G # Kinetic tf Ft. # Emergency Terminal Speed Limiting Device Tested d Was the Test Satisfactory: Yes) d No C If not, explain. Representative of the Insurance Company, City or State Inspector or Owner, Present at test: MECHANIC'S SIGNATURE d' t -tile 3 y SUPT. SIGNATURE i Copy of this Report Given to Customer: Yes E No ❑ CUSTOMER'S SIGNATURE *Acceptance Test Only WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK -ZONE COPY MAHI &TO301 ThyssenKrupp Elevator HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) X ANNUAL TEST !DATE �/-./ -7-a %7 E ACCEPTANCE TEST OFFICE 4 7 4 / NAME OF BUILDING t'7`'4 N ?1/0'1-t / r/ ✓4'. LOCATION 1_64114, t- ' ; t'rf ,t?rkw ELEVATOR SERIAL NO. 7 "3d CITY & STATE Ilf �.r-K, i 40 f7 (IF NONE, USE MOTOR OR CONTROL BUILDING EL TOR N0. f " SERIAL NO.) THYSSENKRUPPSERVICE CONTRACT N0. /'f <l r f' EVACUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR a7MUWsi RATED CAR SPEED !r r7 F.P.M. RATED CAPACTY s ,d TYPE OF ELEVATOR I i 3.�r L— LBS. ` RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEI 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 A is Physical Dimension of Reservoir Make (3) Round Trips Before Setting Relief Valve 1 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 ' 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 o p.S.l. No Load Car Speed: Up , F.P.M. Down // ;o F.P.M. Relief Valve Sealed: t c 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 ITI _ Tank Oil Temperature At Start of Standing Test U 1"e G 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 /4 f Amount Car Settled During Standing Period " Oil Temperature At End of Standing Period G' 6 Tank Oil Level At end of Standing Period a ?r - r Amount of Leakage At Packing During Test * /r/ayt' Condition of Piston Packing 114f 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 i " f Standby (Emergency Battery Lowering) Povfer Operation Tested ✓r <A Power Door System Tested: Torque �1 K # Kinetic 11 Ft. # Emergency Terminal Speed Limiting Device Tested Was the Test Satisfactory: Yesp No E If not, explain. xi:,lf 5 `f 1`P, (f y_ Representative of the Insurance Company, City or State Inspector or Owner, Present at test: (Indicate Name and Title) , MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this Report Given to Customer: Yes{/ No E CUSTOMER'S SIGNATURE *Acceptance Test Only WHITE - BRANCH COPY YELLOW - CUSTOMER COPY MAHI &T0301 PINK -ZONE COPY ThyssenKrupp Elevator HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) .. ANNUALTEST DATE ❑ ACCEPTANCE TEST OFFICE effl NAME OF BUILDING � v "i� {/1 c 141 stAL � 1 -, LOCATION 1 G f '. 3 .-AV6 ELEVATOR SERIAL N0. C t 5s� K 3 CITY & STATE iC 4f�. r rrJ (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO: BUILDING ELEVATOR NO. / G CUSTOMER P.O. NO. JOB N0. MAKE OF ELEVATOR nrrlsi RATED CAR SPEED / C F.P.M. RATED CAPACITY Cxer n LBS. TYPE OF ELEVATOR ,�,-Y RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACE REQUIRED NOT MORE THAN 6 YEAR INTERVAL Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replac ant Date " Hose Tagged With Replacement Date & SAE Type _ Condition of Reservoir Oil _v Physical Dimension of Reservoir Make (3) Round Trips Before Setting Relief Valve,5 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 7 - / 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 l4 n P.S.I. No Load Car Speed: Up f) a' F.P.M. Down /9� F.P.M. Relief Valve Sealed: 1/4 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 P t "T Tank Oil Temperature At Start of Standing Test r* /r-;.r 0 After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. Length of Time Car Standing -Empty r 5 v Amount Car Settled During Standing Period ; t o Oil Temperature At End of Standing Period e vr; ^, a Tank Oil Level At end of Standing Period r /' Amount of Leakage At Packing During Test ',7nra° Condition of Piston Packing tii 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 "Heavy Load Car Speed: Up Normal and Final Terminal Stopping Devices Test Standby (Emergency Battery Lowering) Polder OF Power Door System Tested: Torque l =: Emergency Terminal Speed Limiting Device Teste Was the Test Satisfactory: Yes; No C If not, or MECHANIC'S _F.P.M. Down - F.P.M. 1/1 r m Tested Lt; # Kinetic � R. # fin. a Inspector or Owner, Present at test: ;Indicate Name and Title) SUPT. SIGNATURE Copy of this Report Given to Customer: Yesed,., No ❑ CUSTOMER'S SIGNATURE "Acceptance Test Only WHITE - BRANCH COPY ` YELLOW - CUSTOMER COPY MAHI &T0301 PINK -ZONE COPY' ThyssenKrupp Elevator HYDRAULIC INSPECTION & TEST (FILL „OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUAL TEST DATE �P f f , ❑ ACCEPTANCE TEST OFFICE ✓ `r NAME OF BUILDING L') i: `AA ia L LOCATION a7dd' lam'. Vf Ale- ELEVATOR SERIAL N0. kill , c /Gr CITY & STATE iP i tW G a T , rre (IF NONE, USE MOTOR OR CONTpOL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT F0. 7 / i BUILDING ELEVATOR NO. I Lf CUSTOMER P.O. N0, a. e CA JOB NO. MAKE OF ELEVATOR G >r`i t RATED CAR SPEED 1:' e F. TYPE OF ELEVATOR it P.M. RATED PACITY t, are LBS. , RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACE 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 C IV_ Physical Dimension 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 e { <,u P.S.I. (Should be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve egg P.S.I. (If Required) No Load Working Pressure: Up 14a P.S.I. No Load Car Speed: Up ? F.P.M. Down f;; F.P.M. Relief Valve Sealed: f 'i h 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 V entering the pit. Tank Oil Level At Start of Standing Test e'14L Tank Oil Temperature At Start of Standing Test <`U r After a minimum of 15 minutes, note the positip n of the platform with respect to the chosen reference. Length of Time Car Standing -Empty d Pt Amount Car Settled During Standing Period G' Oil Temperature At End of Standing Period A jie,4 om Tank Oil Level At end of Standing Period r=3f��. Amount of Leakage At Packing During Test f Osw r' Condition of Piston Packing rI 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 11W F Standby (Emergency Battery Lowering) Power Operation ested e. b) Power Door System Tested: Torque f <_ # Kinetic __x~ Ft. # Emergency Terminal Speed Limiting Device Tested V Was the Test Satisfactory: Yes d No C If not, explain. of the I Representative nsurance Company, City or State Inspector or Owner, Present at test: (Indicate Name and Title) - MECHANIC'S SIGNATURE SUPT. SIGNATURE k4e` c-r- Copy of this Report Given to Customer: Yes X, No ❑ CUSTOMER'S SIGNATURE _ r "Acceptance Test Only WHITE - BRANCH COPY YELLOW- CUSTOMER COPY PINK -ZONE COPY MAHI &T0301 ThyssenKrupp Elevator ffYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) y ANNUAL TEST DATE ❑ ACCEPTANCE TEST OFFIC +P NAME OF BUILDING tj L.�f�G� L"t,'i .LLJ (i1Z'_ LOCATION 9 C 4 '/ , ELEVATOR SERIAL NO. S_3:L 1 CITY &STATE La -V ae 10 (IF NONE, USE MOTOR OR CON7R , L SERIAL N0.) THYSSENKRUPP SERVICE CONTRACT NO. b- x`11" 0 el BUILDING ELEVATOR NO. CUSTOMER P.D. NO. JOB NO. TYPE OF ELEVATOR MAKE OF ELEVATOR 0 /S RATED CAR SPEED U /J F.P. M. RATED CAPACITY h a� LBS. RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACE REQUIRED NOT MORE THAN 6 YEAR INTERVAL. Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replace nt Date Hose Tagged With Replacement Date & SAE Type Condition of Reservoir Oil 1_, Physical Dimension of Reservoir Make (3) Round Trips Before Setting Relief Valve Y 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. in Relief Valve Set C 0 P.S.I. (Should be 125% of Heavy Load Up Working Pressure) Corrected Relief Valve Setting _P,S.L (If Required) No Load Working Pressure: Up -...n ® P.S.I. No Load Car Speed: Up 5 u F.P.M. Down V0 F.P.M. Relief Valve Sealed: Fi 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. Tank Oil level At Start of Standing Test CO / P t ' Tank Oil Temperature At Start of Standing Test "f After a minimum of 15 minutes, note the posJJ'tio of the platform with respect to the chosen reference. Length of Time Car Standing -Empty > S �t,, Amount Car Settled During Standing Period Oil Temperature At End of Standing Period Tank Oil Level At end of Standin Period I 1 % Amount of Leakage At Packing During Test IVOA' Condition of Piston Packing Fe 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 M F.P. Devi Down Normal and Final Terminal Stopping ces Tested S S Standby (Emergency Battery Lowering) Power Operation Tested 61Y ff Power Door System Tested: Torque _ " _ # Kinetic Ft. # Emergency Terminal Speed Limiting Device TestedjEg Was the Test,Satisfactory: Yes % No G If not, explain. P'o, a'' 1'"4' t , r1 i'_ C or state Inspector or Owner, Present at test: and MECHANIC'S SIGNATURE t ;L / j 1 t l? } m SUPT. SIGNATURE �F u Copy of this Report Given to Customer: Yes`. No ❑ CUSTOMER'S SIGNATURE _ F.P.M. *Acceptance Test Only WHITE- BRANCH COPY YELLOW - CUSTOMER COPY PINK -ZONE COPY MAHI &T0301 ThyssenKrupp Elevator HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUALTEST .DATE G ACCEPTANCE TEST ,� rt OFFICE NAME OF BUILDING �C(% t(fi Z L `( 7 -?r d �fC) LOC TIO G' L,­ d✓r ELEVATOR SERIAL NO. P to F` CITY & STATE ���i i- N 7 r J (IF NONE, USE MOTOR OR C¢ OL SERIAL N0.) THYSSENKRUPP SERVICE CONTRACT NO. ' 3` /fi 0 v -// BUILDING ELEVATOR NO. ,. CUSTOMER P 0. NO JOB N0. MAKE OF ELEVATOR L)0 f"Z_ RATED CAR SPEED �a S F.P.M. RATED CAPACITY S OC' LBS. TYPE OF ELEVATOR r RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLAC REQUIRED NOT MORE THAN 6 YEAR INTERVAL. Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replacem nt Date Hose Tagged With Replacement Date & SAE Type Condition of Reservoir Oil Physical Dimension 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.Lode ANSI A17.1 Rule 1005 & 303. Relief Valve Setting 5 <to 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 F.P.M. Down /1 S F.P.M. Relief Valve Sealed: WS 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 6 'If f Tank Oil Temperature At Start of Standing Test t f`GG `' After a minimum of 15 minutes, note the positio / o ,. the platform with respect to the chosen reference. Length of Time Car Standing -Empty 'A Amount Car Settled During Standing Period " Oil Temperature At End of Standing Period C' rote - Tank Oil Level At end of Standing P riod 011 " Amount of Leakage At Packing During Test &O Condition of Piston Packing /f 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: U P.S.I. *Heavy Load Car Speed: Up F. Down F.P.M. Normal and Final Terminal Stopping Devices Tested 1 } Standby (Emergency Battery Lowering) Operation Tested Power Door System Tested: Torque / : ! f fZ L; 0 # Kinetic . J h Ft. # Emergency Terminal Speed Limiting Device Tested, i s th Test Satisfa ory: YesX No C If not, explain. Representative of the Insurance Company, CRy or State Inspector or Owner, Present at test: and MECHANIC'S SIGNATURE r r SUPT. SIGNATURE Copy of this Report Given to Customer: Yes 'P ° No ❑ CUSTOMER'S SIGNATURE - *Acceptance Test Only WHITE - BRANCH COPY YELLOW - CUSTOMER COPY , PINK -ZONE COPY MAHI &T0301 Thyssenl(rupp Elevator HYDRAULIC INSPECTION & TIES7 (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUAL TEST 7 DATE ' 1 -' f ❑ ACCEPTANCE TEST j OFFICE (5 ?�I NAME OF BUILDING t LOCATION z >f L � ��f ✓)ir`�- ELEVATOR SERIAL NO ✓ / — t/ , j r 1 CITY & STATE k, . /Er•A„ -1 r 5t n (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT NO( BUILDING ELEVATOR N ? J CUSTOMER P.O. NO. JOB NO MAKE OF ELEVATOR L RATED CAR SPEED 4;-2$' F.P.M. RATED CAPACITY � =r, r, LBS. P TYPE OF ELEVATOR n -- RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACI 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 C_ Physical Dimension of Reservoir Make (3) Round Trips Before Setting Relief Valve 1� 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 _ !� 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: U P.S.I. No Load Car Speed: Up Z 7 c F.P.M. Down 1":9:L' F,P.M. Relief Valve Sealed: I J ' c NO de 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 ( 22 rr Tank Oil Temperature At Start of Standing Test :G'G After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. Length of Time Car Standing -Empty ,/ 5 Amount Car Settled During Standing Period e. ` Oil Temperature At End of Standing Period 1�! rd 1 Tank Oil Level At end of Standing Period r— F F Amount of Leakage At Packing During Test u > r � Condition of Piston Packing /�' 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 *Heavy Load Car Speed: Up Normal and Final Terminal Stopping Devices Tested Standby (Emergency Battery Lowering) Power Operation Power Door System Tested: Torque !2 S'" # Emergency Terminal Speed Limiting Device Tested Was the Test Satisfactory: Yes q No G If not, explair Down F.P.M. .S.I. R. Company, City or State Inspector or (Indicate Name and Title) MECHANIC'S SIGNATURE SUPT. SIGNATURE rr f' Copy of this Report Given to Customer: Yes- No ❑ CUSTOMER'S SIGNATURE *Acceptance Test Only WHITE- BRANCH COPY YELLOW - CUSTOMER COPY- PINK -ZONE COPY MAHI &T0301 ThyssenKrupp Elevator HYDRAULIC INSPECTION &TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ANNUAL TEST DATE X 4) °7 ❑ ACCEPTANCE TEST n OFFICE 41.14 NAME OF BUILDING f "`wR J° ? l Li .-'i (K— LOCATION nth C ' I ELEVATOR SERIAL N0. 3 r5 CA � / 'CITY & STATE Ft ✓ (IF NONE, USE MOTOR OR CONTROL SERIAL N11) THYSSENKRUPP SERVICE CONTRACT N 0.` /. 1 f ' ' "i✓ BUILDING ELEVATOR NO. 'c2 _3 CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR , Ar7f RATED CAR SPEED Jt"Y7 F.P.M. RATED CAPACITY `f. "�!J LBS. TYPE OF ELEVATOR of e4 RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17,1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEI REQUIRED NOT MORE THAN 6 YEAR INTERVAL. Flex Hose and Fittings Tested at Relief Pressure For 30 Sec. Hose Replace r�ept Date Hose Tagged With Replacement Date & SAE Type Condition of Reservoir Oil f�- Physical Dimension of Reservoir Make (3) Round Trips Before Setting Relief Valve Test the relief valve setting by first inching the epty 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 t11 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 !„ O P.S.I. No Load Car Speed: Up t4,1 F.P.M. Down 1,2 <j F.P.M. Relief Valve Sealed: I it r 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 t'` r ` Tank Oil Temperature At Start of Standing Test r c7 f`% n G After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. Length of Time Car Standing -Empty f r`�g ✓ Amount Car Settled During Standing Period ft} " Oil Temperature At End of Standing Period _ 1Jv 0 Tank Oil Level At end of Standing Period F' f ,. Amount of Leakage At Packing During Test Condition of Piston Packing / 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 r F.P.M. Down — F.P.M. Normal and Final Terminal Stopping Devices Tested /, Standby (Emergency Battery Lowering) P er Operation fested n ! Power Door System Tested: Torque g # Kinetic e Ft. # Emergency Terminal Speed Limiting Device Tested Was the Test Satisfactory: Yes M' No C If not, explain. Representative of the Insurance Company, City or State Inspector or Owner, Present at test: (Indicate Name and Title) ` tjy MECHANIC'S SIGNATURE SUPT. SIGNATURE ✓� c. �✓` Copy of this Report Given to Customer: Yes T No ❑ CUSTOMER'S SIGNATURE Yi *Acceptance Test Only WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK -ZONE COPY MAHI &T0301 ThyssenKrupp Elevator SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) c KANNUALTEST DATE 0 5 YEAR TEST OFFIC 0 NEW ELEVATOR Ge f ) (7f d ✓�' " CLa'( fPfG41✓fL C'L 83ed/ Z-V 3&Vj Avg' NAME OF BUILDING )�(A LOCATION ELEVATOR SERIAL N , o V 6 CITY & STATE l�'�f � '�� 40 (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) THYSSENKRUPP SERVICE CONTRACT N0. / �1 / O �T'4' BUILDING ELEVATOR NO. CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR )t.> e/E- RATE CAR SPEED %O1J F.P.M, RAT D CAPACITY SJIDG7 LBS. . SAFETY MFG. 04002 GOVERNOR MFG. ll TYPE OF GOVERNOR: FLY BALL _ FLYWEIGHT 1 )4 TYPE GRIP JAWS: STEEL BRONZ GOVERNOR ROPE: IRON X STEEL 8X90 6X10 SIZE (DIA.) �6 " O R ED ULTIMATE STRENGTH. CONDITION OF ROPE ee_e CONDITION OF JAWS R CD!J TYPE OF SAFETY: INSTANT H WEDGE CLAMP& FLEX. GUIDE 0 pTHEIR (TYPE) CONDITIO CONTACT ON: GOVERNOR % - RELEASING CARRIER 0 SAFETY 0 RATED CAP. OF SAFETY CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: `. ANNUAL TEST ---- OMIT ITEM (3- 4- 6- 18 -19) 5 -YEAR TEST - - -- COMPLETE ALL ITEMS To Comply with ANSI /ASME A17A Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: YesA No 0 (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intendedtL 131 Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) -(4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car Safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no loads® 46) Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed _ Switch trip spd. F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Yes No 0 How much out of level D.B.G. Max. 3/8" per ft.) 48) Length of cable pulled off the drum . Number of turns of cable left on the drum ` 19)' Governor and safety reset, safety drum rewound evenly: Safety jaw clearance (4.0) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. -0-1) Rails inspected and filed where necessary: Yes)9 .N (12) Was it necessary to readjust the governor? Yes 0 Nog (13) Condition of governor rope after test d Af (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes,,' No 0 Was the test satisfactory: YesA. No 0 If not, explain. (15) Normal and Final Terminal stopping devices tested;[ (16) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5. Year Tests) 0 (17) Power Door System tested: Torque �2® # Kinetic X_ # r(-1 -8) Brake tested with 125% of Rated Load Rule 207.8 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. .49) Emergency Terminal Speed Limiting Devices tested D epresematives of the Insurance Company, City or State Inspector or Owner, present at test: Yes 0 No 0 (Indicate name and title) MECHANIC'S SIGNATURE �/ SUPT: SIGNATURE 0 Copy of this report given to customer: Yes No D CUSTOMER'S SIGNATURE MASGTR0301 CITY OF WHEATRIDGE ELEVATOR INSPECTION BUILDING ADDRESS CITY ZIP CODE BUILDING NAME 8 300 N. 38th Avenue Wheat Ridge CO 80033 Lutheran Hospital OWNER ADDRESS CITY ZIP CODE PHONE NUMBER MANUFACTURE UNIT NUMBER I�fSRAULIC CABLE. ESCALATOR DUMBWAITER 1 ��^ J L I I FRT I I PASS I I FRT LAST SAFETY TEST NEXT DUE DATE , I I MATERIAL LIFT lift DATE INSTALLED °/ CAPACITY CQ L�s wheelchair / / ✓� RECORDED SPNS z � �oa5 °q9 \- 9 1 b7 Y b O a c LT] r 13 c o n 3 �1 z � v m o S -3 n r z � p ti 'ca b H H H ro o b n n H ` r7 Ll n n H b ro w r x c f H Y Ll O b �c u u u n � to n �. 1 � b E b ro n M H -] C k ra C z z m n b C) O d co 0 CD m z e 0 < d a r CD s (_� CD tv tn rr A C-1 0 N o U C) C) w O d W w x 3 r N N w Y � e 0% rD d CJ 0 C � y a ry z N a n b C) O d co 0 CD m z e 0 < d a r CD s (_� CD tv tn rr A C-1 0 N o U C) C) w O d W w x 3 r N N w Y � e 0 a y0 O "g i 9 � t=1 b y HU 0 0 :4 0% rD d CJ 0 0 a y0 O "g i 9 � t=1 b y HU 0 0 :4 lam' I� - z 91.11 a c � f H ^n ro > r — n z t o b j H \ 13tn O z 7 •3 r7 7 to I \ H > � r \ a a v o H N n n < a 0 H 2 c ro ro n H 0 0� o z n m c H r 0 H n Ln n H ro H I v H N a i 3 H N n n < a 0 H 2 c ro ro n H 0 0� o z n m c H r 0 H n Ln n H ro H I o m Q ( ;[ \ \ \ } e »Q\ .� k) .» } — \ > �� ) /) tv rh Q0 �@ 2 e �\ / \ /. 4 ! e \ \ \ �) s , �§ _\ /. \ � b \ \ \ <\ \ / < / \ o ! \. ».I (D :\ CD C) ) 8 o m ( \ ƒ ..Q � t2j eo o� ■ Ba m� \§ 0 § 0 M p� Ln \ \ \ \ X 3 I V �. q-- -3 -3 ti C � n o z C n z co p cv ca ro 0 0 \ zzM m v o m 0 b d td ro o -- — c w w of Ln y -2I\ � ^7 9 \ a z z m C r t r ra N w �a q F � 0 d N ro n O d l� o O O z d W C+ s n m c !n cn s CJ m a 0 N C) ro o t7 w O u lm r � C+ C� CD S 0, ` Z o- z N \ y d C h7 yy H. \ yy Kl co v y fir, RI H W N O � � Z o O O z d W C+ s n m c !n cn s CJ m a 0 N C) ro o t7 w O u lm r � C+ C� CD S 0, ` Z o- z N 4 n d C o O O z d W C+ s n m c !n cn s CJ m a 0 N C) ro o t7 w O u lm r � C+ C� CD S 0, ` Z o- z N r z o w W 4J �O H o c M C .q > M o H O Gl �z ,, k M M SY In cn W �r, cn G1 ,� c... 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D O Z C7 r ~ y O 0 A N W n N n O O rn C r O 2 O 0 n y 0 z m r m O 37 z m 0 C m - C Z 0 m v s o m _� c w 1 C Z 1 \ 3 m m T O p m G) m i L1 m 9 0 m D D p m o m m r O 2 p n 9 H ti .. m N•n Z N A D Ic 3 m � _ r , 0 `�„ V p � O C n D v n y N m m r O 2 p n 9 H ti .. m r � m m m � � O = _ n y N m m � � i y 0 Z= a t/1 � N � m m 1 �ye/ R"ere ` L'LbVtalV±e I.Cl YDl 11ViY BUILDING ADDRESS CITY ZIP CODE i p3 v® t). *YFA -< Z�)G v k,a,, ( o - BU / I � LDING NJ OWNER ADDRESS CITY ZIP CODE PHONE NUi MANUFACTURE UNIT NUMBER - 1 - HYD 4BLE I £�G1LA�DR kDU I PASS /' FRT PA55 I ifC ,., 2 Al . F LAST SAFETY TEST NEXT DUE DATE MA ER IFi fd.' DATE LNSTALLED 1 hair Iitt fs�� S�U RECORDED INSPECTIONS I I I — Z� —a �✓ I l f ' iz� - w I /3 ELEVATOR INSPECTION BUILDING ADDRESS CITY ZIP CODE r r EUL,D_NG NAM] OWNER ADDRESS CITY ZIP CODE PHONE NUMB, MANUFACMRE LAST SAFETY TEST UNTI' NUMBER HYDRAULIC C-.=LE PASS . ESCALATOR O FRT f I PASS FR-, 1 NEXT DUE DATE MATERIAL LIFT, DATE MSTALLED / / [ ) wheelchair list _RECORDED INSPECTIONS DU1fBP CA.oA( ..,.- 3 -1 W° 'e w e-� I-- BUILDING ADDRESS ELEVATOR INSPECTION CITY ZIP CODE BUILDING NAME v.r •.y,a \nL,L�CGJ.7 (,��,�,r�� (O L'LJr. yiiiUK liVJYt.l.11vai - BUILDING ADDRESS CITY ZIP CODE BUILDING NAM �F3 oo 4AeJ ZA-C, C 16 l DATE INSTALLED CA.oACIT RECORDED INSPECTIONS OWNER ADDRESS CITY ZIP CODE PHONE NUMI MANUFACTURE UNIT NUMBER RAULIC '. Z (]PAS �EJPASS ',BLE I E T DDV S� ( l �•1 5 (] FRT ( ] /hj� FrRT / LAST SAFEi'Y TEST NEXT DUE DATE (] M TE LIFT DATE INSTALLED (] Chair ar /7 / az vScnPe 35 RECORDED INSPECTIONS z s���— , I I 3- 2�q -u3a ..,.