BC Safety Authority New Westminster Office: 505 Sixth Street, Suite 200 New Westminster, BC V3L 0E1

Local number: 778-396-2000 Local Fax: 778-396-2064 Toll Free: 1866-566-SAFE(7233) Website: www.safetyauthority.ca

Electric Elevator Data Sheet Checklist

The information on this form is collected to administer the provisions of the BC Safety Standards Act and section 26 of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, use, or disclosure of this information, contact the Records, Information and Privacy Analyst for the BC Safety Authority at 1-866-566-7233.

Date: Unit Number: Address: City: Contractor: Access to M/R

GENERAL

Class: Unit #:

Type: # Floors:

Capacity: Adjuster: Signature:

Speed:

Ropes Number, Diameter Governor, Seal, Plate Door, Lock, Closer, Threshold Plate Governor Rope, Type Lighting, GFCI Outlet Type of Roping ABC Powder Extinguisher 1:1 2:1 Safety Type Ventilation, Heating A, B, C Other Equipments, Floor Openings Sprinklers & Guards Seismic Machine Numbering MRL Passenger Rescue Procedure Rope Guards
Current % of Load
amps amps

MACHINE ROOM

BALANCE LOAD

Voltage Motor Volts ETS

Vs Vs

Motor Data Plate

Vs Current Vs Volts

Main Disconnect Switch amps Volts Vs Fuse 110 V Switch

FULL LOAD

Motor Current amps amps NTS Car Buffer Test Break Traction

Speed

Line Current Line Volts amps Vs amps Vs Safety Test

f/mTripping Speed

Over Speed Switch

Break Traction

Governor Test Tag

125% Tests

Roll Away Down NTS Down Motor Current amps amps NTS C/W Buffer Test

Main Brake Test Traction Sheave Test Stopping Accuracy Bottom Level Motor Volts
Vs Vs

NO LOAD

Speed

Line Current

Line Volts
Vs Vs
f/m In

ETS Break Traction

amps amps Ascending Car Over-speed: Roll Away Up

FRM-1214-03 (2013-02-25)

BC Safety Authority New Westminster Office: 505 Sixth Street, Suite 200 New Westminster, BC V3L 0E1

Local number: 778-396-2000 Local Fax: 778-396-2064 Toll Free: 1866-566-SAFE(7233) Website: www.safetyauthority.ca

Where there is a conflict between this Guideline & the Act & Regulations the regulations shall Prevail.

- Page 2 - Electric Elevator Data Sheet Checklist

Redundancy Brake Contactor Bypass Leveling Inner landing Ground Failure Roll-Away Detection Ascending Car Detection Hoistway Access Switches Car Gate Hall Door Fuse

Top Access Switch Stop Switch, Light and Outlet Inspection Operation Inspection Open Door, Bypass Equipment on car , Guard Rails, Toe Board Refuge Space and Marking Overhead & Deflector Sheaves Terminal Limit Switches Top-of-car clearance Top Counterweight Clearance Top Emergency Exit Hoistway Construction Hoistway Clearances Windows, Projections Recesses Pit Access Switch Lighting Stop Switch(s) GFCI Drain, Sump Pump Limit Switches Comp. Chain Switch(es) Buffer, Plates, Switches Wiring, pipes, and ducts Traveling Cables Emergency Light & Bell Ventilation Car Area & Capacity Plate BCSA Plate

Rope Fastening & Hitch Plate Ropes , Tag All Data Plates & Signs Car Frame Guides Guide Rails and Equipment Safety Slide C/W & C/W Safeties In C/W Guides & Stiles Identification of Floors In Governor Rope Tag, Clearance In Traveling Cable, Junction Box Pipes, Wiring, and Ducts Door Closed Position Retainer Door Hanger & Locking Device Pull On: Pull Through: Car Buffer Stroke CW Buffer Stroke Car Runby, Signs CW Runby Car Clearance Bottom Pit Depth Refuge Space and Marking Governor Tension Device Car Frame, Platform, Apron Seismic Door Open Devices Sill Clearance Car Communication Power Closing Test

Hoistway & Top-Of-Car

In

In In In In In In In

PIT

INSIDE CAR

Where there is a conflict between this Guideline & the Act & Regulations the regulations Shall Prevail.

FRM-1214-03 (2013-02-25)