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Crane ID #: Against (d) (e)Warning (a)General (c)Safety (j)(2)(iii) (c)(1) (c)(2)Cracks, Nicks, (c)(3)Attachment (c)(6)Self-Locking (c)(7) (a) (b) (c)DistortionCorrosionBroken (a)(1)(a) (a)(1)(b) (a)(1)(c) (j)(2)(vii)Load Rating , Cracks, (b)(1)Air (c)(3) & (j)(2)(ii)Hydraulic (c)(3) & (j)(2)(ii) (c)(1) & (j)(2)(vi) (c)(1) & (j)(2)(vi) (c)(1) & (j)(2)(vi)Crane Inspection & Certification Box 621388 Orlando, FL 32862-1388(800) 327-1386 * (407) the appropriate boxes S - SatisfactoryU - UnsatisfactoryN - Not ApplicableReference StandardWi r eRopeSt ructureTrol l eyHo i s tCon t r o l sHookCha i nBr i dgeMachine Description & NumberMonthCICB Overhead Crane/Hoist Monthly (a) & (g)(5)(i) (b)(12)

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