- 3 -1 W° 'e w e-� I-- BUILDING ADDRESS ELEVATOR INSPECTION CITY ZIP CODE BUILDING NAME v.r •.y,a \nL,L�CGJ.7 CITY ZIP CODE PHONE NUMBEI KkNUFACCL'RE UNIT NUMBER HYDRAULIC -' . G' - -� (] PASS (] FRT (] PASS (] FRi ESCALATOR DUTSBWAJ LAST SAPE Y TEST NEXT DUE DATE MATERIAL LIFT. (] wheelchair list l DATE INSTALLED CA.oACIT RECORDED INSPECTIONS I I I I 3wvK ONICI MET 3000 dIZ UI0 AIOl.LOadSS I aoly! aqa SS32IQQd DRIQ'II_R3 ?.sL. ap a SNOU39dSN1 G3crama i Vq aTULIOIa [ G31'fY]Sk7 3.LYQ .T- 31'I'M ._[.Y [ 3.LYG ana .LX3N .LS3.L AlUYS .ISYT I .i.Lt3 [ SSYd lad PL'1V�Ld [ 8:39: i aGOO dIZ T LIO SS: KVm `JlIIQIIIIH J xarlmo 3000 dIZ IUIO J / SS3d(ICI V ONIC[MnH k*nir- i 'T.rQ'1 *r xnr.crn7rTlT 9J � � 7� � nl SNOLLOUdSNI G3Q'AooaH LIOYnYJ G37'iV_',Sh'I 3.LYQ :?I'I 7vnIMLYI1' [ 3LYG 3RQ J.X3N - ,L531 ;-LadYS 1SS"! rv, ALric I Niolty7YOS3 SSYd [ J I ry4 [ ] SSVd [ 3 ] - onnyamm c=ENIRN.LINa zv-ajDvanKvw i3HMIAI 3IIOHd 3QOD dIZ 3wvK ONICI MET 3000 dIZ UI0 AIOl.LOadSS I aoly! aqa SS32IQQd DRIQ'II_R3 ?.sL. ap a SNOU39dSN1 G3crama i Vq aTULIOIa [ G31'fY]Sk7 3.LYQ .T- 31'I'M ._[.Y [ 3.LYG ana .LX3N .LS3.L AlUYS .ISYT I .i.Lt3 [ SSYd lad PL'1V�Ld [ 8:39: i aGOO dIZ T LIO SS: KVm `JlIIQIIIIH J xarlmo 3000 dIZ IUIO J / SS3d(ICI V ONIC[MnH k*nir- i 'T.rQ'1 *r xnr.crn7rTlT 9J � � 7� � nl IadhffiaalvledicalCeraer (LevelI Fite DepartmantKey) Trams: - CP cable p °M'-^g lip hyftulicpassenger 8300 W. 3e St, Wheat Ridge, CO DW dumbwaiter OH overhead (top floor) Primary phase I key switch - _ Adj. (dose to elev.) Elavator# Primary Type Group blachincRoomI"— Floors Served 1. Service I CP Ys OR (top floor P) (B -6) 0,� U� 2. Service I CP 2/2 OH (B,1 (B,1 3. Public I CP I12 OR (8,1 -6) S 07 } CP 2/2 OH ( &1 6) 4. Public S. Church No Prim CP I OH(4 floor adj. byelev . ll) (B . ,1,2)Qrn < <k 1 tvez- �g DW �}' CountertopB Cs��7 l � "^,( (B > I) a l a 6. Service - (/l 7. service No Prim CP I OH $, Service No Prim CP I OH (5"' floor access rm,5505) (3,1,2,3,4) 9.Public/Ser I HP 1/2 I FloorAdj. (1,2,3,4,) b' /3 - 10.Public/Ser I HP 2/2 1"flowAdj. - (1,2,3,4) 11.PublicJ5cr } CP I OH(5a`floorAdj.Rm.44}2) (1,2,3,4) /Sr . 112. Service - DW I Counter top smgery/}ab(1) (1, 13. Service - DW I Counter top Pharmacy (B) (3,1,2) V/ 7 14. Service - DW I Across iiom elev. 15 (3) (B > - 15_ Stavice 2 Cp I OH (Adj. P) (B,1,2,3,4,! ,6,P) 16. Public/ser I HP I Basement Floor Adj. (3,1,2„3) 17. Service 1 HP l Basement Floor Adj. (B,1,2) - , 18. Service ID HP 1 r Basement Floor Adj. (B>LD) � 2 - >, — 19- Service JD HP I Basenumi wAdj- (B>LD) ,� 2 2 Y 20 Service LD HP 1 Basement floor Adj, ($,LD) 21. Service 1Rear HP 1 Basementfloor Adj. (B, 1,2) 22. Service 1Frout HP 1 Basement floor Adj. (B,1,2) Via? 23_ Service I DF I BasemeatBoorAdj.. (B 1 ,2 ) 1 24. Poblic/Service I CP Yz OH, (B,1,2,3,4„5,6) 25. Public/Service I CP 2/2 OH - (3,1,2,3,4,5,6) CP 1 OR (1,2,3,4,5,6) 26. Public/Service I S C. 3 A w a C m O H m ° N G O < .w+ O O N N w < Q- 0 N ' 0 .o w w A L1 Vl �c w CL 0 v O 0 / � V _v Z 7 O m v O N O O w 0 M En * c Z N O n o. 3 O 3 0 m � O 3 "G Z O w0 < m O -I a Ca m �o O w O ' 0 m o � �(D v 9 °N to n. c _O O O 0 7 fQ 2 m < a O S w O O .1DO» N S C. 3 A w a C m O H m ° N G O < .w+ O O N N w < Q- 0 N ' 0 .o w w A L1 Vl �c w CL C O 0 / � V _v Z n O N M En * c Z cn oU o. m 3 0 m m 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 1 CP 4/17/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3122/06 2/1/07 2/1/08 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridae. 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 5000 lbs Inspector: Bill Gardner I LOCATION ID NUMBER 8300 W. 38th Ave. 2 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 TYPE SAFETY II CID 4/17/06 Inspection Issue Expiration Date Date Date 3/22/06 211/07 2/1/08 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridqe, 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 5000 lbs Inspector: Bill Gardner TION ID NUMBER TYPE SAFETY W. 38th Ave. 3 CP 4/17106 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 211/07 211/08 Lutheran Medical Center Engin. 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 5000 lbs Inspector: Bill Gardner LOCATION ID NUMBER 8300 W. 38th Ave. 4 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 TYPE SAFETY 11 CP 4/17/06 Inspection Issue Expiration Date Date Date 3/22/06 211/07 2/1/08 Lutheran Medical Center Engin. 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 1500 lbs Inspector: Bill Gardner ID NUMBER TYPE SAFETY W. 38th Ave. 5 CP 4/17/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 3/22106 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 50 lbs. Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 6 DW N/A Lutheran Medical Center Engin Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 3/22/06 211107 2/1/08 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridqe. 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 2700 lbs Inspector: Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 7 CID 4/17106 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 211/07 2/1108 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridqe. 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 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 8 CP 4117/06 Lutheran Medical Center Engin Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 2/1/07 2/1108 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner ID NUMBER TYPE SAFETY W. 38th Ave. 9 HP 4/17/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner TION ID NUMBER TYPE SAFETY 8300 W. 38th Ave. 10 HP 4117/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3122106 211/07 2/1/08 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridae. 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 3500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 11 CID 4/17/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 50 lbs. Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY 8300 W. 38th Ave. 12 DW N/A Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 3/22/06 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 50 lbs. Inspector: Bill Gardner ID NUMBER TYPE SAFETY W. 38th Ave. 13 DW N/A Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22106 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 500 lbs Inspector: Bill Gardner TION ID NUMBER TYPE W. 38th Ave. 14 DW Lutheran Medical Center Engin Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 SAFETY N/A Inspection Date Issue Date Expiration Date 3/22106 211/07 211108 Lutheran Medical Center Engin. 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 4500 lbs Inspector: Bill Gardner LOCATION ID NUMBER 8300 W. 38th Ave. 15 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 TYPE SAFETY II hP 4/17/06 Inspection Issue Expiration Date Date Date 3/22/06 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 16 HP 4117106 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 3/22/06 211/07 211/08 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner TION ID NUMBER TYPE SAFETY W. 38th Ave. 17 HP 4/17/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3122/06 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner LOCATION ID NUMBER TYPE SAFETY 11 8300 W. 38th Ave. 18A HP 4117/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 3/22106 211/07 211108 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner TION ID NUMBER W. 38th Ave. 19 Lutheran Medical Center Engin Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 TYPE SAFETY HP 4/20/06 Inspection Issue Expiration Date Date Date 3/22106 2/1/07 2/1108 Lutheran Medical Center Engin. 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 20.000 lbs Inspector: Bill Gardner ID NUMBER TYPE SAFETY W. 38th Ave. 20 HF 4/20/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 2/1/07 2/1/08 Lutheran Medical Center Engin. 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 ID NUMBER TYPE SAFETY W. 38th Ave. 21 HP 4/20/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22106 2/1/07 211108 Lutheran Medical Center Engin. 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 W. 38th Ave. 22 HP 4120/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Date Issue Date Expiration Date 3/22/06 2/1/07 211/08 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridae. 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 5500 lbs Inspector: Bill Gardner LOCATION ID NUMBER TYPE SAFETY W. 38th Ave. 23 HP 4/20/06 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Inspection Issue Expiration Date Date Date 3/22/06 211107 2/1/08 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridqe, CO 80033 address y " GJ. 3/-. -ems, running pressure LF k o avemortrp r relief pressu re 4Q�a ovemorsw. pressure switch 2 r rail marks undertravel overtravel -- pressure , door open time z�`,��� It date recheck req'd, { elevattortype /no. — „� l9 / ropes aS-” capacity wrap 33 speed r ROOM coke detector at detector wishunt trip I 0— vent 0� closer /self locking battery back -up elevator _ lighting GFCI outlet dedicated car liglit/lockable disconnect emergency power/transfer switch PIT -' bottom limit D tt switch ght/switch /GFI outlet it ladder sumo /sump cover NA sump pump to separator 00 limit nspection station /atop switch ;ar top light/GFCI outlet ;ar top escape panel /latching? ntedocks /aux. closers ar door restrictor all door retainers moke detector -lobby moke detector -top of hoistway eat detectomop of hoistway oistway vent oistway enclosure ocr numbers )mmunication device 'e warning signs CAR alarm /illuminated alarm button T emergency light fire instruction signs finished floor handrail _�__ ohase II NOTES Ok counterwelgflts Jrnaxc.. cF l J 14- / kn� Sk /�j O�r pit can amb plates phase I address / ° -/ _�G- ( running pressure relief pressure : pressure switch 'r( _under °( overtravel 1— door pressure , door open time a4 / o ovemortrip � ovemor sw. 3 r`' rail marks. date — � recheck req'd_ eie typeino. 2.4 r ropes 'f }p0 capacity (r l wrap �> o speed MACIJINE ROOM t moke detector heat detector w/shunt trip d vent enclosure OTC — door closer /self locking W_ GFCI outlet battery back -up & dedicated car light/lockable disconnect 1J elevator tt L . h emergency poweritransfer switch ql— lighting PIT bottom limit it switch light/switch /GFI outlet it ladder sumo /sump cover sump pump to separator 1 G v top limit inspection station /;top switch d car top light/GFCI !outlet (/ car top escape panel /latching? interlocks /aux. closers car door restrictor hall door retainers 0 smoke detector- lof)by smoke e oFt of st way ay heat detector-top of hoist way hoistway vent aK _ hoistway enclosure _UK floor numbers u� communication device fire warning signs rrm /illuminated alarm button iergency light instruction signs ished floor NOTE 6i' \ counterweights " can j amb plates thn phase I r i if i' r3 address _ running pressure ovemorthp ^ relief pressure pressure pressure switch rt rail marks. undertravel —— overtravel door pressure i � door open time MACHINE ROOM n97% oke detector _ enclosure defector wishunt trip enclosure —LWL GFCt outlet _Q& dedicated car ligft/lockabie disconnect : emergency power/transfer switch PIT OK bottom limit ® it switch 6 light/switch /GFI outlet it ladder a sumo /sump cover, °— sump pump to sebarator _ 6LIC too limit inspection station /stop switch car top light/GFCI outlet car top escape panel /latching? mtedocks /aux. closers car door restrictor hall door retainers �nx smoke detector -lobby VA smoke detector -toj� of hoistway heat detector -top of hoistway hoistway vent * hoistway enclosure � flocr numbers —1 — fire device fire warning signs CAR alarm /illuminated alarm button emergency light fire instruc',ion signs C floor d handrail __ C' 11 NOTES date r— 7 — ° a recheck req'd elevator type/no. " I J r , ropes rte" capacity P/ wrap /.des}' speed y / —^a s d7 OK e vent R ddCC door closer /self locking battery back -up elevator-, ighting 9d�w�, �sr. po/ 0 counterweiohts . pit can �Gt amb plates phase I :/ ££008 00 'a6pl�{ ;eew anuany y }g£ 'M 00£8 ja}uao leolpayl ueaay}n anuany yjg£ 'M 00£8 00'026$ :jol uogoadsul ao}en919 6 }soO le}ol uol}duosad A}l;uenO ££008 00 96 pRi }eayM anuany yjg£ 'M 00£8 aa}uao leolpeVq uejay;n 00 /Z 6/b : a }ea ££008 00 'a6pi�j }ea4m anuany y ;BE •M OOE8 ja}ua0 leoipaW uejay;n anuany y 18E •N1 00£8 00.026$ :jo; uoi}oedsui Jo}en913 }so0 lelol uogduosaa ApjuenO EE008 00 '96pib }eGMA anuany y19E 'M OOE8 aa}ua0 leoipaW uejay}n 00 /Z6 /t? : a }ea 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 002 CID 3130/1998 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/1999 4/9/1999 3/31/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Lutheran Medical Center 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 001 CID 413/98 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Date: 4/12100 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description Total Cost 1 Elevator inspection for: 8300 W. 38th Avenue $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge CO 80033 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue 4 Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue s Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 33 Avenue U/ Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue K Total Cost $120.00. Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description Total Cost 1 Elevator inspection for: 8300 W. 38th Avenue /6 $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue 0 Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue l Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. (f 38th Avenue !j Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue l� Total Cost $90.00 Lutheran Medical Center 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 003 CID 3/31/1998 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/19/1999 4/9/1999 3/31 /00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 I Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue C 7ota Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date : 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO. 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue. Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W. 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity Description 1 Elevator inspection for: 8300 W, 38th Avenue Total Cost $120.00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Date: 4/12/00 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Quantity 1 Description Elevator inspection for: 8300 W. 38th Avenue �3 Total Cost $120.00 Lutheran Medical Center 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 004 CG 4/1/98 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/19/99 4/9/99 3/31/2000 Lutheran Medical Center 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 1500 lbs. Inspector: Randy Pabst LOCATION 8300 W. 38th Avenue Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 ID NUMBER TYPE SAFETY INSPECTION DATE 005 CID 3/31/1998 Inspection Issue Expiration Date Date Date 3/19/1999 4/9/1999 3/31/00 Lutheran Medical Center 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 50 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 006 DW Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/19/99 4/9/99 3/31/2000 Lutheran Medical Center 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 2700 lbs. Inspector: Randy Pabst LOCATION 8300 W. 38th Avenue Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 ID NUMBER TYPE SAFETY INSPECTION DATE 007 CID 4/5/1998 Inspection Issue Expiration Date Date Date 3/18/1999 4/9/1999 3/31/00 Lutheran Medical Center 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 2700 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION. DATE 8300 W. 38th Avenue 008 CID 4/6/1998 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/1999 4/9/1999 3/31/00 Lutheran Medical Center 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 4000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 009 HP 4/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3118/99 4/9/99 3/31/2000 Lutheran Medical Center 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 4000 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 010 HP 4/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 3500 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 011 CI? 4/6/98 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 50 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 012 DW Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 l 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: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 013 DW Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 50 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 014 DW Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 4500 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 015 CID 4/15/1997 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 . Inspection Issue Expiration Date Date Date 3/18/1999 4/9/1999 3/31/00 Lutheran Medical Center 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 4000 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 016 HP 4/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 4000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 017 HP 4/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3118/99 4/9/99 3/31/2000 Lutheran Medical Center 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 4000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 018 HP 4/1811998 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/1999 4/9/1999 3/31100 Lutheran Medical Center 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 4000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 019 HP 4115/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 8300 W. 38th Avenue 020 HP 4/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 8300 W. 38th Avenue 021 HP 4/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 8300 W. 38th Avenue 022 HP 2/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 3/31/2000 Lutheran Medical Center 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 5500 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Avenue 023 HP 2/15/97 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/18/99 4/9/99 .3/31/2000 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 7500 WEST 29TH AVENUE WHEAT RIDGE, COLORADO 80215 October 15, 1999 Mr. Mark Valerius Cator / Ruma 1550 Dover Street Lakewood, CO. 80215 Re: Exempla Lutheran Medical Center - Wheatridge Mark, The City of Wheat - •�— Enclosed are my inspection notes - probably not worth much. The identified elevators were # 1,2,3,4 &7; all are traction elevators with overhead machine rooms. Any other hoistways or machine rooms that will be sprinkled must also have shunt trip circuit breakers. In each instance, automatic fire recall will be required to return the elevator to the designated fire service landing prior to shunt trip operation and application of water. Please feel free to call with any questions. 303.885.3706. Respectfully submitted, Randy Pabst Elevator Inspector Pc: John Cook -LMC Engineeri _k__0_Q (303) 234 -5900 • ADMINISTRATION FAX: 234 -5924 POLICE DEPARTMENT FAX: 235 -2949 ••' Fyn / �� � C�JC)� ` � L� r l c —2 r - address date recheck req'd_ elevator typemo. running essure 4 q 9 P y ovemortrip ropes $� ' J capacity relief pressure �g ovemor sw. pressure switch rail marks. wrap i ✓ t spee t - -- -- - -- undertravel /I . .- -- overtravel i 2b door pressure door (,`-� L r open time / XN or trip On vent door closer /self locking _(LK GFC; outlet OK dedicated car light /lockable disconnect battery back -up emergency powerftransferswitch elevator N fighting PIT bottom limit g switch light switch /GFl outlet it ladder sumo /sump cover, SUMP pump to separator HOIST?NAY too limit i nspection station/5 switch t�(\ counterwei_ghts car top light/Gr=CI' outlet car top escape parcel /latching? intedocks /aux. closers —. car door restrictor o_- hall door retainers _ d smoke detector- lot detec -toIP of hoistway ::� smoke heat detector -top of hoistway hoistway vent � hoistway enclosure pit —4 Floor numbers - can jamb plates communication device — fire warning signs _als ohase I CAR alarm /illuminated alarm button emergency light OK fire instruction signs OX finished floor handrail phase 11 address date ""L recheck req'd_ elevator typem o. — ' unning pressure ovemortrip g ropes 3�'O relief pressure res - capacity " oressuwitc switc h ovemor sw. � wral ) speed rail marks. unde travel�^^11 — � �� 2 1 ` overtravel 3 f door pressure Cr 4,j �j" door open time MACHINE ROOM 0 � smoke detector .•`---� heat detector wishunt trip _4�4- vent outlet tied car ligtit/lockable disconnect ency poweiftransfer switch PIT �x bottom limit — �` 7 �' it switch light/switch /GFI outlet 0 it ladder sump /sump cover sump pump to separator .top limit ynspection station /stop switch car top light/GFCI outlet _car top escape parcel /latching? —interlocks/aux. closers car door restrictor .hall door retainers smoke detector - lobby smoke detector -tojt of hoistway heat detector -top of hoistway hoistway vent hoistway enclosure Floor numbers imunication device warning signs CAR alarm /illuminated alarm button �K emergency light fire instruction signs � finished floor CSC handrail - — ohase If door closer /self locking battery back -up elevator N lighting "'` counterweights AJ+ pit can pP�_'amb plates CM Dhase I address date J'J recheck req'd elevator typemo. r unning pressure ovemortrip �° u� ` roues capacity ,_- relief pressure ovemor sw. ! wrap sa — pressure switch ra i /marks. speed undertravel 9vertravel door pressure _._ door open time J Kt` ev ✓/ MACHINE ROOM dr( smoke detector C ��31 C)n 2 Ft heat detector w /shunt trip el dK enclosure — - GFCI outlet — vent closer /self locking Air 4, l' - dedicated car light/lockable disconnect battery back -up 3 � emergencypower/transferswitch elevator oX lighting PIT 0K bottom limit t snitch / ight/switch /GFI outlet QApit ladder sump /sump cover, sump pump to seflarator limit _ G2_ counterweights U�_ insoection stationl:;iop switch _(1Yt car top lighf/GFC!'outlei 4� pe parcel /latching? � 1 car top escape closers 0 A car door restricfor 0K halt door retainers OK smoke detector lobby �smoke detector -tort of hoistway h e dcte i Or -top Of hoistway hoistway vent U hoistway enclosure ny� Flocr mbers d comm device M ire warning signs CAR alarm /illuminated alarm button G emergency light a�rire instruction signs Finished floor handrail phase 11 NOTES_ �> &, �/ pit can — � - i amb plates aA phase I �I address ?