The document is an escalator inspection report form from the Minnesota Department of Labor and Industry Construction Codes and Licensing Division. It contains fields to record information about the location and specifications of an escalator, as well as the results of tests conducted to check that it meets safety standards before being approved to return to service. Test results cover over 30 safety devices and performance measures.
The document is an escalator inspection report form from the Minnesota Department of Labor and Industry Construction Codes and Licensing Division. It contains fields to record information about the location and specifications of an escalator, as well as the results of tests conducted to check that it meets safety standards before being approved to return to service. Test results cover over 30 safety devices and performance measures.
The document is an escalator inspection report form from the Minnesota Department of Labor and Industry Construction Codes and Licensing Division. It contains fields to record information about the location and specifications of an escalator, as well as the results of tests conducted to check that it meets safety standards before being approved to return to service. Test results cover over 30 safety devices and performance measures.
The document is an escalator inspection report form from the Minnesota Department of Labor and Industry Construction Codes and Licensing Division. It contains fields to record information about the location and specifications of an escalator, as well as the results of tests conducted to check that it meets safety standards before being approved to return to service. Test results cover over 30 safety devices and performance measures.
Elevator Inspections 443 Lafayette Road North St. Paul, MN 55155-4341 Phone: (651) 284-5071 Fax: (651) 284-5749 www.dli.mn.gov
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Escalator Inspection Report
PRINT IN INK or TYPE
LOCATION
COUNTY
ADDRESS
CITY
NORMAL DIRECTION OF TRAVEL:
ESCALATOR SERVES
OWNER ID NO. STATE
ZIP CODE
STATE ID NO.
UP DOWN UP AND DOWN LEVEL TO LEVEL ASME Inspection Standard to be applied for this unit: Year of Installation People per hour (pph) Total travel (ft) Rated speed (fpm) NOTES: Step Skirt Performance Index Has the escalator skirt been cleaned?
Yes
Did the index polycarbonate test specimen meet the following criteria: Material: Polycarbonate without fillers. No Yes No
Is all equipment calibrated and current?
Yes
No Color: Natural, no pigments.
Yes
No
Was the unit tested in the normal direction of travel?
Yes
No Finish: Glossy (roughness less than 0.32 uin.
Yes
No
Was the applied load 25 lbf?
Yes
Did it deviate more than +/- 2.5 lbf?
Yes
No Area in contact with skirt plane: 4.5+/-0.5in2 and
at least 0.03in thick. No
Yes
No
Is the distributed load area between 3in2 & 6in2
Yes
Does this unit have skirt deflection devices?
At what intervals was the index recorded?
No Specification: GE Lexan 100 series or equivalent
polycarbonate. No
Yes
No
Yes
Left What were the Step/Skirt Performance Index measurements? How many readings per side were taken during the test? (Identified when looking up from the bottom on the unit.) CHOOSE ONE OF THE FOLLOWING THREE ITEMS as described in ASME A17.1a 2005 Item 8.6.8.3.3
Right Left
Right
Condition 1: All units range < 15
Condition 2: Escalators installed under ASME A17.1a-2002 and later editions Range: < .25 with skirt deflection devices. Condition 3: Escalators installed under ASME A17.1-2000 and earlier editions Range: < .4 with skirt deflection devices. Did the escalator meet one of the applicable conditions above using the highest measurement obtained?
Yes
No
Have all readouts been attached to this form? Must be submitted for each test, properly labeled and dated?
Yes
No
DID THE UNIT PASS ALL TESTING REQUIREMENTS PRIOR TO BEING RETURNED TO SERVICE? Brake Lining Condition: Machine Room Light: Broken Drive Chain Device: Machine Room Stop Switches: Broken Step Chain: Missing Step Device: Comb Step Impact Devices: Reversal Stop Device: Demarcation Lighting: Reverse Phase Relay: Disconnected Motor Device: Rolling Shutter Device: Drain in Bottom for Outside Escalators: Signage: Drain Chain Tension: Skirt Switches: Emergency Stop Buttons: Speed Governor: Handrail Chain Tension: Step Chain Tension: LH RH Handrail Entry Device: Step Level Device: LH RH Handrail Monitoring Device: Step Rollers: Top Bottom Landing Plate Switches: Step Upthrust Device: Top Lockable Fused Disconnect/CircuitBre Step Upthrust Device: Bottom
Yes
No
Machine Room Cover Switches:
Top
Bottom
Top Top
Bottom Bottom
LH
RH
LH LH
RH RH
Tandem Operation Interlock Device:
COMPANY CONDUCTING TEST
NAME OF PERSON CONDUCTING TEST
ADDRESS
SIGNATURE OF PERSON CONDUTING TEST
CITY
STATE
ZIP CODE DATE
This material can be made available in different forms, such as large print, Braille or on a tape. To request, call 1-800-342-5354 (DIAL-DLI) Voice or TDD (651) 297-4198. EL003 (10/08)