� �— 0 j - ---- -- date recheck req'd elevator typemo. act — upping pressure ._ g ovemortrp r ( Wes u � -- " relief p ressure . �_Gapacity - -� p ° /, .? _o ovemor sw. Wrap r,4 I speed pressure switch 24 rail marks. undertravel dx s — ovenravel ✓�jw �tt'� y( �Z S (� _� Ck. 13w y` OK _2b Id oorpressure ✓ _._ door open time �- MACHINE ROOM oX _ smoke detector heat detector defer or w /shunt trip d vent enclosure door closer /self locking�e-+ �h GFCI outlet battery back -up dedicated car Iigf Ulockable disconnect elevator M emergency, poweritransferswitch Z' lighting PIT om limit switch CAR �f l alarm /illuminated alarm button ' emergency light fire instruction sign; 01C finished floor 0K handrail — - phase If NOTES light/switch /GFI outlet it ladder N" sumo/sump cover, sump pump to separator —WAY limit 4 cou nterweights ection station /:top switch T top light/GFCI outlet top d. G ct►^ escape panel /latching? W pl., ntedocks /aux. closers car door restrictor hall door retainers 0 smoke detector -lobby a smoke detector -too of hoistway dK, heat detector -top df holsiway hoistway vent noistway enclosure 40 G floor numbers communication device pit can amb plates P phase I fire warning signs CAR �f l alarm /illuminated alarm button ' emergency light fire instruction sign; 01C finished floor 0K handrail — - phase If NOTES J� address It c,i date S'' recheck req'd elevator iypemo. r r. i� running pressure g ovemorirp — ropes /t t " ;3 relief pressure capacity g ovemor sw. wrap o speed i pressure switch rail ma undertravel overiravel ' G , door pressure door open time MACHINE ROOM smoke detector I N heat defector /shunt trip CI111 ent enclosure — door closer /self locking GFCl outlet C GFCI outlet — 1�/� battery back -up Ot'- dedicated car light/lockable disconnect _ elevator X�E poweri'transferswitch J� lighting PIT�p bottom limit it switch � light/switch /GFI outlet -f.� pit ladder �7�"� sumolsump cover _ AM- sump pump to separator HOISTNAY too limit cpunterweights !? inspection station /stop switch PSG car too IighUGFCI 'outlet car top escape parcel /latching.7 interlocks /aux, closers car door re'strictor r hall door retainers smoke detector -lobby smoke detector -top of hoistway heat detector -top of hoistway hoistway vent hoistway enclosure � � ` .. 1 r � pit can near numbers Vr` pit c plates �I communication device p J amb I fire warning signs C alarm /illuminated alarm button emergency light _. k ure instruction signs finished floor _ --\ phase II 4a - 1 6- "m od�r �tk lJ „ y 7500 West 29th Avenue Wheatridge, CO 80215 Re: Exempla Lutheran Elevator #15 Dear Bill: This is to confirm that ThyssenKrupp Elevator accepts with no reservations the opening in the machine room wall for governor access on elevator #15. The opening is shown on our shop drawing as 2'- 6 "x2' -6" and actual opening is less than this. The smaller size will not be a problem for us. Best regards, frarry District Jones � District Mana er U I HJ: kah cc: Bill Stott i Gbrald H. Phippes General Contractor, 1530 West 13th Avenue, Denver, CO 80204 -2400 ThyssenKrupp Elevator Corporation 6374 South Racine Circle Englewood, CO 80111 Telephone: (303) 790 -8566 Fax: (303) 790 -1230 E -mail: Harry.Jones @thyssenkruppelevator.com Internet: www.thyssenkruppelevatoccom ThyssenKrupp Elevator 0 August 12, 2002 Bill Gardner City of Wheatridge 7500 West 29th Avenue Wheatridge, CO 80215 Re: Exempla Lutheran Elevator #15 Dear Bill: This is to confirm that ThyssenKrupp Elevator accepts with no reservations the opening in the machine room wall for governor access on elevator #15. The opening is shown on our shop drawing as 2'- 6 "x2' -6" and actual opening is less than this. The smaller size will not be a problem for us. Best regards, Karry Jones District Mani HJ: kah cc: Bill Stott Gerald H. Phippes General Contractor 1530 West 13th Avenue, Denver, CO 80204 -2400 ThyssenKrupp Elevator Corporation 6374 South Racine Circle Englewood, CO 80111 Telephone: (303) 790 -8566 Fax: (303) 790 -1230 E -mail: Harry.Jones @thyssenkruppelevator.com Internet: www.thyssenkruppelevator.com address_ �' iv running pressure q 4,jao;� g ovemortnp relief pressure ovemorsw. pressure switch rail marks. date elevator typemo. / � r echeck req'd — r/ ropes capacity wrap > aj speed un e rave 7 / QLl' Se t G_ overtravel b '2 door pressure — , � � v _t door open time �) /SUN y_ MACLJHNE ROOM - smo ke detector heat detector wishunt trip vent enclosure —_0 r_GFCI outlet 07 '� 7_ dedicated car lig6t/lockable disconnect _ emergency powe0transfer switch PIT ����// — k U� bottom limit - p it switch light/switch /GFI outlet it ladder sumo /sump cover sump pump to separator 1 too limit nspection station /stop switch ._ car top light/GFCI outlet _LT _ car top escape panel /latching? aK ntedocks /aux. closers Car door restrictor DKhall door retainers s moke detector-lobb o smoke detector-top of hoistway eat detector -top of hoistway 06 hoistway vent hoistway enclosure 6 Hoar numbers 4 communication device Q fire warning signs CAR alarm /illuminated alarm button _ emergency light 0 fire instruction signs finished floor = Ioor closer /self locking battery back -up 1 S — elevator r >ac lighting counterweights a � A S.• Lt dc2r "r NJt pit can � 'amb plates ohase I NOTE BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at 6 j I have this day inspected this structure and these premises and have found the following violations of City and/or State laws gov- erning/s/ame: f L 6J,n 4 ) k l ,.r 6 C,4-. You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. Date Inspector for Building Dept. DO NOT REMOVE THIS TAG FORM WR6 -22 BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice 1 � Job Located at I have this day inspected this structure and these premises and have found the following violations of City and/or State laws gov- erning same: I You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. Date :7 —fit Inspector for Building Dept. DO NOT REMOVE THIS TAG FORM WR6.22 /Ll ." -r_ r( e lc(4 GCS.. n<r -6 C�'wTn o✓/ Y.;; 7 tm n tti o u, r iP r. v, I r _ n W . 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Box 638 Wheat Ridge, Colorado 80034 Phone 237-6944 STATEMENT DATE J F P CD „* @ r, 'zJ C LN l a � v z c � v rn t0 � s a € fA € m o / � n J l I O \ / \� \ \� -\ k <;� 3 ).§ d� q d d � \ J « .. � \�\ � \/ rl :, � \\ . l ioll, Id \�\` ^�. \ / \� \ \� -\ k <;� 3 ).§ d� q d d � \ J « .. � \�\ � : OM - 1 3 , Z ' ED N m N m n M< m C E Z O v { Gs D D I m H m O N Z 9 l ev ;a rr, m a n n m < a L> O C., J v. N n n N s p a C j� a CD n n CP N N �- (U : n nY co S M Irl S i ll Z, S S `: Ln 3 , Z ' ED N m N m n M< m C E Z O v { Gs D D I m H m O N Z 9 l ev ;a rr, m a n n m < a L> O C., J v. N n n N 9 l ev ;a rr, m a n n m < a L> O C., J v. N n n N C) 1 - a �, n ol tD P Cj n � o a a r� n 71 -� ID r' C1 RS to � z o R1 tr3 I Z y (1 Pff CU Cj Y^Y R7+ w 6k a� Ip- tc r; ww G" 6J G7 to F �i � N S lD ZT n m _ o a w� n N lD f' ft N r� Z tp O Z' 'D • GL 0 ro CD W LO c. r. rD � O c. r. rD � a ca s V7 as Tr N P� > e� C? 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PJ1 m N p C n Fq iI; I \ .§ \ ;� o \: \\q CD . �. � .. ^ \�< .< q � \2 � � .�.�. \� k <� \�\ CIO > Z« \ \\ \ )K m9. .\ , |7 I \ .§ \ ;� o \: \\q CD . �. � .. ^ \�< .< q � \2 � � .�.�. \� k <� \�\ I \ .§ \ ;� o \: \\q CD . �. � .. ^ \�< .< q � \2 � � .�.�. \� k <� F S v C> P I w co haw a o o P a o w aY G :o O rD IL O r-�- s �- nma o: m Qr Z s I d M o i o G H m z c, o '? e a n t" z z � w m 777 BUILDING DEPARTMENT (303) 235-2855 CITY OF WHEAT RIDGE Correction Notice Job Located at ELD�4'11� Luun"'rL4�-x I have this day inspected this-,structur"nd-these-pr-emises and have found the following violations of City and/or State laws gov- erning same: ,%\ 1 7 k - 1- f - * VE�; z OD Yo Afare l hgr2y? ��tif t violations. When corrections have been made, call for inspection. Date 10 inspector for Building De pt DO NOT REIVIOVE��S TAG FORM WR6-22 BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at d �4V �irr have this day inspected this®stt -aka " p` Y� *9ses and. have found the following violations of City and/or State Jaws gov- erning same: A s { d You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. Date > -� inspector for Building Dept. DO NOT REMOVE THIS TAG 2 FORM WRG -22 4 CITY OF WHEAT RIDGE 7500 West 29th Avenue P.O. Box 638 Wheat Ridge, Colorado 80033 Phone 234-5900 STATEMENT DATE April 13, 199s Lutheran Medical Center 8300 N. 38th Avenue BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at 1'3 14 7-k A r>� I have this day inspected this structure and these premises and have found the following violations of City and/or State laws gov- erningsame: You are hereby notified to correct the foregoing violations. 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O n,:.° z,' r� All CL h 04 -ni m �, sq" � � O ;r � "tee Ay , •� x� � e`PT m m A N z � m fry s 0 \ q N 3 tn ., ��r� rSiYiaV1� alt �gc ztf co tr. IP S r, mn o -a_ CD At a 31 e rt m D =. nY0.� °-:� tC; r •, CD ~ p `t5 W G n < " S O 0 (D fD { WI O p O �. Lq rt n W CD Ii M1S' IN IN o ' ji T ny tp rl x h Z Q 4ma Z p }� i sit. c a ID y G Ul to S N Z O.v, m to N 4\ o � f U f A «n Elevator Locations #1 Dover elevator, Radiology corridor, Serial No. C- 23816, Traction elevator. #2 Dover elevator, Radiology corridor, Serial No. C- 23817, Traction elevator. � 13 Dover elevator, Main lobby, Serial No. Cr 23818, Traction elevator. , —#4 Dover elevator, Main lobby, Serial No. C- 23819, Traciton elevator. NOTE:, THIS BANK OF FOUR (4) ELEVATORS MUST BE FUNCTIONAL AT ALL TIMES #5 Montgomery elevator (near. Auditorium),, Serial No. 4572, Traction elevator. NOTE: THIS ELEVATOR MAY BE LEFT IN A NON - OPERATIONAL STATUS AFTER 4:00 P.M. WEEKDAYS AND ON WEEKENDS #6 Matot (Dumbwaiter located in Surgery and the Lab). Serial No. 15271. NOTE: THIS DUMBWAITER'MUST BE OPERATIONAL AT ALL TIMES #7 Dover elevator (Basement near Plumbing Storage), Serial No. C7-23820, Trac tion elevator. -48 Dover elevator (Basement, next to main kitchen), Serial No. C- 23821, Trac- tion elevator. NOTE: ELEVATORS #7 and #8 MUST BE FUNCTIONAL AT ALL TIMES #9A Montgomery Hydro elevator (near Surgery), Serial No. C -14178 North. #10B Montgomery Hydro Elevator (near Surgery), Serial No. C -14179 South. NOTE: ONE ELEVATOR OF THE ABOVE: ( #9A or #IOB) MAY BE LEFT IN A NON- OPERATIONAL STATUS AFTER 4:00 P.M. ON WEEKDAYS AND ON WEEKENDS #11 Westinghouse elevator (near E.R.), Serial No. 70716, Traction elevator. NOTE:. THIS ELEVATOR MUST BE OPERATIONAL AT ALL TIMES 2 Matot (Dumbwaiter located n C.S., Surgery and Labor and Delivery). Serial No. 8757. NOTE: THIS DUMBWAITER MUST BEIOPERATIONAL AT ALL TIMES 41 3 Matot (Dumbwaiter located in South Wing Pharmacy), Serial No. MT 16577. #14 Matot (Dumbwaiter located in South Wing Basement in room across from .service elevator), Serial No. MT 16576. #15 Dover service elevator (South Wing), Serial No. C- 36877. #16 Dover passenger elevator (South Wing), Serial No. E- 71735. #17 Dover service, loading dock elevator (South Wing), Serial No. E- 71736. NOTE:. THE ABOVE DUMBWAITERS AND ELEVATORS MUST BE OPERATIONAL AT ALL TIMES a LLI_VP,I01 i';;iJ i„;if, WAI ILR LMLRGLNLY Id PAIR Pi"W i I;U; iL Elevator Locations # Dover elevator, Radiology corridor, Serial No. C- 23816, Traction elevator #2 Dover elevator, Radiology corridor, Serial No. C- 23817, Traction elevator:/ 3 Dover elevator, Main lobby, Serial No. C- 23818, Traction elevator 4 Dover elevator, Main lobby, Serial No. C- 23819, Traction elevator NOTE: This bank of four (4) elevators may function with one (1) elevator In a non - operational status after 4:00 p.m. weekdays and weekends #5 Mongomery elevator (near Auditorium), Serial No. 4572, Traction elevator NOTE: This elevator may be left in a non - operational status after 4.00 p.m weekdays and on weekends rp a tot (Dumbwaiter located in Surgery and the Lab). Serial No. 15271 NOTE: This Dumbwaiter must be operational at all times #7 Dover elevator (Basement near main kitchen), Serial No. C- 23820, Traction elevator Dover elevator (Basement between north and west corridor) Serial No. C -23821 Traction elevator NOTE: One elevator of the above; ( #7 or #8) may be left in a non - operational Status after 4:00 p.m. weekdays and on weekends Montgomery Hydro elevator (near Surgery), Serial No. C -14178 North 10 Montgomery Hydro elevator (near Surgery), Serial No. C -14179 South NOTE: One elevator of the above ( #9A or #10B) may be left in a non - operational status after 4:00 p.m. weekdays and on weekends t�Traction estinghouse elevator (near E.R.; Core "0" elevator) Serial No. 70716, elevator NOTE: This elevator must be operational at all times #12 Matot (Dumbwaiter located in C.S., Surgery and Labor and Delivery). Serial No. 8757 pe I �NOTE: This Dumbwaiter must be operaitonal at all times 13 Matot (Dumbwaiter located in South Wing Pharmacy) Serial No. MT 16577 //fM (Dumbwaiter located in South Wing Basement in room across from service elevator) Serial No. MT 16576 15 Dover service elevator (South Wing) Serial No. C 36877 # 6 Dover passenger elevator (South Wing) Serial No. E 71735 #17 Dover service, loading dock elevator (South Wing) Serial No. E 71736' NOTE: The above dumbwaiters and elevators must be operational at all times NOTE: When an elevator or dumbwaiter becomes non - operational; or operatinq below a satisfactory condition ma ke _a complete physical and visual check of elevator for common problems, restore to service if possible and check for safe operating condition If unable to solve problem refer - to above required operational status If the unit is to-be in an operational status at all times call Dover Elevator Co. (777 -3061) and request a service person to respond - to the situtation If the elevator in concern is one that may be substituted by another elevator or elevators. Lock doors open, shut off power and label elevators "Out of Service" on main floor and wherever elevator may be. Give detailed descriptive write up in General Information Log directe to the Maintenance Supervisor for action ---, =(.) ELEVAT O R S DOVER ELEVATOR COMPANY 0 ANNUAL TEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR DATE OFFICE f? NAMEOFBUILDING it d.J 4d'W./�CrIAl 114 PJY LOCATION YIeO W, .-irk' 'FM �f✓k` ELEVATOR SERIAL NO. ! - 7 y/6 CITY & STATE "JI f("Al 1212/ t� AQ (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. >tld /3 r.S>P75� BUILDING ELEVATOR NO. ')' CUSTOMER P.O. NO. JOB NO. MAKE OF ELEVATOR .00 w eR RATED CAR SPEED 1 0 F.P.M. RATED CAPACITY 4' 019 LBS. SAFETY MFG. PIO VeA2, GOVERNOR MFG. AME12- TYPE OF GOVERNOR: FLY BALL FLYWEIGHT '•( TYPE GRIP JAWS STEEL - BRONZE GOVERNOR ROPE: IRON ti 11 STEEL 8 x 19 ❑ 6 1x 9 to SIZE (DIA.) ❑ RATED ULTIMATE STRENGTH � r CONDITION OE ROPE _ x` CONDITION OF JAWS �r TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP d FLEX. GUIDE ❑ OTHER (TYPE) CONDITION 61 CONTACT ON: GOVERNOR [A RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY /t` a # CONDITION OF SAFETY DRUM ROPE - SIZE INSTRUCTIONS: *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) * 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes M No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended 43)^ Force required to pull rope through governor jaws. (Must be less than 20°% of Rated Ultimate Strength.) . Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at $lowest possible speed in down direction, no load !A {6) Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd F.P.M. Jaw trip spd F.P.M. (7) Did the car stop level: Yes 0 No ❑ How much out of level D.B.G. - (Max. 3/8" per ft.) -(8) Length of cable pulled off the drum . Number of turns of cable left on the drum -(9p Governor and safety reset, safety drum rewound evenly: Safety jaw clearance •(10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. .( Rails inspected and filed where necessary. . Yes p No ❑ - (12) Was it necessary to readjust the governor Ye 11 No ,^ (13) Condition of governor rope after test _ r2 (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes 10 No ❑ tr Was the test satisfactory: Yes ®. No ❑ If not, explain. G1 (15) Normal and Final Terminal stopping devices tested] -(16)r Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ g (17) Power Door System tested: Torque# Kinetic ft.# t o *Z18y Brake tested with 1 F1 25% of Rated Load 4Jf *(19)- Emergency Terminal Speed Limiting Devices tested * *(20)' (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. i Representatives of the Insurance Company, City or State Inspector or Owner, present at test:. t 1 (indicate name and fine) t i MECHANIC'S SIGNATURE �2 'tNB ., G Copy of this report given to customer: Yes 1� No ❑ r . DC -46 -GS SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) SUPT. SIGNATURE CUSTOMER'S SIGNATURE ELEVATORS DOVER ELEVATOR COMPANY ANNUAL TEST ❑ 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT DATE f^ El NEW NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE 0 NAME OF BUILDING I l 1 Q n d A44? , t"'_r/1,G. LOCATION '�� /.'j • 729 0.1 A +I ELEVATOR SERIAL N a5'61 CITY & STATE f%3 (IF NONE, USE MOTOR OR C TROL SERIAL NO.) DOVER SERVICE CONTRACT NO. . TVIA6,f.�.' °, '3 BUILDING ELEVATOR NO. , CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATYR - > - ° - ✓L• RATED CAR SPEED -f 7 ✓' F.P.M. RATED CAPACITY _ LBS. SAFETY MFG tJ U`�;tU..,. GOVERNOR MFG. (Jlixa TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL BRONZE X GOVERNOR ROPE: IRON STEEL 8 x 19 ❑ 6 x 19 d SIZE (DIA-) ❑ RATED ULTIMATE STRENGTH CONDITION OF ROPE ad CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP .'t` FLEX. GUIDE ❑ OTHER (TYPE) CONDITION r» CONTACT ON: GOVERNOR RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFEW /_ # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: * *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt Yes 19 No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended ,(3)• Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength) (4) Force required to pull governor rope from the release carrier. (Can be no more than 60 of pull-through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down FI _ direction, no load f"` lt(% Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd F.P.M. Jaw trip spd. F.P.M. (7) Did the car stop level: Yes 1,0 No ❑ How much out of level - D.B.G. (Max. 3/8" per ft) JB)• Length of cable pulled off the drum Number of turns of cable left on the drum (9p Governor and safety reset, safety drum rewound evenly: Safety jaw clearance -0% Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left mil inches. Right rail inches. (11) Rails inspected and filed where necessary. Yes No ❑ (12) Was it necessary to readjust the governor. Yes ❑ No d: (13) Condition of governor rope after test rG400 (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes ® No El Was the test satisfactory. Yes K No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested LX (46)- Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque .-2 S # Kinetic — A�_ ft. # *(48) Brake tested with 125% of Rated Load *.(,19) Emergency Terminal Speed Limiting Devices tested ❑ (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at its lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: MECHANIC'S SIGNATURE Copy of this report given to customer: Yes q No ❑ t DC -46 -GS SUPT SIGNATURE CUSTOMER'S SIGNATURE "`?�,✓�� =ELEVATORS DOVER ELEVATOR COMPANY �. ANNUAL TEST 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT ❑ ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING ELEVATOR SERIAL NO. _— € ax 7 0 CITY & STATE (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 62 BUILDING ELEVATOR NO. _ T CUSTOMER P. O. NO. JOB DATE OFFICE MAKE OF ELEVATOR . i - rd �- RATED CAR SPEED .5- F.P.M. RATED �APACITY P.1 O LES. S'� P&2– SAFETY MFG. GOVERNOR MFG. ,/l/+tt IPd''c. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT ,,,� (I TYPE GRIP JAWS: STEEL BRONZE GOVERNOR ROPE: IRONS STEEL 8 x 19 E3 6 x 19 4J SIZE (DIA.) 8 ;'T `r El RATED ULTIMATE STRENGTH CONDITION OF ROPE F CONDITION OF JAWS fe TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMPI,Y7- FLEX. GUIDE ❑ OTHER (TYPE) CONDITION 661 -L CONTACT ON: GOVERNOR RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY .' # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: * *'ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST -- COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended p (� Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) �(4)` Force required to pull governor rope from the release carrier. (Can be no more than 60 of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load 0. *(6) Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed , Switch trip spd. F.P.M. Jaw trip spd- F.P.M. (7) Did the car stop level: Yes 0 No ❑ How much out of level D.B.G. (Max. 3/8" per ft.) .(Sy Length of cable pulled off the drum . Number of turns of cable left on the drum (9) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance ¢10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes a No ❑ (12) Was it necessary to readjust the governor. Yes ❑ No ,❑"'e (13) Condition of governor rope after test (14) Governor adjustments sealed and tagged tagged and Release Carrier tagged: Yes 0 No El u Was the test satisfactory: Yes No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested L»J (16) Standby (Emergency) Power Operations' tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque # Kinetic ft. # N48) Brake tested with 125% of Rated Load tfl$ Emergency Terminal Speed Limiting Devices tested ❑ " (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: name MECHANIC'S SIGNATURE Copy of this report given to customer: Yes n No ❑ M 46 -GS SUPT. SIGNATURE r/ CUSTOMER'S SIGNATURE7 /, i i ELEVATORS w DOVER ELEVATOR COMPANY °J ANNUAL TEST '.: AFETY AND GOVERNOR TEST REPORT 5 YEAR TEST DATE 0 V C NEW ELEVATOR. (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE l ELEVATOR SERIAL NO ' L ,r l 5 ✓! ( CITY & STATE tA/ (IF NONE, USE MOTOR OR CO TROJy L SERIAL NO.) DOVER SERVICE. CONTRACT NO. BUILDING ELEVATOR NO. E CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR 04'A P RATED CAR SPEED 7-0– F.P.M. RATED CA PAC Y LBS. SAFETY MFG. -�,.` GOVERNOR MFG.i✓ei✓ TYPE OF GOVERNOR: LY BALL FLYWEIGHT '�/, TYPE GRIP JAWS: STEEL BRONZE GOVERNOR ROPE: IRON STEEL - 8 x 19 ❑ 16 xx 9l� SIZE (DIA.) ❑ RATED ULTIMATE STRENGTH, M_ ?. CONDITION OF ROPE — 490 CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMPS FLEX. GUIDE ❑ OT ER (TYPE) fi .� CONDITION "r CONTACT ON: GOVERNOR 4 RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY # CONDITION OF SAFETY DRUM ROPE - SIZE INSTRUCTIONS `ANNUAL TEST OMIT ITEM (3- 4- 6- 18- 19 -20) * *5 YEAR TEST = COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI '/ ASME A17.1 Code Section 205, 206, 207, 208, 209,1002, & 1003. (1) 'Governor & safety free of excessive lubrication, lint and dirt Yes ;9 No ❑ a rr �i (2) Nand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended X ^. (•3)m Force require4to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) (44) -Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull-through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load In ft @y Safety checked and tested with rated cap. - lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed , Switch trip spd F.P.M. i0w trip spd - ` F.P.M. �- (7) Did the car stop level: Yes. 1� No ❑ How much out of level D.B.G. ' .:(Max. 3/8" per ff.) (8f -Length of cable pulled off the drum Number of turns of cable left on the drum . -{9)~ Governor and safety reset, safety drum rewound evenly: Safety jaw clearance I 410) Indicate the length of the mark on the guide rails made by the safety jaws in inches Left rail inches. Right rail inches. (11) Als inspected and filed where necessary Yes �. No ❑ 3 y (12) Was it necessary to readjust the governoy Ye ❑ No EK (13) Condition of. governor rope after test tif;,?5.. (14) Governor adjustments sealed and tagged and Release Carrier tagged 'rfs'� No ❑ Was the test satisfactory: Yes Cd No ❑ If not explain. 1 p (15) .Normal and Final Terminal stopping devices tested i .,(46)– Standby (Emergency) Power Operations'tespd (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque, `� a # Kinetic ft # , *(18p Brake tested with 125% of Rated Load '(49)r Emergency Terminal Speed Limiting Devices tested ❑ * *(201' (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test MECHANIC'S SIGNATU .SUPT. SIGNATURE Copy of this report given to customer Yes ® No ❑ GC -46 -GS CUSTOMER'SSIGNATURE rr?)f ELEVATORS DOVER ELEVATOR COMPANY El ANNUAL TEST . SAFETY AND GOVERNOR TEST REPORT �f . ,✓' 4 ;%r . ` El 5 YEAR TEST DATE ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE a 71 z NAME OF BUILDING (L> €14 . t 4 �'t (• -e.. LOCATION ir� W • . ;'l'if't A r� C. ELEVATOR SERIAL NO. i'i'-2 CITY & STATE (IF NONE, USE MOTOR OR CON'ROL SERIAL NO.) DOVER SERVICE CONTRACT NO. e fJ.o U rJ `"' �r5 BUILDING ELEVATOR NO. - CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR r^.+. 9 TL'r` ATED CAR SPEED "W F.P.M. RATED CAPACITY 1,7Q9 LBS. SAFETY MFG. s P.P`t .0 a t = 44 F GOVERNOR MFG. 1 'dO` 1 F eWIAI. i?,I?V TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS: STEEL V BRONZE GOVERNOR ROPE: IRON STEEL 8 x 19 E1 x 19 [ SIZE (DIA.) - j�t" ❑ RATED ULTIMATE STRENGTH CONDITION OF ROPE f_' � CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP p FLEX. GUIDE ❑ OTHER (TYPE) CONDITION (rG41 _ ,CONTACT ON: GOVERNOR 19 RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY —# CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) * *5 YEAR TEST — COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208,209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt Yes ® No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended ❑ 4 Force required to pull rope through governor jaws. (Must be less than 20% of Rated. Ultimate Strength) {4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load 8 . &(6y Safety checked and tested with rated cap. Ibs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed , Switch trip spd F.P.M. Jaw trip spd F.P.M. (7) Did the car stop level: Yes 1K No ❑ How much out of level D.B.G. (Max. 3/8" per ft.) , (8) Length of cable pulled off the drum . Number of turns of cable left on the drum -(9y Governor and safety reset, safety drum rewound evenly: Safety jaw clearance (10)-_Jndicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail - inches Right rail inches (11) `Rails inspected and filed where necessary. Yes d No ❑ - (12) Was it necessary to readjust the governor: Yes ❑ No Q 3 (13) ,Condition of governor rope after test 666 t (14) Governor adjustments sealed and tagged and Release Carrier tagged Yes 0 No 11 Was the test satisfactory: Yes P No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested] (16) Standby (Emergency) Power Operations'tested (with 125 °k of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque /jA ,)' #. Kinetic . f.6 ✓' ft. # *{48) Brake tested with 125% of Rated Load `(99) Emergency Terminal Speed Limiting Devices tested ❑ * *f2O) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at its lowest terminal with 125% of Rated toad Representatives of the Insurance Company, City or State Inspector or Owner, present at test (Indicate name and tlde f MECHANIC'S SIGNATURE `!`'�� - -9. s+✓� SUPT SIGNATURE Copy of this report given to customer: Yes 12 No ❑ CUSTOMER'S SIGNATURE DC -46 -GS ELEVATORS DOVER ELEVATOR COMPANY ANNUAL 0 5 YEAR TEST EST - SAFETY AND GOVERNOR TEST REPORT DATE ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE !t NAME OF BUILDING 04 a;+.9 C^1kAIJ /4RI), �"°C - LOCATION H,7e V 7 9T {e ,/ ELEVATOR SERIAL NO. e2 5,r7 CITY & STATE LPl (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR NO. CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR , IJGVI RATED CAR SPEED F.P.M. RATED , PA jTY JCJI✓ LBS. SAFETY MFG. II fits ` GOVERNOR MFG. ZiV �e� TYPE OF GOVERNOR: FLY BALL FLYWEIGHT m 9 TYPE GRIP JfiWS: STEEL BRONZE GOVERNOR ROPE: IRON STEEL 8 x 19 ❑ 6 x 19 F1 SIZE (DIA) ,: 2" ❑ RATED ULTIMATE STRENGTH CONDITION OF ROPE CONDiTION:OF JAWS 4L' TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP FLEX. GUIDE ❑ .OT`�H�ER "' (TYPE) CONDITION 15 &dt 'i CONTACT ON: GOVERNOR'P RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: * *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes o No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended ,(3) -Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength) -(4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force) (5) Car safety operated by tripping governor by hand with car operating at Slowest possible speed in down direction, no load M *t Safety checked and tested with rated cap. lbs. evenly distribu(ed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jttw trip spd.. F.P.M. (7) Did the car stop level: Yes ❑'- No ❑ How much out of level D.B.G. - (Max. 3/8" per ft.) .(8)^ Length of cable pulled off the drum . Number of turnslof cable left on the drum ..(9) Governor and safety reset, safety drum rewound evenly: ' Safety jaw clearance .(10)- .Indicate the length of the mark on the guide rails made by the safety jaws in inches Left rail - inches. Right rail - inches. (11)' Rails inspected and filed where necessary. Yes S N6 (12) Was it necessary to readjust the governor. Yes ❑ No P (13). Condition of governor rope after test !�'T y' (14), Governor adjustments sealed and tagged and Release Carrier tagged: Yes El No ❑ Was the test satisfactory: Yes 19 No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested I (16)- Standby (Emergency) Power Operatio s Vested (with 125°/% of Rated Load on Acceptance and 5 Year Tests) El (17) Power Door System test( d: Torque " - -� Kinetic 'k ff. # *(18) Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested ❑ * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: (Indicate name and tltlel, MECHANIC'S SIGNATURE j�" /�? � �mu'" SUPT. SIGNATURE 4 t✓ CUSTOMER'S SIGNATURE? +i Copy of this report given to customer: Yes No ❑ a -as -cs ELEVATORS c D OVER ELEVATOR COMPANY M ANNUAL TEST ❑ 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT DATE Y' f l -� et. /o ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING F- s"(e%) %;�e `'- Zt.3 >I.. 8`'1(' '` LOCATION ELEVATOR SERIAL NO. �> CITY & STATE t`_. f i r t`� i11t4' ia✓'e C%`. /� (IF NONE, USE MOTOR OR CONTf),OL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR NO. A CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR _ 9 � t''� RATED CAR SPEED %{ •' F.P.M. RATED C PACITY x�d�'`° LBS. SAFETY MFG. 12 ':✓E-< GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHT '�"^ TYPE GRIP JAWS: STEEL BRONZE Y GOVERNOR ROPE: IRON STEEL 8 x 19 ❑ 6 x 19 .❑`'`,SIZE (DIA.) l ❑, RATED ULTIMATE STRENGTH CONDITION OF ROPE L1. ^.l4 CONDITION OF JAWS 6� TYPE OF SAFETY: INSTANT ❑ WEDGE CLAMP (Q FLEX. GUIDE ❑ OTHER (TYPE) CONDITION 4D 24' CONTACT ON: GOVERNOR 19 RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY S 00 # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: * *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A171 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes 0 No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended, (3)" Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) (4)� Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load Q, *(6) Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed , Switch trip spd. F.P.M. Jaw trip spd F.P.M. (7) Did the car stop level: Yes Q No ❑ How much out of level D.B.G. (Max. 3/8" per ft.) (6) Length of cable pulled off the drum . Number of turns of cable left on the drum 19r Governor and safety reset, safety drum rewound evenly: Safety jaw clearance (40)- Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail - inches. (11) Rails inspected and filed where necessary: Yes �, No ❑ (12) Was it necessary to readjust the governor. Yes ❑ No d (13) Condition of governor rope after test f4.t 1 (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes El No ❑ Was the test satisfactory: Yes 5 No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested Q (16) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque Kinetic * {•18r• Brake tested with 125% of Rated Load *(49) Emergency Terminal Speed Limiting Devices tested ❑ * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: (Indicate name and tine) MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this report given to customer. Yes 0 No ❑ CUSTOMER'S SIGNATURE DC -46 -GS t ELEVATORS DOVER ELEVATOR COMPANY C ANNUAL TEST HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE " El ACCEPTANCE TEST OFFICE_ NAME OF BUILDING E. Gd( >,PAd M t_,ept,„„ LOCATION IT7 ELEVATOR SERIAL NO. 160 5 CITY & STATE i ✓6�t n F�c IJAF,/`a (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. p> - t 1 r P3 ; SSE BUILDING ELEVATOR NO. 4 CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR 46yV AF - RATED CAR SPEED 1 F.P.M. RATED CAPACITY 6 /0 00 LBS. TYPE O F ELEVAT f 4 4 5 RATED CAPACITY TEST TO COMPLY WITH AM ERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303AND 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 t`l- Physical Dimensions of Reservoir Make (3) Round Trips Before Setting Relief Valve 9 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 All 7.1 Rule 1005 & 303. Relief Valve Setting -7 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 1 ¢3 P.S.I. No Load Car Speed: Up i F.P.M. Down F.P.M. Relief Valve Sealed: VP' —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 `r` 6 /� 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 P,$rr Amount Car Settled During Standing Period Oil Temperature At End of Standing Period Tank Oil Level At End of Standing Perio Amount of Leakage At Packing During Test i+/C1r=+'�' Condition of Piston Packing 6e .NOTE: A CHANGE IN CAR POSITION WHICH CANNOT BE ACCOUNTED FOR BY VISIBLE OIL LEAKAGE OR TEMPERATURE CHANGE OF THE OIL INDICATES A LEAK IN THE CYLINDER. OR IN THE UNDERGROUND PIPING, AND NEED FOR FURTHER INSPECTION TESTS OR REPAIRS. Pres. Switch Rule 306.14 Tested *Heavy Load Working Pressure: Up P.S.I. I *Heavy Load Car Speed: Up ""� F.P.M. Down F.P.M. Normal and Final Terminal Stopping Devices Tested f Standby (Emergency Battery Lowering) P ^ er Operation Tested "-(A f Power Door System Tested: Torque � # Kinetic 1, Ft. # Emergency Terminal Speed Limiting Device Tested Was The Test Satisfactory: Yes U No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test: (Indicate Name and Tine) SUPT. SIGNATURE MECHANIC'S SIGNATURE _ v Copy of this Report Given to Customer: Yes q No ❑ CUSTOMER'S SIGNATURE *Acceptance Test Only DC-W -GS WHITE - BRANCH, COPY YELLOW - .CUSTOMER COPY PINK -.70NF COPY ELEVATORS DOVER ELEVATOR COMPANY d ANNUAL TEST HYDRAULIC INSPECTION & TEST ❑ ACCEPTANCE TEST (FILL OUT SEPARATE FOR EACH ELEVATOR) NAME OF BUILDING t' ='2 �' +`$ 1t e1. ,/'g /n�'"j r., LOCATION ELEVATOR SERIAL NO. dJ�, -6 CITY & STATE Lt,d (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR NO. CUSTOMER R O. NO. 1 DATE `7`f - 1 2 L OFFICE f:'' MAKE OF ELEVATOR 126WR RATED CAR SPEED /0a F.P.M. RATED CAPACITY T LBS. TYPE OF ELEVATOR 40A f V 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 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 tecomply with the American National Safety Code ANSI At 7.1 Rule 1 05 & 303. Relief Valve Settin 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 /lei F.P.M. Down y F.P.M. Relief Valve Sealed: V/_ 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. Tank Oil Level At Start of Standing Test a Tank Oil Temperature At Start of Standing Test C I" G After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. Length of Time Car Standing -Empty f3 NYnd Amount Car Settled During Standing Period Oil Temperature At End of Standing Period Tank Oil Level At End of Standing Period Amount of Leakage At Packing During Test rZ'6v Condition of Piston Packing OK 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,AV1 Down F.P.M. Normal and Final Terminal Stopping Devices Tested Standby (Emergency Battery Lowering) Power Operation Tested A6A Power Door System Tested: Torque �<`J # Kinetic I+ Ft # Emergency Terminal Speed Limiting Device Tested Was The Test Satisfactory: Yes 91 No El 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 C6 No ❑ *Acceptance Test Only i Dc -so -GS WHITE - BRANCH COPY 1 SUPT. SIGNATURE CUSTOMER'S SIGNATURE 7L42-df 3 D ELEVATORS DOVER ELEVATOR COMPANY ANNUAL TEST ❑ 5 YEAR TEST ❑ NEW ELEVATOR SAFETY AND GOVERNOR TEST REPORT (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING IL' +'• `�� r.' Ci:,..- LOCATION �1 "GG' e'/y • — c`Q / ELEVATOR SERIAL NO. 1)G 7 CITY & STATE (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. /13 BUILDING ELEVATOR NO. �f J CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR t.tsC` f �?l+t/te 1'A'TED CAR SPEED t JO- F.P.M. RATED CAPACITY ele $ wTd LES. SAFETY MFG. �' �+i"i '¢,' v, SE? GOVERNOR MFG /,' +✓ <r.A' F'fYEtc 1 ,:y TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS STEEL BRONZE GOVERNOR ROPE: IRON J STEEL 81190 6 x 19 ® SIZE (DIA) 1f ❑ RATED ULTIMATE STRENGTH ) 0 'W CONDITION OF ROPE 1 f CONDITION OF JAWS 6 126,0 TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP ® FLEX. GUIDE ❑ OTHER (TYPE) CONDITION f fxriG1 CONTACT ON: GOVERNOR9 RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY Z601 < -Ci d # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: * ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) * 5 YEAR TEST -- COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A1Z1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes 4 No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended -(8)b Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength) . {4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at Slowest possible speed in down direction, no load❑g. A(6) Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd F.P.M. (7) Did the car stop level: Yes (A No ❑ How much out of level D.B.G. (Max. 3/8" per ft.) G.. .(8).. Length of cable pulled off the drum Number of turns of cable left on the drum ( . (Q) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance y (16)' Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail - inches. I (11) Rails inspected and filed where necessary: Yes 0. No ❑ t (12) Was it necessary to readjust the governorf Yes No `�4 (13) Condition of governor rope after test (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes ®, No ❑ Was the test satisfactory: Yes 5- No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested Q (16) Standby (Emergency) Power Operations' tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque _ # Kinetic ft. # *(48) Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested ❑ * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125 of Rated Load. .Representatives of the Insurance Company, City or State Inspector or Owner, present at test: (lndwate name and tine) MECHANIC'S SIGNATUR ��✓�'"`� SUPT. SIGNATURE P Copy of this report given to customer: Yes No El CUSTOMER'S SIGNATURE�JZA.` Dc -w -GS .1 =ELEVATORS DOVER ELEVATOR COMPANY ANNUAL TEST b 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT DAT / C ;; ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING ! %° lr@ Y^ YrIN ii ". <;:'^ =,-� LOCATION Gy 1Ora L,a . _;a g t r' fiGt te... ELEVATOR SERIAL Ni f ` c CITY &STATE_ (A (IF NONE, USE MOTOR OR CONTRQL SERIAL NO.) DOVER SERVICE CONTRACT NO. �? ✓.u�^:^ :a� + BUILDING ELEVATOR NO. - -� CUSTOMER R O. NO. JOB NO. MAKE OF ELEVATOR ' 1 _ - RATED CAR SPEED ar6. F.P.M. RATED CAPACITY t if0 LBS. SAFETY MFG fl... GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHTS TYPE GRIP JA STEEL BRONZE GOVERNOR ROPE: IRON /, STEEL 8 x 19 ❑ 6 X19 ❑ SIZE (DIA.) `/=' t' ❑ RATED ULTIMATE STRENGTH CONDITION OF ROPE 6 66,,0 CONDITION OF JAWS 6_fe a d TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP Q FLEX. GUIDE ❑ T ER (TYPE) � CONDITION E ' 7 CONTACT ON: GOVERNOR IJ RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY �'� # CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) * *5 YEAR TEST -- COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSUASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt Yes No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended 19 {3)^ Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength) (4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force.) ~ Q Car safety operated by tripping governor by hand with car operating at Slowest possible speed in down direction, no load Pq i(6) Safety checked and tested with rated cap. Ibs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed Switch trip spit. F.P.M. Jaw trip spit F.P.M. (7) Did the car stop level: Yes El No ❑ How much out of level D.B.G. (Max. 3/8" per ft.) ,(8)- Length of cable pulled off the drum . Number of turns of cable left on the drum ,.(9) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance ,.(10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. If 1) Rails inspected and filed where necessary Yes No ❑ (12) Was it necessary to readjust the governor Yes ❑ No Q (13) Condition of governor rope after test e�='F (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes ET No ❑ Was the test satisfactory: Yes "0- No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested ❑ 116) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque A) U # Kinetic ft. # *(16)° Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested ❑ (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: MECHANIC'S Copy of this report given to customer: Yes U� No ❑ SUPT. SIGNATURE .CUSTOMER'S SIGNATURE �l =�' Do 46 -Gs 0 ELEVATORS DOPER ELEVATOR COMPANY .4 ANNUAL TEST HYDRAULIC INSPECTION & TEST DATE � � �`•���� ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE 0 td I NAME OF BUILDING a 1.;r'; G�a'C.C1/ A -4 - fPl t /2- LOCATION s p "` 777 6A, e ELEVATOR SERIAL NO. - ¢ r-i CITY & STATE /Wk At , (IF NONE, USE MOTOR OR Cq�TROL SERIAL NO.) DOVER SERVICE CONTRACT NO. � a'' '/ t3 0 Z ? f BUILDING ELEVATOR NO. CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR C.:.. RATED CAR SPEED Z"� 6 F.P.M. RATED CAPACITY 1 11460 LBS. TYPE OF ELEVATOR, 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 t: 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 At 7.1 Rule 1005,` 303. Relief Valve Setting 4 -1 ( 10 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 t F4I P.S.I. No Load Car Speed: Up /42 b F.P.M. Down le G - F.P.M. Relief Valve Sealed: o? f 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. .r✓:'� ¢'.f 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 platformwith respect to the chosen reference. t /,, Length of Time Car Standing -Empty / a .t'ICd Amount Car Settled During Standing Period r{45 Oil Temperature At End of Standing Period P/,-;a Tank Oil Level At End of Standing Period c py Amount of Leakage At Packing During Test AJ6AI '. Condition of Piston Packing 62A 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 ) ✓;L Standby (Emergency Battery Lowering) Power O eration Tested .�'IA Power Door System Tested: Torque Kinetic Ft. # Emergency Terminal Speed Limiting Device Tested 4 Was The Test Satisfactory: Yestp No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test MECHANIC'S SIGNATURE Copy of this Report Given to Customer: Yes ® No ❑ *Acceptance Test Only Dc -W -GS. WHITE - BRANCH COPY SUPT SIGNATURE CUSTOMER'S SIGNATURE°] VIA ISiPirQO'&ICd &1 :1 L . • L • I ® ELEVATORS DOVER ELEVATOR COMPANY 0 ANNUAL TEST ❑ ACCEPTANCE TEST HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE OFFICE NAME OF BUILDING , `"tf ✓fit AAt ✓ G It !c-. LOCATION 22c"2 t`` -'& , fm 'AVC ELEVATOR SERIAL NO C CITY & STATE last R �°�'✓ _"' F;� (IF NONE, USE MOTOR OR CO TROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 0 .2 1 /f' O'; BUILDING ELEVATO N O. C R 0. NO. JOB NO. MAKE OF ELEVATOR OhVeK, .: RATED CAR SPEED 164' F.P.M. RATED CAPACITY �'>''���'"� LBS. TYPE OF ELEVATOR 4LA 4' RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 RULE 303 AND RULES 1005 & 1006. FLEX HOSE REPLACEMENT REQUIRED NOT MORE THAN 6YEAR 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 At 7.1 Rule 1005 & 303. Relief Valve Setting 1/ 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 1a P.S.I. No Load Car Speed Up t } d F.P.M. Down 1041 F.P.M. Relief Valve Sealed. (la 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 1.5 minutes, note the position of the platform with respect to the chosen reference. Length of Time Car Standing -Empty / ' .W Ar • Amount Car Settled During Standing Period (° III Oil Temperature At End of Standing Period lid H'd'r Tank Oil Level At End of Standing Period > `> Amount of Leakage At Packing During Test Condition of Piston Packing 040' i 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 y � Standby (Emergency Battery Lowering) Power Operation. Tested Al fA Power Door System Tested: Torque „-�° If ' Kinetic d, /�. Ft. # Emergency Terminal Speed Limiting Device Tested) - Was The Test Satisfactory: Yes 10 No ❑ If not, explain. . Representatives of the Insurance Company, City or State Inspector or Owner;. Present at test (Indicate Name and Title) - MECHANIC'S SIGNATURE '44 r �'i` SUPT. SIGNATURE V Copy of this Report Given to Customer: Yes K1 No ❑ CUSTOMER'S SIGNATURE Z,r7k- - Acceptance Test Only DC-so-GS WHITE - .BRANCH COPY .` - YELLOW - CUSTOMER .COPY PINK - ZONE COPY ELEVATORS DOVER ELEVATOR COMPANY M ANNUAL TEST ❑ ACCEPTANCE TEST NAME OF BUILDING — ELEVATOR SERIAL NO. HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) CITY & LOCATION (IF NONE, USE MOTOR OR CQNTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR 110. r CUSTOMER P. 0. NO. JOB DATE 4 1 270- 1- 2 0c' / OFFICE b/ MAKE OF ELEVATOR O ? 5 RATED CAR SPEED i`e). F.P.M. RATED CAPACITY ' 60e ) LBS. TYPE OF ELEVATOR OA s RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 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 IM 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 qg0 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 /Ko P.S.I. No toad Car Speed: Up F.P.M. Down 42 F.P.M. Relief Valve Sealed: E!`� 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 a Tank Oil Temperature At Start of Standing Test ° C 1 iJ After a minimum of 15 minutes, note the position of the,platform with respect to the chosen reference. .�. +`.Sr"` /•+ Amount Car Settled During Standing Length of Time Car Standing -Empty g g Period Oil Temperature At End of Standing Period 8/& e Tank Oil Level At End of Standing Perio Amount of Leakage At Packing During Test a rc16 .r'e Condition of Piston Packing 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 -` Standby (Emergency Battery Lowering) Power Operation Tested Power Door System Tested: Torque ,% `r #. Kinetic Ft. # Emergency Terminal Speed Limiting Device Tested (' Was The Test Satisfactory: Yes VI No El If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test MECHANIC'S SIGNATURE SUPT. SIGNATURE Copy of this Report Given to Customer: Yes 91 No ❑ CUSTOMER'S SIGNATURE /OL' ! -Acceptance Test Only Dc -60-GS WHITE - BRANCH COPY `= YELLOW - CUSTOMER COPY PINK - ZONE COPY - ELEVATORS DOVER ELEVATOR COMPANY M ANNUALTEST ❑ ACCEPTANCE TEST NAME OF BUILDING HYDRAULIC INSPECTION & TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) ELEVATOR SERIAL NO. 1 1-1 C f JJ iyq (IF NONE, USE MOTOR OR C� SERIAL NO.) BUILDING ELEVATOR NO. I DATE OFFICE CITY & S' DOVER SERVICE CONTRACT NO. CUSTOMER P. 0. NO. JOB MAKE OF ELEVATOR 6'05 RATED CAR SPEED la F.P.M. RATED CAPACITY '11090 LBS. TYPE OF ELEVATOR e A RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 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 C] 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 t dt 4 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 11 P.S.I. No Load Car Speed: Up );2 C F.P.M. Down > 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 r1 ; , Tank Oil Temperature At Start of Standing Test After a minimum of 15 minutes, note the position. of the plattorm with respect to the chosen reference. pd F Length of Time Car Standing -Empty �' esa�p,� Amount Car Settled During Standing Period Yr Oil Temperature At End of Standing Period C� l4Z � Tank Oil Level At End of Standing Period Amount of Leakage At Packing During Test X/0/`r Condition of Piston Packing 4 & 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 ff -'. Standby (Emergency Battery Lowering) Power O_ peration Tested Power Door System Tested: Torque `� # Kinetic - Ft. # Emergency Terminal Speed Limiting Device Tested Was The Test Satisfactory: Yes`,] No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test MECHANIC'S SIGNATURE !-*/ / /&24 SUPT. SIGNATURE Copy of this Report Given to Customer Yes F, ' No ❑ CUSTOMER'S SIGNATURE 'Acceptance Test Only DG -60-GS WHITE - BRANCH COPY YELLOW - CUSTOMER COPY PINK - ZONE COPY I � 2 , ELEVATORS DOVER ELEVAT COMPANY ANNUAL TEST HYDRAULIC INSPECTION & TEST Lp DATE ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING AAM !1 � Ir LOCATION 61"06 f^ ° " ° + t ( ✓ - ELEVATORSERIALN - ~'° (:ITV &STATE t -F?_: / (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. O>YVI II O'Q >y ff BUILDING ELEVATOR NO. 2 � — CUSTOMER P. 0. NO. JOB NO. _ .MAKE OF ELEVATOR 61 RATED CAR SPEED 41 F.P.M. RATED CAPACITY _1,21Q)d'T LBS. TYPE OF ELEVATOR 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 € oe' Physical Dimensions of Reservoir Make (3) Round Trips Before Setting Relief Valve 19, 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 4170 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 r P.S.I / No Load Car Speed: Up + F.P.M. Down ds F.P.M. .Relief Valve Sealed: r ye f 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 ,.r.^� 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 ,/'•3 �' Amount Car Settled During Standing Period Oil Temperature At End of Standing Period i? ✓i Tank Oil Level At End of Standing Period f,fi Amount of Leakage At Packing During Test Condition of Piston Packing d 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 i .. 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 Zut!i ...Power Door System Tested: Torque. "^""" #. Kinetic I Ft. #. - Emergency Terminal Speed Limiting Device Tested FT Was The Test Satisfactory: Yes ®. - No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test: (Indicate Name and Title).: MECHANIC'S SIGNATURE a+'? SUPT. SIGNATURE . ._ Copy of this Report Given to Customer: Yes © No ❑ CUSTOMER'S SIGNATURE -Acceptance Test Test Only. r - oC -so Gs WHITE -. BRANCH COPY YELLOW '- CUSTOMER COPY PINK. -ZONE COPY Z0 1111YMN ELEVATORS DOVER ELEVAT COMPAN 0 ANNUAL TEST HYDRAULIC INSPECTION & TEST t¢. 7 DATE 1 ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE 6+3V NAME OF BUILDING t c=:' n"d LOCA ELEVATOR SERIAL N L d p 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 e1. RATED CAR SPEED 42S' F.P.M. RATED CAPACITY F 6�0 LBS. -- TYPE OF ELEVATOR -�_ RATED CAPACITY TEST TOCOMPLYWITH AMERICAN NATIONAL SAFETY CODE ANSI A17 .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 W, Condition of Reservoir Oil e)—< 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 'c.7 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 ; F.P.M. Down 1c7r F.P.M. Relief Valve Sealed: 1 k,5 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 ( J ' 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 �`���- Amount Car Settled During Standing Perio Oil Temperature At End of Standing Period fay' d Tank Oil Level At End of Standing Period 4 9_42 l Amount of Leakage At Packing During Test Condition of Piston Packing eAf" 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 a P.S.I. *Heavy Load Car Speed: Up F.IA. A. Down °"" F.P.M. Normal and Final Terminal Stopping Devices Tested W Standby (Emergency Battery Lowering Power Operation Tested A,: lad. Power Door System Tested: Torque o rra # Kinetic + c= Ft. # Emergency Terminal Speed Limiting Device Tested 0 - Was The Test Satisfactory: Yes Q No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test: MECHANIC'S SIGNATURE SUPT. SIGNATURE - v 1 Copy of this Report Given to Customer: Yes ® No ❑ CUSTOMER'S SIGNATURE 'Acceptance Test Only DC -eo -cS WHITE - BRANCH COPY YELLOW- CUSTOMER COPY PINK - ZONE COPY �(;,. •.:a,^ P n.. ... a °e:• rn -. 4«?..,,, ELEVATORS D ELEVAT COMPANY ' ANNUAL TEST HYDRAULIC INSPECTION & TEST - DATE 4 1 " 1 c: ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE ep L/ NAME OF BUILDING ✓. L9 - 4'�r^r/ : { "tl�- LOCATION - ELEVATOR SERIAL NO. t °" CITY & STATE 1- t1e>t't•1`2VL (IF NONE, USE MOTOR OR CpNTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 6 BUILDING ELEVATOR NO. my CUSTOMER P. O. NO. JOB NO._ MAKE OF ELEVATOR &AeIC RATED CAR SPEED d 5r F.P.M. RATED CAPACITY 0 LBS. TYPE OF ELEVATOR e 4 e RATED CAPACITY TEST TO COMPLYWITH AMERICAN NATIONALSAFETYCODEANSI 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 e) Ar 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 greaterthan 125% of working pressureto comply with theAmerican National Safety Code ANSI A17.1 Rule 1005 & 303, Relief Valve Setting 5 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 :s P.S.I. `No Load Car Speed: Up 4? C Down ,list F.P.M.. Relief Valve Sealed: 4 - 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. r Tank Oil Level At Start of Standing Test t'.xE. 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. f Length of Time Car Standing -Empty A Amount Car Settled During Standing Period Oil Temperature At End of Standing Period 'lfia Tank Oil Level At End of Standing Period L Amount of Leakage At Packing During Test A' � Condition of Piston Packing 6;x 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: i- Pres. Switch Rule 306.14 Tested *Heavy Load Working Pressure: Up P.S.I. *Heavy. Load Car Speed: Up °' - F.PM. Down F.P.M. Normal and Final Terminal Stopping Devices Tested )r5 Standby (Emergency Battery Lowering) Power Operation Tested A '�+'`* Power Door System Tested Torque rr55 # Kinetic 4� Ft. # Emergency Terminal Speed Limiting Device Tested N Was The Test Satisfactory: Yes F No ❑ If not explain. Representatives of the Insurance Company, City . or State Inspector or Owner, Present attest: (Indicate Name and Title) - 1 'MECHANIC'S SIGNATURE e1'� ,. = '�S',v''� SUPT SIGNATURE r Copy of this Report Given to Customer. Yes V] No ❑ CUSTOMER'S SIGNATURE' - Acceptance Test Only DG-so-GS. .: WHITE - BRANCH. COPY:. ... YELLOW - CUSTOMER COPY PINK - ZONE COPY ® ELEVATORS DOVER ELEVAT COMPAN IN ANNUAL TEST HYDRAULIC INSPECTION & TEST y DATE ❑ ACCEPTANCE TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING ELEVATOR SERIAL NO. CITY & (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. f23 snf` BUILDING ELEVATOR NO I-? CUSTOMER R O. NO. JOB MAKE OF ELEVATOR - 5 CAR SPEED �_ F.P.M. RATED CAPACITY 6 -"' do LBS. TYPE O F ELEVAT A RATED CAPACITY TEST TO COMPLY WITH AMERICAN NATIONAL SAFETY CODE ANSI A17.1 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 At 7.1 Rule 1005 g & 303. Relief Valve Setting -/ 1r 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 a_r; f P.S.I. No Load Car Speed: Up & -e3 F.P.M. Down ? >- F.P.M. Relief Valve Sealed: 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 r fr 60 Tank Oil Level At Start of Standing Test > Tank Oil Temperature At Start of Standing Test 1a� After a minimum of 15 minutes, note the position of the platform with respect to the chosen reference. F . ,, Length of Time Car Standing -Empty J ?�`� Amount Car Settled During Standing Period J' Oil Temperature At End of Standing Period r Tank Oil Level At End of Standing Period 10 5, Amount of Leakage At Packing During Test , Condition of Piston Packing 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 I F.P.M. Down F.P.M. Normal and Final Terminal Stopping Devices Tested ff-- Standby (Emergency Battery Lowering) Power O eration Tested fU'.9A Power Door System. Tested: Torque Kinetic - Ft. # Emergency Terminal Speed Limiting Device Tested Was The Test Satisfactory: Yes` No ❑ If not, explain. Representatives of the Insurance Company, City or State Inspector or Owner, Present at test MECHANIC'S SIGNATURE Copy of this Report Given to Customer: Yes `�- No ❑ *Acceptance Test Only Dc -saDS WHITE - BRANCH COPY SUPT. SIGNATURE CUSTOMER'S SIGNATURE % v:11111LiPirQO-10111C17&I L • i ELEVATORS DOVER ELEVATOR COMPANY � `❑ ANNUALTEST im., 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE ✓�-� OFFIC NAME OF BUILDIN ft A€ , ia Orl LOCATION ELEVATOR SERIAL NO. - ° -`+' :r 1 CITY & STATE I (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 0't 4 1 "T 1 =, ^�� 7 P 1 7 BUILDING ELEVATOR NO. - - CUSTOMER R O. NO. JOB NO. MAKE OF ELEVATOR F )"A 40 V° RATED CAR SPEED F.P.M. RATED CAPACITY -+0017 LBS, SAFETY MFG. 1 ) 6 t JP V GOVERNOR MFG. ti) fi , _r V " TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JA S: STEEL BRONZE >� "- GOVERNOR ROPE: IRON � _ STEEL - 8 x 19 11 6 x 19 N SIZE (DIA.) I ' a 7r ❑ RATED ULTIMATE STRENGTH 1 t -I C CO CONDITION OF ROPE 6 A CONDITION OF JAWS _ 6c, d .TYPE OF SAFETY: , INSTANT. ❑ WEDGE CLAMP O FLEX. GUIDE ❑ OTHER (TYPE) CONDITION CONTACT ON: GOVERNOR Z RELEASING CARRIER ELI S ETY. RATED CAP. OF SAFETY 1 ,106 « # CONDITION OF SAFETY DRUM ROPE SIZE �� INSTRUCTIONS: * *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A171 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt Yes ® No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended ® '—' (3) Force required to pull rope through governor jaws. l r' it (Must be less than 20 of Rated Ultimate Strength.) -(4) Force required' to pull governor rope from the release carrier. (Can be no more than 60 of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load ❑°'"�� '(6) Safety checked and tested with rated cap. .J' a z90' lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated sp or over speed, Switch trip spd '� fi F.P M -Awtrip spd f F.P.M. <G t (7) Did the car stop level: Yes El No El How much out of level D.B.G (Max. 3/8" per ft.) (8) Length of cable pulled off the drum f"��.> 4- Number of turns of cable left on the drum (9) Governor and safety reset, safety drum rewound evenly: 7 - Safety jaw clearance (10) Indicate the length of the mark on the guide rails madeby the safety jaws in inches: Left rai inches. Right rail % �� inches. (11) Rails inspected and filed where necessary Yes fl' No ❑ (12) Was it necessary to readjust the governor. Yes ❑ No UT (13) Condition of governor rope after test '•+' -�, 1, - (14) Gov ,mor adjustments sealed and tagged and Release Carrier tagged: Yes No ❑ (15) Normal and Final Terminal stopping devices tested R (16) Standby (Emergency) Power Operations'Yested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque 2 � # Kinetic ft # *(18) Brake tested with 125 "k of Rated Load 4;7Z -S7 6 *(19) Emergency Terminal Speed Limiting Devices tested ©r * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at its lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: w :. -... MECHANIC'S SIGNATURE . �. SUPT. SIGNATURE -';tea Copy of this report given to customer: Ye�❑ No � - CUSTOMER'S SIGNATURE ELEVATORS DOVER ELEVAT COMPANY ❑ ANNUAL TEST TRACTION ELEVATOR OIL BUFFER TEST Z 5 YEAR TEST DATE !l° ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING f_ " i /� fc' ?T:�' y C� �� LOCATION J �'�t 7 r� 1 ELEVATOR SERIAL NO. -� /�> 1 J CITY &STATE �+`��'t17 , ( - /I" ; f, ._ 1� C (IF NONE, USE MOTOR OR COIyJnROL SERIAL NO.) DOVER SERVICE CONTRACT NO. f_'J ; f/�- T --= 1 - -a BUILDING ELEVATOR NO. - CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR WNY/ '' �-> _S RATED CAR SPEED 5 �? 0 F.P.M. BUFFER MFG. �� f�'�J" NUMBER OF BUFFERS ,� CAR -2—CWT. / TYPE OF MOUNTING CAR: CHANNEL FLOO TYPE OF MOUNTING CWT: CHANNEL '' FLOOR CONDITION OF CAR BUFFERS �l"'`C:'C�''' CONDITION OF CAR BUFFER PLUNGERS C >^`".+` %/% ° C�Y - CONDITION OF CWT. BUFFERS CONDITION OF CWT. BUFFER PLUNGERS CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. . 'er iY MAX >r��) RATED BUFFER SPEED F.P.M. ANNUAL TEST — OMIT ITEM (3, 4, & 5) ONLY INSTRUCTIONS: 5 YEAR TEST — COMPLETE ALL ITEMS NEW ELEVATOR TEST — COMPLETE ALL ITEMS To Comply with /ASME A171 Section 1000 and Section 201. 1 Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes �"'" No ❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a`maximum of 90 sec. Tested return time in seconds (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release',When released with the weight resting on top, the .plunger must return to the fully extended position in 30 seconds. Tested return time In seconds ,z - 3: Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes El ` No ❑ 4. ' Car oil buffers tested by running the car with rated load onto the buffers at rated speed. Yes 9`` No ❑ Exception Sections 1000, 201 & 209 where reduced stroke buffer applicable. 5:: Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes No ❑ In malkirt6 the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if recessary, be temporarily relocated to allow full compression of buffer during the test Accepted safety measures and extreme caution must be exercised when conducting these tests making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. 'Tag buffers with appropriate tag giving date and name of company testing. Yes Z]� No El 7,. Was the test satisfactory: Yes E `- m No ❑ If not, explain �Sf` Representatives of the insurance Company, City or State Inspector oG:Owner, present attest (indicate name and title) MECHANIC'S SIGNATURE„ " % SUPT. SIGNATURE i` Copy of this report given to customer: YES ❑ NO P- :CUSTOMER'S SIGNATURE DC -59 -ES r i ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST ,,✓ a F, -, 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT DATE LJ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING ✓' 7 .6 't' (' ✓/z LOCATION E - ..i /1 6) ', 4" ELEVATOR SERIAL NO. _ <., ,¢' °J CITY & STATE r'r/c.r i lf Id (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR NO. �' . > CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR RATED CAR SPEED "% S - 6 F.P.M. RATED CAPACITY �7> li LBS. :SAFETY MFG. _ /'J //!/ri GOVERNOR MFG. /!/Ci&el' TYPE OF GOVERNOR: FLY BALL FLYWEIGHT 'V' TYPE GRIP JAWP: STEEL BRONZE GOVERNOR ROPE: IRON STEEL — 8 x 19 ❑ 6 x 19 ©- SIZE (DIA.) //2 // [T ULTIMATE STRENGTH CONDITION OF ROPE CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP,R' FLEX. GUIDE ❑ OTHER (TYPE) CONDITION CONTACT ON: GOVERNOR�n RELEASING CARRIER [I SAFETY ff RATED CAP. OF SAFETY /,n f ` + # CONDITION OF SAFETY DRUM ROPE "''� ' SIZE INSTRUCTIONS: * * ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes 0^' ❑ ✓' (2) Hand test made of safety &governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended (3) Force required to pull rope through governor jaws. / r` r� (Must be less than 20 °h of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. '" (Can be no more than 60% of pull- through force.) - (5) Car safety operated by tripping governor by hand wit car operating at slowest possible speed in down direction, no load ❑� °'°� *(6) . Safety checked and tested with rated cap. lbs. evenly distribured over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed G% G.% or over speed t,! ,r --- Switch trip spd. °/+a n, F.P.M. Jaw M� spd. w �- f F.P.M. (7) Did the car stop level: Yes © El How much out of level -(�_ D.B.G. G (Max. 3/8" per ft.) (8) Length of cable pulled off the drum Number of turns of cable left on the drum s%J ✓+' (9) Governor and safety reset, safety drum rewound evenly: Safety Safety jaw clearance ( ) g g y safety jaws in inches: Left rail ✓ �/ inches. Right rail Z�'L" 10 Indicate the length of the mark on the guide rails made b the safe � inches ' (11) Rails inspected . and filed where necessary Yes ❑ ❑ (12) Was it necessary to readjust the governor. Yes ❑ No 9�_ i (13) Condition of governor rope after test => r (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes ❑ No ❑ Was the test satisfactory: Yes ® °`°NO ❑ If not explain. h (15) Normal and Final Terminal stopping devices tested ❑"°�~ (16) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested:. Torque f2 ,"R # Kinetic ft. # l 118) Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested i * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the carat it's lowest Terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: ftd,C.R name and title) MECHANIC'S SIGNATURE "%`�"�' e-- SUPT SIGNATURE Copy of this report given to customer: Yes ❑ No ❑ 'CUSTOMERS SIGNATURE W -C G5 ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST 5 YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST ` - DATE El NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) -� OFFICE NAME OF BUILDING LOCATION -' ELEVATOR SERIAL NO. CITY & STATE (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. l Y / e' i BUILDING ELEVATOR NO. / CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR!" ✓ 11f, RATED CAR SPEED � %%i F.P.M. BUFFER MFG. ? <:e=';':..'i`��:o ^i NUMBER OF BUFFERS �� CAR / CWT. TYPE OF MOUNTING CA 3: CHANNEL FLOOR `% TYPE OF MOUNTING CWT: CHANNEL FLOOR CONDITION OF CAR BUFFERS CONDITION OF CAR BUFFER PLUNGERS CONDITION OF CWT. BUFFERS %fC CONDITION OF CWT. BUFFER PLUNGERS CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER: MIN. -4: MAX. `,'uGt✓ RATED BUFFER SPEED G%,`: F.P.M. ` ANNUAL TEST — OMIT ITEM (3, 4, & 5) ONLY INSTRUCTIONS: 5 YEAR TEST — COMPLETE ALL ITEMS NEW ELEVATOR TEST — COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1 Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes 9-� No ❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds k (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds 3. Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes 0 No ❑ 4. Car oil buffers tested by running the car with rated load onto the buffers at rated speed. Yes ©' " No ❑ - Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. 5. Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes EJ No ❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if recessary,.be temporarily relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these tests making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving date and name of company testing. Yes [T� No ❑ 7. ' Was the test satisfactory: Yes El" No ❑ If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, present attest MECHANIC'S SIGNATURE -� ��L,✓ % /'G. %�'� SUPT. SIGNATURE Copy of this report given to customer: CUSTOMER'S SIGNATURE YES ❑ NO DC -59 -ES : ELEVATO I . D ELEVA COM PANY ❑ ANNUALTEST " 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING: -: t"Lt' lA el' el LOCATION ELEVATOR SERIAL NO v if CITY & STATE? (IF NONE, USE MOTOR OR COYTPOL SERIAL NO.) DOVER SERVICE CONTRACT NO. nJ L, ' BUILDING ELEVATOR NO. r CUSTOMER P. 0. NO. JOB DATE � OFFIC MAKE OF ELEVATOR C RATED CAR SPEED v€✓ F.P.M. .RATED CAPACITY LBS. SAFETY MFG. � %r,S e GOVERNOR MFG. TYPE OF OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAWS ,STEEL BRONZE GOVERNOR ROPE: IRON STEEL 8x 19 ❑ 6 x 19 01 SIZE (DIA.) ❑ - 9ATEDULTIMATE STRENGTH X6 CONDITION OF ROPE CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMPM FLEX. GUIDE ❑ OTHER (TYPE) CONDITION -. CONTACT ON: GOVERNORt RELEASING CARRIER ❑ SAFETYE1 RATED CAP. OF SAFETY I -"000 # CONDITION OF SAFETY DRUM ROPE e' '11 SIZE INSTRUCTIONS: * * TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207,208,209,10092,_& 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes LJ No ❑ (2) Hand test made of safety & governor to insure all bearing and.rubbi g surfaces, including rope grip -jaws operate freely as intended J 3 � �,j () Force required to pull rope P through 9 governor 1 aws. (Must be less than 20% of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. '`"` (Can be no more than 60% of pull -thro�gb force.) (5) Car safety operated by tripping governor by.. and with car operating at slowest possible speed in down direction, no load El *(6) Safety checked and tested with: rated cap- Slryu Abs. � eply,distributed over platform area, (Gov. & safety switch made inoperative) / J f i rope grip -jaws tripped by hand at rated speed or over speed Switch trip spd. ' - '` S F.P.M. Jaw trip spd. C_) F.P.M' (7) Did the car stop level: Yes ❑ No ❑ How much out of level D.B.G. ^' (Max. 3/8" per ft.) (8) Length of cable pulled off the drum GSt ' Number of turns of cable left on the drum (9) Governor and safety reset, safety drum rewound evenly: Safety jaw r cl fiance (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail // inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes No El (12) Was it necessary to readjust the governor. Yes No LJ (13) Condition of governor rope after test (14) Governor adjustments sealed and t�ged and Release Carrier tagged: Yes Er No ❑ Was the test satisfactory: Yes n' No ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested ©� (16) Standby (Emergency) Power Operations..tgsted (with 125% of -Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque If Kinetic ft. # * 18) Brake tested with 125% of Rated Load __� 2 *(19) Emergency Terminal Speed Limiting Devices tested Ef * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: (lndlcale name and till.) - MECHANIC'S SIGNATURE r. J SUPT. SIGNATUR Copy of this report given to customer: Yes ❑ No Ej DC-46-GS CUSTOMER'S SIGNATURE ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST R 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE �- OFFICE O _ q NAME OF BUILDING C^` i'C'l C °C'r" f4ffd t € Gt l �,.. ! 8 LOCATION �'1'�✓"� �, in � P� �� �`�� ELEVATOR SERIAL NO 6° r � 45,' 'd I w.. 9 CIT �"' sr? I (IF NONE, USEIMOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. ay' y � /-a 'Z6 .BUILDING ELEVATOR NO. _ -_ CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR ` 6 r' RATED CAR SPEED E� 0 F.P.M. RATED CAPACITY LBS. SAFETY MFG and k'o°`° GOVERNOR MFG. r✓" o- TYPE OF GOVERNOR. FLY BALL FLYWEIGHT TYPE GRIP JAWS; STEEL BRONZE - GOVERNOR ROPE IRON ef '� STEEL 8 x 19 ❑ 6 x 19 .SIZE (DIA.) �' : ❑ RATED ULTIMATE STRENGTH CONDITION OF ROPE ` a'S CONDITION OF JAWS _ � `� ' = ?'� TYPE OF SAFETY: INSTANTA WEDGE CLAMP FLEX. GUIDE ❑ 9THER (TYPE) CONDITIONS 6-00d CONTACT ON: GOVERNOR le' RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY Z06 # CONDITION OF SAFETY DRUM ROPE ..-•- SIZE INSTRUCTIONS: * *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSUASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt Yes []...No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended El�- »- (3) Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier, (Can be no more than 60% of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load El *(6) Safety checked and tested with rated cap ";� '9 0 Ibs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed +a or over speed 2 Switch trip spd. •� �%r"i F.P.M. Jaw trip spd ? F.P.M. (7) Did the car stop level: Yes ❑ °"'KIO ❑ How much out of level F-^ D.B.G �'' a' (Max. 3/8" per ft) (8) Length of cable pulled off the drum - . Number of turns of cable left on the drum (9) Governor and safety reset, safety drum rewound evenly: Safety jaw clearance (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail � r' r anches. Right rail ��'� inches. (11) Rails inspected and filed where necessary Yes El No 8` I (12) Was it necessary to readjust the governor. Yes ❑. No ®✓ (13) Condition of governor rope after test '(14) .Governor adjustments sealed and tagged and Release Carrier tagged: Yes ®""60 1] Was the test satisfactory: Yes © No ❑ If not explain. (15) Normal and Final Terminal stopping devices tested (16) Standby (Emergency) Power Operations' tested (yrith 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque 4 y'� 1t f Kinetic :L �'�A. # *(18) Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested c - * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test (' (Indicate name and hVel p- MECHANIC'S SIGNATUR� `'rr�"�r ""� ,r^ � � SUPT SIGNATURE .�d' °.�`r?��/•'�'°°'G`'%d---+"` `Copy of this report given to customer: Yes ❑ No �`�� .. CUSTOMER'S SIGNATURE ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST SAFETY AND GOVERNOR TEST REPORT , W5 YEAR TEST DATE ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING L IVi k1 C"l Ah M Vdli? ,i _ 1 1, LOCATION ELEVATOR SERIAL NO. + " ,.,�w - CITY & STATE Wt_1<4 / I (IF NONE, USE MOTOR OR CO TRO L SERIAL NO.) DOVER SERVICE CONTRACT NO. z ,r - JP , t BUILDING ELEVATOR NO... CUSTOMER P. O. NO. JOB MAKE OF ELEVATOR & d 'GV g5=°°' RATED CAR SPEED of Cl U F.P.M. RATED CAPACITY �K t elV LBS. SAFETY MFG. - -h>� GOVERNOR MFG. TYPE OF GOVERNOR: FLY BALL FLYWEIGHTS TYPE GRIP JA :STEEL BRONZE GOVERNOR ROPE: IRON STEE 8 x 19 ❑ 6 x 19 e SIZE (DIA.) �� ❑ RATED ULTIMATE STRENGTH CONDITION OF ROPE 0 CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP,R9 FLEX. GUIDE ❑ OTHER (TYPE) CONDITION Q 00A CONTACT ON: GOVERNOR RELEASING CARRIER ❑ SAFETY ❑ RATED CAP. OF SAFETY gogay # CONDITION OF SAFETY DRUM ROPE Au��' SIZE ILZ . INSTRUCTIONS: '`ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) * *5 YEAR TEST -- COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A171 Code Section 205, 206, 207, 206, 209, 10 (1) Governor & safety free of excessive lubrication, lint and dirt Yes Lam' No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip-jaws operate freely as intended (3) Force required to pull rope through governor jaws. /r- >^'�r> (Must be less than 20% of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. � 1.1 (Can be no more than 60 of pull - through. force.) (5) Car safety operated by tripping governor by hand with car operating at Slowest possible speed in down direction, no load 4a' '(6) Safety checked and tested with rated cap ._2_" fJ lbs. evenly distributed over platform area, (Gov. &safety switch made inoperative) rope grip -jaws tripped by hand at rated speed V or over speed - 2 `.� Switch trip spd. '2. 6, e F.P.M. Jaw trip spd. -x- '�� l ' F.P.M. (7) Did the car stop level: Yes ❑ No © "How much out �°f level (', --' D.B.G. �` +� � (Max. 3/8" per ft.) (8) Length of cable pulled off the drum Z1 .�+ Number of turns of cable left on the drum da i,// (9) Governor and safety reset, safety drum rewound evenly: �= ' IA Safety jaw cl rance '�/+ �"f f (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail inches. Right rail inches. (11) Rails inspected and filed where necessary: Yes ❑ No Q` (12) Was it necessary to readjust the governor. Yes ❑ No ®--" (13) Condition of governor rope after test (14) Governor adjustments sealed and ta�gged and Release Carrier tagged: Yes �o El _ Was the test satisfactory: Yes ❑ ta llo ❑ If not explain. (15) Normal and Final Terminal stopping devices tested i! (16) Standby (Emergency) Power Operations to Jed (with 125% of Rated Load on Acceptance and 5 Year Tests) El (17) Power Door System tested: Torqur a fre # Kinetic ft. # *'(18) Brake tested with 125% of Rated Load — 1—if Emergency Terminal Speed Limiting Devices tested ©� • *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at its lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: name MECHANIC'S SIGNATURE •' r"'''" '" SUPT: SIGNATURE i 1 Copy of this report given to customer: Yes ❑ No E CUSTOMER'S SIGNATURE i i ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST (1) Governor & safety free of excessive lubrication, lint and dirt Yes ©'" No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended ©" " 5 YEAR TEST Force required to pull rope through governor jaws. X - 6 © (Must be less than 20% of Rated Ultimate Strength.) - SAFETY AND GOVERNOR TEST REPORT / ' . / ''"' . DATE V l� El NEW ELEVATOR Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load e_' (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE ,y 1,2 J '° NAME OF BUILDING 4 4 1 ' A,­ tyk c "I I' r t f LOCATION % -L-C ELEVATOR SERIAL NO. �-'� '' CITY &STATE l _,) I. E ra'F 9'' r res f. [' I' (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. Rails inspected and filed where necessary. Yes © No ❑ .,,. (12) BUILDING ELEVATOR NO. . CUSTOMER P. O. NO. JOB NO. ,- r Governor adjustments sealed and tagged and Release Carrier tagged: Yes 91 No ❑ MAKE OF ELEVATOR. �at`r RATED CAR SPEED CJ /i F.P.M. RATED CAPACITY ✓ 2& r'J LBS. SAFETY MFG. _ Zg a J - e''C,� GOVERNOR MFG. "£> c p£ i'r'tii / %/ TYPE OF GOVERNOR. FLY BAL FLYWEIGHT _ TYPE GRIP JAWS: STEEL � BRONZE GOVERNOR ROPE: IRON _ 1` STEEL S x 19 ❑ 6 x 190 SIZE (DIA.) ' El RATED ULTIM TE STRENGTH CONDITION OF ROPE t !` - i'� CONDITION OF JAWS TYPE OF SAFETY: INSTANT. ®' WEDGE CLAMP ❑ - FLEX. GUIDE ❑ OTHER (TYPE) CONDITION CONTACT ON: GOVERNOR Dr RELEASING CARRIER ❑ SAFETY P RATED CAP. O ' SAFETY # CONDITION OF SAFETY DRUM ROPE " "'% l SIZE INSTRUCTIONS: * 'ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST — COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt Yes ©'" No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended ©" " (3) Force required to pull rope through governor jaws. X - 6 © (Must be less than 20% of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. !'.. ;✓-" (Can be no more than 60% of pull- through force) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load e_' *(6) ;Safety checked and tested with rated cap. 1 C? lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed ✓� ' %� or over speed - Switch trip spd. F.P.M. Jaw V1P spd ✓�'°' �- F.P.M. ' (7) Did the car stop level: Yes ❑ No 0-"How much out of level ; _ r ' D.B.G. (Max. 3/8" per ft) (8) Length of cable pulled off the drum ✓' F &/- . Number of turns of cable left on the drum .m -/ �'- (9) Governor and safety reset, safety drum rewound evenly: /ll ✓ .4 Safety jaw clearance ''"`✓' / (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail mches. Right rail inches (11) Rails inspected and filed where necessary. Yes © No ❑ .,,. (12) Was it necessary to readjust the governor. Yes ❑ No �' cr' �"✓ (13) Condition of governor rope after test -� =° -- (14) ,- r Governor adjustments sealed and tagged and Release Carrier tagged: Yes 91 No ❑ r . Was the test satisfactory: Yes EI"' No ❑ If not, explain. I (15) Normal and Final Terminal stopping devices tested ti❑^'^ - "` ^ (16) Standby (Emergency) Power Operations' tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ (17) Power Door System tested: Torque # Kinetic r *'(18) Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested ©� - * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: I name arm v MECHANIC'S SIGNATURE -%% "L r + -'Fa' r✓'r.� `.^'"l { '"� "' SUPT. SIGNATURE -'" f . r Copy of this report given to customer: Yes ❑ No 0/" .CUSTOMER'S SIGNATURE DU1111 4;2 ® ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST Q 5 YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST DATE L0 - %✓ ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE f NAME OF BUILDING r art LOCATION. .%' r✓iCJ -{: x %: r ELEVATOR SERIAL NO. C r CITY & STATE ` C t l r' n sr YI ; r( r.. o C & 1 r7 (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. BUILDING ELEVATOR NO. L CUSTOMER P.O. NO. JOB NO. MAKE OFELEVATOW ) Ut'1 s i;' RATED CAR SPEED F.P.M. BUFFER MFG. (.1u v -F y NUMBER OF BUFFERS - CAR 'L CWT. TYPE OF MOUNTING CAR: CHANNEL FLOOR TYPE OF MOUNTING CWT: CHANNEL FLOOR CONDITION OF CAR BUFFERS � e"ri' CONDITION OF CAR BUFFER PLUNGERS CONDITION OF CWT. BUFFERS G% re' air CONDITION OF CWT. BUFFER PLUNGERS CONTACT ON: BUFFER SWITCH RATED CAP. OF BUFFER:. MIN Sr, a MAX. 5 aC O RATED BUFFER SPEED t / %':. F.P.M. ANNUAL TEST — OMIT ITEM (3, 4, & 5) ONLY INSTRUCTIONS: 5 YEAR TEST — COMPLETE ALL ITEMS NEW ELEVATOR TEST — COMPLETE ALL ITEMS To Comply with ANSI /ASME A17.1 Section 1000 and Section 201. 1. Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes ❑"s' No ❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested . x ..,.. return time in seconds (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds t 3. Examine the buffer name plates to make sure load range and maximum speed conforms to the job require .ants. Yes 2" No ❑ 4. Car oil buffers tested by running the car with rated load onto the buffers at rated speed. Yes No El Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. t 5. Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ®' No ❑ In making the No. 4 and No. 5tests,the normal limit switches must be made temporarily inoperative with the final limits remaining operative but ! can, if recessary, be temporarily relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these tests making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, eta 6. Tag buffers with appropriate tag giving date and name of company testing Yes 9- No El - 7. Was the test satisfactory: Yes ©'-" No ❑ If not, explain :. 8. Representatives of the Insurance Company, City or State Inspector or Owner, present at test (indicate name and title) MECHANIC'S SIGNATURE +- ^'.' -*'� s'=^"� / /.�i SUPT SIGNATURE Copy of this report given to customer: YES ❑ NO ®`"" CUSTOMER'S SIGNATURE DC -59E5 3=, ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST 5 YEAR TEST SAFETY AND GOVERNOR TEST REPORT DATE r ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING // /a✓'r?N$a�.J d�^I t�l C _r. LOCATION ELEVATOR SERIAL NO. C` ? CITY & STATE L✓ 1 K . <�� - !t st3 •P {� �^ (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. (+ "y 4 '� d "`+ BUILDING ELEVATOR NO. ( ' °f CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR b r' '.F N RATED CAR SPEED .? S 0 F.P.M. RATED CAPACITY J !)firs LBS. SAFETY MFG. _ 0 (" iJ E V GOVERNOR MFG. 1 "ln ( )-y ✓^ TYPE OF GOVERNOR: FLY BALL FLYWEIGHT %e" TYPE GRIP JAW . STEEL BRONZE GOVERNOR ROPE: IRON STEEL 8 x 19 El x 19.® SIZE (DIA.) +J j ❑ RATED ULTIMATE STRENGTH" LZ ;90 CONDITION OF ROPE G f; /e i CONDITION OF JAWS {_ ".. g� 2 di TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP ©` GUIDE ❑ OTHER (TYPE) CONDITION CONTACT ON: GOVERNOR ❑" RELEASING CARRIER ❑ SAFETY `" RATED CAP. OF SAFETY /L7G G "il p CONDITION OF SAFETY DRUM ROPES SIZE INSTRUCTIONS: * * ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) 5 YEAR TEST -- COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. - (1) Governor & safety free of excessive lubrication, lint and dirt Yes In No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended 3` (3) Force required to pull rope through governor jaws. G" (Must be less than 20 °h of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. (Can be no more than 60% of pull- through force) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load 9"" *(6) Safety checked and tested with rated cap. lbs. evenly distributed over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed or over speed r. Switch trip spd. e ✓l eo e'J F.P.M. Jaw trip spa * „ '- F.P.M. (7) Did the car stop level: Yes ❑^'No El How much out of level _" <. - ` D.B.G. 2 (Max. 3/8" per ft.) ' (8) Length of cable pulled off the drum /1.r/'.r --- Number of turns of cable left on the drum ,d 6r' (9) Governor and safety reset, safety drum rewound evenly: Safety jay+ clearance �_ , (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail — ches. Right rail! inches. (11) Rails inspected and filed where necessary. Yes 93 No ❑ (12) Was it necessary to readjust the governor. Yes ❑ No (13) Condition of governor rope after test t;. co � (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes ©° No ❑ Was the test satisfactory: Yes 131 ❑ If not, explain. (15) Normal and Final Terminal stopping devices tested (16) Standby (Emergency) Power Operations tested (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑'"� (17) Power Door System tested: Torque ; 2V If Kinetic ft. If *(18) Brake tested with 125% of Rated Load / ,' .2 'j r'••� *(19) Emergency Terminal Speed Limiting Devices tested Z�� * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load Representatives of the Insurance Company, City or State Inspector or Owner, present at test: MECHANIC'S SIGNATURE .- - 'SUPT SIGNATURE Copy of this report given to customer: 1 ❑ No [3- -- CUSTOMER'S SIGNATURE We -GS ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST TRACTION ELEVATOR OIL BUFFER TEST C p' YEAR TEST DATE � " ''✓" � "' r ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE NAME OF BUILDING ' r' re ,%2 ?,ci3' C l' f LOCATION A 36 !_ai 7L' ELEVATOR SERIAL NO . � %' ( 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 f " -F />" f RATED CAR SPEED S f� F.P.M. BUFFER MFG. 4)6 i..e'v NUMBER OF BUFFERS 3- CAR :I CWT.? TYPE OF MOUNTING CAR: CHANNEL %" FLOOR ''y- TYPE OF MOUNTING CWT: CHANNEL FLOOR '-- CONDITION OF CAR BUFFERS '- L:1 C- CONDITION OF CAR BUFFER PLUNGERS CONDITION OF CWT. BUFFERS "% %''� �; CONDITION OF CWT. BUFFER PLUNGERS i CONTACT ON: BUFFER SWITCH - RATED CAP. OF BUFFER: MIN. %o MAX. RATED BUFFER SPEED F.P.M. ANNUAL TEST — OMIT ITEM (3, 4, & 5) ONLY INSTRUCTIONS: 5 YEAR TEST — COMPLETE ALL ITEMS NEW ELEVATOR TEST — COMPLETE ALL ITEMS To Comply with ANSI /ASME At 7.1 Section 1000 and Section 201. 1 Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes ❑' No ❑ (b) Buffer is securely fastened in place. 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds - � (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds f 3. Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes 0' No ❑ 4. Car oil buffers tested by running the car with rated load onto the buffers at rated speed. Yes FA No ❑ Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. 5. Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ° ° "� No ❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if recessary, be temporarily relocated to allow full compression of buffer during the test Accepted safety measures and extreme caution must be exercised when conducting these tests making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. B. Tag buffers with appropriate tag giving date and name of'company testing. Yes f❑ --`No ❑ 7. Was the test satisfactory: Yes 91-No ❑ If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, present at test (indicate name and title) MECHANIC'S SIGNATURE -- '- °'r,�.!i' :.s' .g''.`.� -f"� °� SUPT. SIGNATURE Copy of this report given to customer: YES ❑ NO ❑"— CUSTOMER'S SIGNATURE DC -59 -ES ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST 5 YEAR TEST El NEW ELEVATOR TRACTION ELEVATOR OIL BUFFER TEST (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE C✓-" � OFFICE G7 ,c NAME OF BUILDING `+- ..c LOCATION ELEVATOR SERIAL N C 'g 1 f? CITY & STATE 1 ice_ (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. 2 -e. - .BUILDING ELEVATOR NO. -G- CUSTOMER. P.O. NO. JOB NO. MAKE OF ELEVATOR ,17L i +-P r/ �i f RATED CAR SPEED %''' �i F.P.M.. r , BUFFER MFG. NUMBEROFBUFFERS —_/ CAR '2 CWT.i TYPE OF MOUNTING CAR: CHANNEL FLOOR - TYPE OF MOUNTING CWT: CHANNEL ^" FLOOR Y CONDITION OF CAR BUFFERS C"/ CONDITION OF CAR BUFFER PLUNGERS CONDITION OF CWT. BUFFERS %' f'.+r, E6 CONDITION OF CWT. BUFFER PLUNGERS CONTACT ON: BUFFER SWITCH .RATED CAP. OF BUFFER: MIN. 2 SK�6 MAX. ',y_ RATED BUFFER SPEED '! /.'7 F.P.M. ANNUAL TEST — OMIT ITEM (3, 4, & 5) ONLY INSTRUCTIONS: 5 YEAR TEST — COMPLETE ALL ITEMS NEW ELEVATOR TEST — COMPLETE ALL ITEMS To Comply with ANSI /ASME A171 Section 1000 and Section 201. 1 Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes No ❑ (b) Buffer is securely fastened in place. - 2 Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec Tested return time in seconds (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the r . plunger must return to the fully . extended position in 30 seconds. Tested return time in seconds I/ 3. Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. 'Yes No ❑ 4. Car oil buffers tested by running the car with rated load onto the buffers at rated speed. Yes No ❑ 4 Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. 5. Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ©- No ❑ In making the No. 4 and No, 5 tests the normal limit switches must be made temporarily inoperative with the final limits remaining operative but i can, if Pecessary, be temporarily relocated to allow full compression of buffer during the test. { Accepted safety measures and extreme caution must be exercised when conducting these tests making sure of overhead and pitclearances, ( obstructions, buffer fastenings, buffer strike plates, etc. j 6. Tag buffers with appropriate tag giving date and name of company testing. Yes 91 No ❑ - (P 7. Was the test satisfactory: Yes 19 `" No ❑ If not, explain' 8. Representatives of the Insurance Company, City or State Inspector or Owner, present at test (indicate name and title) . I '� SUPT SIGNATURE , r,`f:s f �= t MECHANIC'SSIGNATURE- .�' �-% / v' ///. rs' `,i`.. Z Copy of this report given to customer: YES ©- - "' NO ❑ CUSTOMER'S SIGNATURE DC -59 -FS ELEVATORS DOVER ELEVATOR COMPANY ED NNUAL TEST JO' 5 YEAR TEST 9AFETY AND GOVERNOR TEST REPORT El NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) DATE Y_� OFFICE elP r-tz NAME OF BUILDING L-4eff� LOCATION 49 ELEVATOR SERIAL N CITY & STATE t� (IFNONE,USEMOTORORCO ROLSERIALNO) DOVER SERVICE CONTRACT NO BUILDING ELEVATOR NO. CUSTOMER P. 0. NO. JOB NO.— MAKE OF ELEVATOR RATED CAR SPEED F.P.M. RATED CAPACITY LBS. SAFETY MFG. 171� �.- GOVERNOR MFG. -on 0 e TYPE OF GOVERNOR: FLY BALL — FLYWEIGHT TYPE GRIP JAWS' STEEL BRONZE GOVERNORROPE: IRON J�� STEEL— 8xl9E:l fix­19.1�'SIZE(Dlk)��" El RATED ULTIMATE STRENGTH— CONDITION OF ROPE �_fynn( CONDITION OF'SAWS Z!9L�_ 0� TYPEOFSAFETY: INSTANTE] WEDGE CLAMP W FLEX. GUIDE El OTHER (TYPE) CONDITION &�4 CONTACTON: GOVERNOR4e RELEASING CARRIER El SAFETY 9- CAP. OF SAFETY 4 f (7 0# CONDITION OF SAFETY DRUM ROPE SIZE INSTRUCTIONS: �ANNUAL TEST - OMIT ITEM (3-4-6-18-19-20) **5YEARTEST - COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSUASIVIE A17.1 Code Section 205,206, 207,208, 209,1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes El No El (2) Hand test made of safety & governor to insure all bearing and rubbm surfaces, including rope grip-jaws operate freely as intended [3 (3) Force required to pull rope through governor jaws. (Must be less than 20% of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. �A /--- (Can be no more than 60D/b of pull-through force.) (5) Car safety operated by tripping governor by hand with car operating at $lowest possible speed in down direction, no load El *(6) Safety checked and tested with rated cap. 'rbs evenly distributed over platform area, (Gov. & safe , r , �ijc� made inoperative) rope grip-jaws tripped by hand at rated speed or over speed Switch trip spd. F.P.M. Jaw trip spd, - F.P.M. (7) Did the car stop level: Yes El No a­H6w much out of level — / e� '�� D.B.G. (Max. 3/8" per ft.) (8) Length of cable pulled off the drum S_fil/ / 4__ Number of turns of cable left (9) Governor and safety reset, Safety drum rewound evenly� " Safety jaw clearance (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail nches. Right rail '76� inches. (11) Rails inspected and filed where necessary. Yes El' No F (12) Was it necessary to readjust the governor. Yes El No El (13) Condition of governor rope after test 52 �� & �,e' (14) Governor adjustments sealed and tagged and Release Carrier tagged: Yes 4-J No LJ Was the test satisfactory: Yes V El if not, explain. (15) Normal and Final Terminal stopping devices tested (16) Standby (Emergency) Power Operations tested (with 125% of 5ated Load on Acceptance and 5 Year Tests) (17) Power Door System tested: Torque �N If � �etiS -(18) Brake tested with 125% of Rated Load *(19) Emergency Terminal Speed Limiting Devices tested -*(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the Gar at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: P1 MECHANIC'S SIGNATURE, F. SIGNATURE Copy of this report given to customer: Yes 0 No CUSTOMER'S SIGNATURE W-�-GS ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST S YEAR TEST TRACTION ELEVATOR OIL BUFFER TEST ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) NAME OF BUILDING f t `s 8'" :i.;f r' 4 rt/ �i'K LOCATION _ ELEVATOR SERIAL NO. CITY & STATE! (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. er BUILDING ELEVATOR NO. �:'- CUSTOMER P. O. NO. DATE OFFICE G —t ✓ — JOB NO. MAKE OF ELEVATOR d.;0M1 -,1r r RATED CAR SPEED - J 0 F.P.M. BUFFER MFG. i 2cii/ o 4 NUMBER OF BUFFERS & CAR 2 CWT. TYPE OF MOUNTING CAR: CHANNEL i FLOOR TYPE OF MOUNTING CWT: CHANNEL ' FLOOR CONDITION OF CAR BUFFERS ' 61 If CONDITION OF CAR BUFFER PLUNGERS CONDITION OF CWT. BUFFERS A'114 CONDITION OF CWT. BUFFER PLUNGERS CONTACT ON: BUFFER SWITC RATED CAP. OF BUFFER: MIN. 1 .5' 0 0 MA3C A � RATED BUFFER SPEED '16 ? F.P.M ANNUAL TEST — OMIT. ITEM (3, 4, & 5) ONLY INSTRUCTIONS: 5 YEAR TEST — COMPLETE ALL ITEMS NEW ELEVATOR TEST — COMPLETE ALL ITEMS To Comply with ANSVASME A17.1 Section 1000 and Section 201. 1 Oil Level Test (a) The levels of the oil have been inspected and found to be within the maximum and minimum allowable limits. Yes ®°° No ❑ (b) Buffer is securely fastened in place. _ 2. Plunger Return Test (a) The plungers have been fully compressed and when released return to their fully extended position within a maximum of 90 sec. Tested return time in seconds 1 (b) Place a fifty (50) pound weight on the plunger, depress two (2) inches and then release. When released with the weight resting on top, the plunger must return to the fully extended position in 30 seconds. Tested return time in seconds 3. Examine the buffer name plates to make sure load range and maximum speed conforms to the job requirements. Yes F-1- ^^'NO ❑ 4. Car oil buffers tested by running the car with rated load onto the buffers at rated speed. Yes +❑�` No ❑ - Exception: Sections 1000, 201 & 209 where reduced stroke buffer applicable. 1 5. Counterweight buffers tested by running the counterweight onto its buffer at rated speed with no load on the car. Yes ❑µ y No ❑ In making the No. 4 and No. 5 tests, the normal limit switches must be made temporarily inoperative with the final limits remaining operative but can, if necessary, be temporarily relocated to allow full compression of buffer during the test. Accepted safety measures and extreme caution must be exercised when conducting these tests making sure of overhead and pit clearances, obstructions, buffer fastenings, buffer strike plates, etc. 6. Tag buffers with appropriate tag giving te, and name of company testing. Yes ©-' No ❑ 7. Was the test satisfactory: Yes Er No ❑ If not, explain 8. Representatives of the Insurance Company, City or State Inspector or Owner, present at test MECHANIC'S SIGNATURE ✓.,� %r'✓G'ia° SUPT SIGNATURE -•"^'' �' :+°�.± +f t-.Y' Copy of this report given to customer: YES ❑ NO CUSTOMER'S SIGNATURE DC -%9 ES =ELEVATORS DOVER ELEVATOR COMPANY ❑ ANNUAL TEST - SAFETY AND GOVERNOR TEST REPORT 19' 5 YEAR TEST DATE � ❑ NEW ELEVATOR (FILL OUT SEPARATE REPORT FOR EACH ELEVATOR) OFFICE - NAME OF BUILDING d F Vie°_ � - LOCATION Y-31062 ELEVATOR SERIAL NO 77 +^^° <— CITY & STA E 0 (IF NONE, USE MOTOR OR CONTROL SERIAL NO.) DOVER SERVICE CONTRACT NO. f BUILDING ELEVATOR NO. _ CUSTOMER P. O. NO. JOB NO. MAKE OF ELEVATOR RATED CAR SPEED F.P.M.. RATED CAPACITY % LBS. SAFETY MFG. "" GOVERNOR MFG. +-Z C TYPE OF GOVERNOR: FLY BALL FLYWEIGHT TYPE GRIP JAM: STEEL BRONZE J" GOVERNOR ROPE: IRON �� STEEL 8 x 19 .R" SIZE (DIA) '' ❑ l RATED ULTIMATE STRENGTH eft? _ CONDITION OF ROPE - .#^�'+•�XiW.d" CONDITION OF JAWS ._ -- TYPE OF SAFETY: INSTANT. ❑ WEDGE CLAMP,] FLEX. GUIDE ❑ OTHER (TYPE) CONDITION CONTACT ON: GOVERNOR." RELEASING CARRIER ❑ ' �SAFETTY 0 CAP. OF SAFETY # CONDITION OF SAFETY DRUM ROPE' A SIZE �4 INSTRUCTIONS: *ANNUAL TEST — OMIT ITEM (3- 4- 6- 18- 19 -20) * *5 YEAR TEST —COMPLETE ALL ITEMS EXCEPT 20 To Comply with ANSI /ASME A17.1 Code Section 205, 206, 207, 208, 209, 1002, & 1003. (1) Governor & safety free of excessive lubrication, lint and dirt: Yes ❑ No ❑ (2) Hand test made of safety & governor to insure all bearing and rubbing surfaces, including rope grip -jaws operate freely as intended (3) Force required to pull rope through governor jaws. !`f' O-/ (Must be less than 20% of Rated Ultimate Strength.) (4) Force required to pull governor rope from the release carrier. (Can be no more than 60 of pull- through force.) (5) Car safety operated by tripping governor by hand with car operating at slowest possible speed in down direction, no load ©" *(6) Safety checked and tested with rated cap. a n lbs. evenly distribured over platform area, (Gov. & safety switch made inoperative) rope grip -jaws tripped by hand at rated speed f or over speed Switch trip spd. 'r"".r,r L:� F.P.M. Jaw trip spd `6 F.P.M. (7) Did the car stop level: Yes ❑' El D. How much out of level - B.G. X ' V d (Max. 3/8 ", per tt) (8) Length of cable pulled off the drum Number of turns of cable left on the drum ✓• p 9) Governor and safe reset, safe drum rewound eve !•1 / o;✓ ( safety ry y: Safety jaw cleance ,?" (10) Indicate the length of the mark on the guide rails made by the safety jaws in inches: Left rail f ✓J inches. Right rail � CJ `ra nches. (11) Rails inspected and filed where necessary. Yes D F No ❑ (12) Was it necessary to readjust the governor. Yes ❑ No P" (13) Condition of governor rope after test e .^ .o (14) Governor adjustments sealed and tagged and Release Carn i tagged: Yes ❑' No ❑ Was th(�(:.est satisfactory: Yes ® ^""lo ❑ If not explain. (15) Normal and Final Terminal stopping devices tested ® ^'° (16) Standby (Emergency) Power Operations tested. (with 125% of Rated Load on Acceptance and 5 Year Tests) ❑ N.; (17) Power Door System tested: Torque �� � " # Kinetic ft. # *(18) Brake tested with 125a/a of Rated Load e� *(19) Emergency Terminal Speed Limiting Devices tested * *(20) (Acceptance Test Only) Rule 207 shall lower, stop and hold the car at it's lowest terminal with 125% of Rated Load. Representatives of the Insurance Company, City or State Inspector or Owner, present at test: anaiune name aim nael MECHANIC'S SIGNATURE - " %r�e�,?.,w°% SUPT SIGNATURE Copy of this report given to customer: Yes ❑ No ❑_� - CUSTOMER'S SIGNATURE ... LUTHERAN MEDICAL CENTER ER /OR FAX TRANSMITTAL HALLER AND LARSON LTD ARCHITECTS MEMORANDUM T f' N F 60 AJV . 1725 3L;QK S7QEE7, DEWEA, CO 80202 TRANSMITTAL FAX #: 303- zs2 — oa37 JAS �JuLTni 2 ?.C2L3 5 rL'G, TZAVSN.2551•^�7 TO L1/�) U11T lelPG� fir{ /tlgP 303 -29- 175 < ^. PLc35= cl_ FRcm: _.� "�iJ 6LmLt'imI NG- NL � 1 r ) c� © Oa �GES: PLUS T£:5 PAG'.. w E v v- v 20- N e r AZJ A-f L A rS F 4 C ATJ (3 r� 5001 a.v /u-&4 r ON S�/Jl - T]?-( P /n L S i F s oTtLg (`G ) 6+0 157 - < JA-t7' ' _A,) S P24 tj/L -, -R. tf&J�-o s I-- f . ©k l3oT (9 Z ` V -i: 0,- Prr rF{o Sr)? o/C.E IAJ G� Srn o /r-f� Y�fr�T7 =�ra25 @ Fct -F--cJ LiJO /N G- 1N clF 5 Tt 5uL•� LUTHERAN MEDICAL CENTER ER /OR FAX TRANSMITTAL HALLER AND LARSON LTD ARCHITECTS MEMORANDUM m 1725 si.aL s_ =:, aE_vr =A, Co 80202 TRANSMITTAL ,— FAX e: 363- 292 -6437 P'CP:._'!S R T�ANSN_55 =CN T0: J f eiJ ?L -A53 CA= 303- 295-2.792. F - M: •r �� ,. ��� ,t.lu/. /N5P• ML ZZZ OF P3G =S: PLUS TP.SS PAG =. DATE: � � - � 3 Project: ��t -T'02 P/r GON IYIUST PJ� �e�c� 61J7 IMF Pll /5t.o.-Jo✓ 7 _ � Gurta -2-VY L.b-�3Fu.�n�n Pr 7 ( 'F vS fl4 rc_ la N 8i L / N /7rct �Ta . I AL 4 4-hj Ct]O &- Mrr r 41 5 _ ADmk ;_' RoSS _ 7500 WEST 29TH AVENUE P.O' BOX 638 The City of WHEAT RIDGE. CO 80034 -0638 (303) 234 -5900 G Wheat City Admin. Fax# 234-5924 Police Dept. Fax #235 -2949 GRidge August 9, 1993 Lutheran Medical Center Engineering Department 8300 W. 38th Avenue Wheat Ridge, CO 80033 Attn: Bill Elliott Dear Mr. Elliott: This is in reply to our telephone conversation on August 6, 1993. After our conversation, I talked with Jack Prose, our Chief Buil- ding Inspector regarding the projected fee for 1994 elevator inspections. Jack said that this time he doesn't know what the fee will be, but City Council is looking at the possibility of increasing this fee from $65.00 to $94.00. The City is charged $94.00 per elevator inspection by DRCOG, so this would be a legitimate change in fee for the City. Until the City Council makes a decision on this matter, it would probably be prudent on your part to use this figure when submitting your budget proposal. If you should have any further questions, please call. Sincerely, Agnes Thoma Building Dept. Secretary /at ltrElliott April 16, 1992 Mr. Dan Krawczun Cemcolifts, Inc. P.O. Box 368 Plumsteadville, PA 18949 Re: Lutheran Medical Center '...eatridge, Colorado Your P.O. #B09132 Your Job #DC- 132 -23611 Peelle Job 1191 -1217 Gentlemen: The freight elevator doors for the subject job are 12'0" wide x 8'0" high and do not bear the Underwriters' Label due to the fact that they are greater than the maximum label size of 8'0" wide x 10'0" high permitted in "U.L." procedure R180. In addition, they are also greater than the oversize certificate maximum of 10'0" wide x 12`0" high. However, we certify that the doors are constructed in exact accordance with our Underwriters' procedure for 1} hour, Class "B" label fire doors. Very truly yours, THE PEELLE COMPANY George Carraro Vice President 'Bay Shore Operations GC:ef a „S ' ,AtP=t . V�HEAT P.O. BOX 638 TELEPHONE: 303/237 -6944 The City of 7500 WEST 29TH AVENUE • WHEAT RIDGE, COLORADO 80034 V m Wheat Ridge c OGORAO O June 26, 1989 Mr. Bill Elliott Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Dear Mr. Elliott: The cost to the City for elevator inspections is increasing. We contract with several other cities and DRCOG for the service. I would imagine you should budget for $65.00 per elevator for 1990. Thank you. Sincerely, Jack E. Prose Chief. Building Inspector JEP /cb "The Carnation City" APR. 15 '92 09 :53 CEMCOLIFTX 3000 215- 766 -0945 PAGE 1 J63 - 1�7 0 P.O.80x 368.6191 Stump Rd, • Plumeteadville, PA 18949 • (215) 768-0900- (800) 982 -3626 INCORF=ORATEb FAX: (215) 768.0610 FAX TRANSMITTAL T0: ors DATE:.. ATTENTION: - - NUMBER OF PAGES: FROM: M,4� `` &.sec . —o /� RE: -44e a� r) 6�' tif'tiyc , a e- - 749 G , . / 7 e- s ; � y ��� r K BUILDING DEPARTMENT 237 -6944 Ext. 255 CITY Of WHEAT RIDGE C t N t orrec ion o oce j- Job Located at .....��d0 G// 38' may(✓ .. I have this day inspected this structure and these premises and have found the following violations of City and /or State laws governing same: .. ...... ......... ..................... ✓3� .IUoSE Fo�c�.. ...ef. .....f . . ......... .. ........ .. /J?GCS� 6E f v� C J ........... ............................... .......... iq } r Tv its ............................................... ............................... . J� Cj5/"7 lar a O.f�Qn c-16 i9la.P #- X You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. /J yy f Date....... o2S— y ............... ......... /J � t / q ............ . Inspectorfbf 8vilding Dept. DO NOT REMOVE THIS TAG BUILDING DEPARTMENT 237.6944 Ext. 255 CITY OF WHEAT RIDGE Correction Notice Job Located at_ .............. ............................... ............................... I have this day inspected this structure and these premises and have found the following violations of City and /or State laws governing same: �sy,... , {s�....... ..... ..`....... :....................... ................................... ............................... ............................................................. ............................... .....d��i� ...1/�.J.....PO .....B.f..f.. �E....... sF�o... 1i ?........f FU c ........lsS ................. ............................... You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. M 4# ee V C Date.......... o7.S ......... 9 Inspector for B �g Dept. __ DO NOT REMOVE THIS TAG FORM WR6- - „ I ' REPAIR ORDER ®ELEVATORS A N D A ACCOUNT OR JOB NUMBER NO. OF HOURS .DOVER ELEVATOR COMPANY - CERTIFICATE OF TIME APPLIED ' .� " T/ t BU1IDING NAME f 5 STREET - r' 1 ! -r L. f MAINTENANCE CONTRACT NO. NO. OF HOURS APPLIED 1 "STATE , CITY 1 S' ZIP WOE CUSTOMER ORDER NO. CUSTOMER - - ELEVATOR NO. BILLING ADDRESS AND ; COMPANY NAME If 91FFEflENT FROM ABOVE DOVER EOUIPMENT SERIAL NO. OR MANUFACTURER ADDRESS STREET, CITY, STATE A MAKE REPAIRS TO ELEVATOR(S) AT DOVER BILLING PRICES FOR ACCOUNT OF THE TYPE OF WORK PERT - ED: UNDERSIGNED SUBJECT TO PROVISIONS ON THE REVERSE SIDE HEREOF SCHEDULED EXTRA SAFETY TEST C4LLSACK REPAIR EXAM OTHER S I YR El ❑ El / 11 t ❑ 11 22 33 46 55 BE CUSTOMER IS WORK ODMPLETEDA plTfS ❑ NO AUTHORIZED SIGNATURE AUTHORIZED APPROVAL TITLE �-' DATE _ V1 I 10n C) •' - j DATE TIME AT BUILDING PAYROLL EMPLOYEE NAME RATE TRAVELING AT JOB'SITE .:.. MO. DAY YR. IN OUT NO M M H P Xt.E %1.5 X2.0 Y.1.0 X1.5 X2.0 •- ..... A M AM. _ • PM F PM M: .A.M. A. M, c . .AM -A.M- ..- • __, ...... 4.” r'A `'{ p 2`t .�.. ... `t . •u PM n�t� 1.. ..'✓'... ., r.: QUANTITY NAME .1 .' •. PART NO .., :.... SOURCE UST PROBLEM AREA CODES. PAYROLL NO. I TYPE (MILEAGE, SIGNATURE BELOW IS TO CERTIFY THAT THE ABOVE IS CORRECT, THAT THE WORK IS SATISFACTORY, AND THAT A COPY OF THIS REPAIR ORDER HAS BEEN RECEIVED BY THE PERSON IV OSE SIGNATURE , APPd%R M { ELOW�Z 1 ` I AUTHORIZE SIGNATURE y- ti'�� ✓J Y i«Jv TITLE F� BILLABLE? DYES ❑ NO (CHECK ONE) Ron DC 0 DOVER ELEVATOR COMPANY 1977,1983,1987, 1956 CUSTOMER COPY Lutheran Medical Center (Level I Fite DepazYment Koy) 8300 W. 3e St., Wheat Ridge, CO Elevator /1 Primary Type Group 1. Service I CP '/, 2. Service 1 CP 2/2 3. Public I CP 112 4. Public l CP 2/2 5. Church No Prim CP 1 6. Service _ - DW 11 7. Service No Prim CP 1 8. Service No Prim CP 1 9. Public/Ser 1 HP 1/2 10. PublictSer 1 HP 2/2 11. Public/Ser I CP I 12. Service - DW 1 13. Service - DW 1 14. Service - DW 1 15_ Service 2 CP 1 16. Public/Ser 1 HP 1 17. Service 1 BP I 18. Service LD. HP 1 19. Service LD HP 1 20 Service LD HP 1 21. Service ]Rear HP 1 22. Service IFront HP 1 23. Service 1 BP 1 24, Public/Service I CP h 25. Public/Service 1 CP 2/2 26. Public/Service 1 CP 1 I Machine Room Loc. OH (top floor P) OH OH OH OH (4' floor adj. by elev. 11) Counter top B OH OH (5' floor access rm.5505) 1 5O Floor Adj. I' floor Adj. OH (5` 11" Adj. Rm.4412). Counter tap surgerytlab (1) Counter top Pharmacy (B) Across from elev. 15 (B) OH (Adj. P) Basement Floor Adj. Basement Floor Adj. Basement Floor Adj. Basement Floor Adj. Basement floor Adj, Basement floor Adj. Basement floor Adj. Baserr mtfloorAdj_ OH. OR OH CP cable passenger HP hydraulic passenger DW dumbwaiter OH overhead (top floor) Primary phase I key switch Adj. (close to elev.) Floors Served (B, 1 , 2 ) (B,1) (B,1 -6) (13,1,2,3,4) (1,2,3,4,) (1,2,3,4) (1,2,3,4) (1,2) ($1,2) (B (13,1,2) (B,LD) 03,1,2) (B,1,2) ($1,2,) (B,1,2,3,4,5,6) (B,1,2,3,4,5,6) (1,2,3,4,5,6) 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 1 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 2 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 3 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/01 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 4 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 1500 lbs Inspector : Bill Gardner LOCATION ID NUMBER -TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 5 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 50 lbs. Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 6 DW N/A Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date 9/29/05 2/1/06 2/1/07 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 7 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 8 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 9 HP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4000 lbs Inspector: Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 10 HP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 3500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 11 CP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 50 lbs. Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 12 DW N/A Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 50 lbs. Inspector : Bill Gardner Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/04 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 500 lbs Inspector : Bill Gardner . LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 14 DW N/A Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 15 hP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 16 H P 4/17/41 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 17 HP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 18 HP 4/17/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 18300 W. 38th Ave. 19 HP 4/20/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 20,000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION 8300 W. 38th Ave. 20 HF 4/20/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 8300 W. 38th Ave. 21 HP 4/20/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date 9/29/05 2/1/06 2/1/07 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 8300 W. 38th Ave. 22 HP 4/20/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 9/29/05 2/1/06 2/1/07 Lutheran Medical Center Engin. 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 5500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 23 HP 4/20/04 Lutheran Medical Center Engin. Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date 9/29/05 2/1/06 2/1/07 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 1 8300 W. 38th Ave. Total Cost Due: $132.00 Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 2 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 3 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 I CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 4 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 II CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 5 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 1 (1 CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303- 235 -2855 INVOICE November 19, 2004 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 6 8300 W. 38th Ave. Total Cost Due: $132.00 Property /Elevator Location # 35 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 II ga CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 7 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 8 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 9 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 10 8300 W. 38th Ave. Total Cost Due: $132.00 Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 11 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 12 8300 W. 38th Ave. Total Cost Due: $132.00 Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 13 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 14 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 15 8300 W. 38th Ave. Total Cost Due: $132.00 Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 16 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 17 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 18 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 F Elevator ID # 19 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 20 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 21 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 11 CITY OF WHEAT RIDGE 7500 West 29th Avenue Wheat Ridge, CO 80033 Phone: 303-235-2855 INVOICE November 19, 2004 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 22 Total Cost Due: $132.00 Elevator InsRection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. 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 Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 23 Total Cost Due: $132.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # Elevator Address: 8300 W. 38th Ave. City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 Pima Ram rummucr ma m' TH Y Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PE ASE - R,ETVRN THIS INVOICE STAR WIM YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PURSE RETt1,RN THIS , INV ICE STUR WITH YOUR PAYMENT : ENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE RETVRN T141S ,tNMICE ST LIB WMH tit PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 AEASE RE MIS INIVoICE 'sTUR t lrm YOURPAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PILUE RETURN Mils INVOICE SCR MYTH YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE RI=TIMN IM INVOICE STUB M' Y�O- VR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PUASE RETURN THIS INV ICE STVIS WITH YOUR .PA EN Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PT,LASE RETURN MIS INVOICE STUD WITS YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE RETURN T141S INVOICE STV8 M YOVR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE R TURN MISINVOICESTUR WITi`9' YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE RETURN MIS INVOICE STUB WITH YOUR PA MT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE k T Ri , THIS IMAOICE SCR WID4 YOUR PAM MEN T Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 AFASEREIVRN MIS INVOICE STUB WITI4 YOVR 1RA EN Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE RFYVRN MIS INVOICE S" WIM YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE RETURN MIS INVOICE STUB WIM YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE REnJRN IMS INVOICE STV2 WIM YOVR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLEASE - R,EnMN MIS INI O CE STUB WITH YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PlEAS RETVRN M IS INVOICE STV8 WM4 YOVR .PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PLFAI SF RETURN THIS INVOICE S'ru1R WIT VR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th Ave. Wheat Ridge, CO 80033 PIEASE RETURN THIS INVOICE VUH MM YOUR PAYMENT Thank You City of Wheat Ridge 7500 W. 29th Ave. Wheat Ridge, CO 80033 (303) 235 -2855 Please call if you have any questions Property /Elevator Location # 35 Elevator Address: 8300 W. 38th Ave. Total due: $132.00 City of Wheat Ridge Building Department 7500 W. 29th 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 5000 lbs Inspector Bill Gardner Expiration Ex i Issue Inspection Lutheran Medical Center Engin. Ins P p' Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 2 CP 4117/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20101 2/7102 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 1 8300 W. 38th Ave. 3 CP 4/17101 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date. Date 8300 W. 38th Ave. 9/20/01 217/02 2/7/03 Wheat Ridge, CO 80033 I Lutheran Medical Center Engin. 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 4 CP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 217/03 Wheat Ridge, CO 80033 f Lutheran Medical Center Engin. 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 1500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATI 8300 W. 38th Ave. 5 CP 4117101 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120/01 2/7102 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 50 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 6 DW N/A Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 I Lutheran Medical Center Engin. 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 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 7 CP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120/01 217102 2/7103 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 I inspected on the date shown below and was found safe to carry 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 8 CP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120101 2/7/02 217103 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 9 HP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20101 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner (LOCATION 1D NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 10 HP 4/17101 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 I inspected on the date shown below and was found safe to carry 3500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 11 CP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20101 2/7/02 2/7103 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 50 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 12 DW N/A Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 217/02 2/7/03 Wheat Ridge, CO 80033 I f E Lutheran Medical Center Engin. 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 50 lbs Inspector : Bill Gardner (LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 13 DW N/A Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 217/02 2/7103 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 14 DW N/A Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120101 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 4500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 15 hP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 217/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 16 HP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120/01 2/7/02 2/7103 Wheat Ridge, CO 80033 i Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 17 HP 4/17/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120/01 217/02 2/7103 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 19 HP 4/20/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 217102 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 20,000 lbs Inspector : Bill Gardner (LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 20 HF 4120/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 8300 W. 38th Ave. 21 HP 4/20/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 J 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 8300 W. 38th Ave. 22 HP 4/20/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9/20101 217/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. 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 5500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 23 HP 4/20/01 Lutheran Medical Center Engin. Inspection Issue Expiration Dept. Date Date Date 8300 W. 38th Ave. 9120/01 2/7/02 2/7/03 Wheat Ridge, CO 80033 Lutheran Medical Center Engin. Dept. 8300 W. 38th Ave. Wheat Ridge, CO 80033 INC. mecnantcal engineers Hwy a Rylatt November 14, 2001 Mr. Bill Gardner Elevator Inspector Wheat Ridge Building Department 7500 West 29` Avenue Wheat Ridge, CO 80215 Re: Exempla Lutheran Medical Center Dear Bill: This letter will document our telephone conversation on November 13, 2001. The discussion concerned one existing South Wing elevator that will not be extended up to the Cardiology expansion. This elevator serves the Basement, First and Second Floors. The elevator shaft is currently vented per UBC, but the new expansion will cover the vent. What initiated my telephone call to you was what could we do for the venting of this Hoistway. Your response was not to vent the Hoistway, which is allowed, by the International Building Code as well as the Standard Building Code for Hoistways, three stories and lower. You suggested that we contact Darren Morgan at Wheat Ridge Building Department for approval. We did discuss our conversation with Darren and he was in agreement with your recommendation. I believe the above to be an accurate summary of our conversation. If you have any questions please don't hesitate to call. Sincerely, Kirt Holloway, P.E. KEH/jlr 5727 W. 6th Ave.. Lakewood, CO 80214 . (303) 233 -1944 . FAX (303) 238 -4155 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 1 CP 4117/01 Lutheran Medical Center /Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date (Wheat Ridge, CO 80033 3114/01 5131/01 211/02 I 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 2 CP 4/17101 Lutheran Medical Center /Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date. Wheat Ridge, CO 80033 3/14/01 5/31/01 2/1/02 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 3 CP 4117101 Lutheran Medical Center /Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 3/14101 5131/01 2/1/02 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 5000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 4 CP 4/17/01 Lutheran Medical Center /Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 3/14/01 5/31/01 2/1/02 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 1500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 5 CP 4/17/01 Lutheran Medical Center /Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 3/14/01 5/31101 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 50 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 1 8300 W. 38th Ave. 6 DW N/A Lutheran Medical Center /Engineering Dept. Inspection Issue Expiration 8300 W. 38th Ave. Date Date Date Wheat Ridge, CO 80033 3114101 5/31/01 2/1/02 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 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 7 CP 4117101 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14101 5131101 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 2700 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 8 CP 4/17/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3114/01 5131/01 211/02 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 9 HP 4117101 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14/01 5/31/01 211102 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 10 HP 4117/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3114/01 5/31/01 2/1702 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 3500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 11 CP 4/17/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3114101 5/31/01 211102 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 : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 12 DW N/A Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14101 5131/01 211/02 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 50 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 13 DW N/A Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14/01 5/31/01 211102 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 S00 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 14 DW N/A Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3114/01 5/31101 2/1/02 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 4500 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 15 HP 4/17101 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14101 5/31101 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 4000 His Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 16 HP 4/17/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration r heat Ridge, CO 80033 Date Date Date 3/14101 5131/01 2/1102 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 17 HP 4/17/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14101 5/31/01 211102 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 18 HP 4/20/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14/01 5/31/01 2/1/02 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 4000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 19 HP 4120101 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14/01 5/31101 2/1102 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 20,000 lbs Inspector : Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 20 HF 4/20/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3114/01 5/31/01 2/1/02 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 8300 W. 38th Ave. 21 HP 4/20101 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration I Wheat Ridge, CO 80033 Date Date Date 3114/01 5/31/01 211102 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 8300 W. 38th Ave. 22 HP 4/20/01 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3/14/01 5/31101 2/1/02 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 5500 lbs Inspector: Bill Gardner LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 23 HP 4/20101 Lutheran Medical Center 8300 W. 38th Ave. Inspection Issue Expiration Wheat Ridge, CO 80033 Date Date Date 3114/01 5/31/01 211102 City of Wheat Ridge Planning and Development Department 7500 West 29th Avenue Wheat Ridge, CO 80215 Phone (303) 235 -2855; Fax (303) 235 -2857 March 28, 2001 Lutheran .Medical Center, or current property owner /management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Re: Elevator Inspection Billing / Payments at location # 35 Dear Lutheran Medical Center, or current property owner /management: With the new year, the City of Wheat Ridge is changing billing procedures to make billing and payment tracking more efficient. Due to this last minute change, payments for elevator inspections at Lutheran Hospital, 8300 W. 38th Ave. will be due on or before May 7, 2001 for the 2001 year. Once payment is received and the elevator has been inspected certificates will be issued. Effective January 1 st, 2002 all elevator inspection payments will be due on February 1st for the fiscal year. Thank you for your cooperation in making our tracking process more reliable. If you have any questions, please call me at (303) 235 -2855. Thank You _ Kristy Shutto Building Department Secretary Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator InSpection For: 1 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 � J--Ir Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Insnection For: 2 8300 W. 38th Ave. Total Cost Due: $120.00 Prooerty /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. E Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator 1D # 4 Elevator Inspection For: 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Eleva Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 5 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 OF )NH c OC OR Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 5 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 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 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Wheat Ridge, CO 80033 Phone: 303- 235 -2855 INVOICE Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 7 Elevator Insoection For: 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 8 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran M d' I C e ica enter, or current property owner / management 8300 W. 38th Ave. - Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For 9 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 i Date: March 28, 2001 Lutheran M d' I C e ica enter, or current property owner / management 8300 W. 38th Ave. - Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For 9 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 10 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Insnection For: 11 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 ■ Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 12 Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator Inspection For: 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center 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 Date: March 28, 2001 Lutheran Medical Center, or current property owner /management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 14 Total Cost Due• $120.00 . Elevator Inspection For 8300 W. 38th Ave. Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 15 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 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 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator InSDection For: 16 8300 W. 38th Ave. Total Cost Due: $120.00 Prooerty /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Elevator ID # 17 Total Cost Due: $120.00 Elevator Inspection For: 8300 W. 38th Ave. Property /Elev ator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 18 $300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 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 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 19 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 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 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For 20 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. P Wheat Ridge, CO 80033 Date: March 28, 2001 Lutheran Medical Center, or current property owner / management' 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # 21 Elevator InsDection For: 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 IL Date: March 28, 2001 Lutheran Medical Center, or current property owner / management 8300 W. 38th Ave. Wheat Ridge, CO 80033 Elevator ID # Elevator Inspection For: 22 8300 W. 38th Ave. Total Cost Due: $120.00 Property /Elevator Location # 35 Lutheran Medical Center 8300 W. 38th Ave. Wheat Ridge, CO 80033 The City of 7500 WEST29THAVENUE WHEAT G ' Vhe at WHEAT RIDGE, CO 80215 -6713 (303) 234 -5900 City Admin. Fax # 234 -5924 Police Dept. Fax # 235 -2949 Ridge August 2, 2000 Lutheran Medical Center 8300 W. 38th Avenue Wheat Ridge, CO 80033 Attn: Engineering Department Thank you for bring to our attention the fact that we made and error on the Elevator Inspection Certificates. The expiration date should be marked as 3/31/01, and we have them marked as 3 /31/00. Please use this letter as a reference to the correct date. Should anyone have any questions, please contact Kristy with the City of Wheat Ridge Building Department at (303) 235 -2855. Again, thank you for bringing this mistake to our attention. Sincerely, ' j Kristy Shutto, secretary City of Wheat Ridge Building Department ,r. RECYCLED PAPER 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 001 CP 418/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 5000 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 002 CP . 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 003 CP 4/8100 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 5000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 004 CP, 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat. Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 1500 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 005 CP 418/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 006 DW N/A Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 2700 l bs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 007 CP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 2700 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 008 CP . 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 4000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 009 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 4000 l bs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 010 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 3500 lbs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. Oil CP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 012 DW N/A Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 SO lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 013 DW N/A Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 500 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 014 DW N/A Lutheran. Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 4500 l bs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 015 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 4000 Ibs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 016 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 4000 l bs. Inspector : Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 017 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 4000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 018 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 cant' 4000 I bs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 019 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 20.000 lbs. Inspector: Randy Pabst LOCATION ID NUMBER TYPE SAFETY INSPECTION DATE 8300 W. 38th Ave. 020 HIP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 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 8300 W. 38th Ave. 021 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 EI 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 8300 W. 38th Ave. 022 HP 4/8/00 Lutheran Medical Center Inspection Issue Expiration 8300 W. 38th Avenue Date Date Date Wheat Ridge, CO 80033 3/30/00 7/21/00 3/31/00 BUILDING.L0PARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at I have this day inspected this structure and these premises and P',, have found the following violations of City and/or State laws gov- erning same: 6W You are hereby notified to correct When corrections have been.made, call Date FORM WR6.22 i A g violations. for Building Dept. THIS TAG BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction N otice Job located at have this day inspected this structure and these premises and have found the following violations of City and/or State laws gov- eerning same: g /I >7 ?� _- n You are hereby notified to correct th / oYegoing violations. s 7s -� }.✓': i BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at A. eHC G I have this day inspected this structure nd these premises and have found the following violations of City and/or State laws gov- erning same ZI r >s r CC v 4 / E. � You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. 4 J F � Date spector for Building Dept. ' DO OT REMOVE THIS TAG ... FORM WR6 -22 BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at Lj-) . 1 have this day inspected 3hl s- structure- and- these°premises°afrd 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 nspector for Building Dept. DO NOT REMOVE THIS TAG .FORM WR6.22 Job Located at f'x5eo L have this day inspected this- str-uctare- and- these- premisesand have found the following violations of City and/or State laws gov- erning same: n{�r,.�w- (✓l .._ �nn�as. n r- €-:�, � �-, � . l-� n...,,, nn.. m 6 ui G clO_A)0A6 J Qk�-J 1 You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. Date Inspector for Building Dept. -DO NOT REMOVE THIS TAG FORM WRG -22 f BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at SaDD UZ) have this day inspected this- structure- and- t#tese- premises -and- have found the following violations of City and/or State laws gov- erning same: Z o� n (a ��1tXic"`� :.'T�iri't�1i►7il�V ►fJI�F[illli(i,'17�1►a1� E�WAWF "An J1 °off You are hereby notified to correct the foregoing violations. When corrections have been made, call for inspection. Date Inspector for Building Dept. DO; NOT REMOVE THIS TAG `r FORM WR6.22 w T �S BUILDING DEPARTMENT (303) 235 -2855 CITY OF WHEAT RIDGE Correction Notice Job Located at i�u.snz_' have this day inspected this-structure- arid- t#lese-premises and have found the following violations of City and/or State laws gov- erning same: J� U You are 'hereby notified to correct the foregoing violations. 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