ПБ 10-611-03. Правила устройства и безопасной эксплуатации подъемников (вышек)

Должность __________________________________________________________

Место работы _______________________________________________________

Сдан экзамен на знание _____________________________________________

(указать правила безопасности)

Основание: протокол N ____ от "___" __________ г.

Председатель экзаменационной

комиссии ___________________________________________________________

Члены комиссии _____________________________________________________

_____________________________________________________

М.П.

Должность __________________________________________________________

Место работы _______________________________________________________

Сдан экзамен на знание _____________________________________________

(указать правила безопасности)

Основание: протокол N ____ от "___" __________ г.

Председатель экзаменационной

комиссии ___________________________________________________________

Члены комиссии _____________________________________________________

_____________________________________________________

М.П.

──────────────────────────────

* Удостоверение издается в жесткой обложке на листах формата 110 х 80 мм.

Приложение 5

Информационное

Форма вахтенного журнала машиниста подъемника

Дата _____________________ Смена ___________________________________

Машинист подъемника ________________________________________________

Результаты осмотра подъемника

┌─────┬──────────────────────────────────────┬────────────┬─────────────┐

│ N │ Наименование механизма, узла, детали │ Результат │ Фамилия, │

│ п/п │ │ проверки │ инициалы и │

│ │ │ │ должность │

│ │ │ │ лица, │

│ │ │ │устранившего │

│ │ │ │неисправность│

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 1 │Металлоконструкция │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 2 │Тормоза: поворота платформы механизма│ │ │

│ │передвижения подъемника │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 3 │Приборы безопасности: ограничитель│ │ │

│ │предельного груза концевые выключатели│ │ │

│ │указатели сигнализаторы │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 4 │Электрооборудование │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 5 │Гидрооборудование │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 6 │Канаты, цепи │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 7 │Крюк │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 8 │Освещение │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 9 │Заземление │ │ │

├─────┼──────────────────────────────────────┼────────────┼─────────────┤

│ 10 │Прочие замечания, выявленные в│ │ │

│ │процессе работы │ │ │

└─────┴──────────────────────────────────────┴────────────┴─────────────┘

Смену принял _______________________________________________________

(фамилия, инициалы и подпись машиниста)

Смену сдал _________________________________________________________

_________________________________________________________________________

(указать состояние подъемника и количество отработанных часов)

_________________________________________________________________________

(фамилия, инициалы и подпись машиниста)

Результаты осмотра подъемника

Слесарем ___________________________________________________________

_________________________________________________________________________

Электромонтером ____________________________________________________

_________________________________________________________________________

Специалист, ответственный за содержание подъемников в исправном

состоянии _______________________________________________________________

_________________________________________________________________________

Приложение 6

Информационное

Форма наряда-допуска

на производство работ подъемником вблизи

воздушной линии электропередачи

_____________________________

(наименование предприятия

_____________________________

и ведомства)

Наряд-допуск N _____

Наряд выдается на производство работ на расстоянии менее 30 м от

крайнего провода линии электропередачи напряжением более 42 В.

1. Машинисту _______________________________________________________

(фамилия, имя, отчество)

_________________________________________________________________________

(тип подъемника, регистрационный номер)

2. Выделенного для работы __________________________________________

_________________________________________________________________________

(организация, выделившая подъемник)

3. На участке ______________________________________________________

(организация, которой выделен подъемник,

_________________________________________________________________________

место производства работ, строительная площадка, склад, цех)

4. Напряжение линии электропередачи ________________________________

5. На участке ______________________________________________________

(необходимость снятия напряжения с линии

_________________________________________________________________________

электропередачи, наименьшее допускаемое при работе

_________________________________________________________________________

подъемника расстояние по горизонтали от крайнего провода

_________________________________________________________________________

до ближайших частей подъемника, способ перемещения

_________________________________________________________________________

люльки и другие меры безопасности)

6. Начало работы ___ ч ___ мин.

"___" __________ г.

7. Конец работы ___ ч ___ мин.

"___" __________ г.

8. Ответственный за безопасное производство работ __________________

(должность,

_________________________________________________________________________

фамилия, имя, отчество, дата и номер приказа о назначении)

9. Рабочий люльки __________________________________________________

(фамилия, имя, отчество)

_________________________________________________________________________

(номер удостоверения, дата последней проверки знаний)

10. Разрешение на работу в охранной зоне ___________________________

_________________________________________________________________________

(организация, выдавшая разрешение, номер и дата разрешения)

11. Наряд выдал главный инженер (энергетик) ________________________

_________________________________________________________________________

(организация, подпись)

12. Необходимые меры безопасности, указанные в п. 5, выполнены _____

_________________________________________________________________________

Лицо, ответственное за безопасное производство работ _______________

(подпись)

"___" ___________ г.

13. Инструктаж получил машинист подъемника _________________________

(подпись)

"___" ___________ г.

Примечания:

1. Наряд выписывается в двух экземплярах: первый выдается машинисту подъемника, второй

хранится у производителя работ.

2. Пункт 11 заполняется в случае работы в охранной зоне линии электропередачи.

3. К воздушным линиям электропередачи относятся также ответвления от них.

4. Работы вблизи линии электропередачи выполняются в присутствии и под руководством лица,

ответственного за безопасное производство работ подъемниками.

Приложение 7

Знаковая сигнализация, применяемая при работе подъемника

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ПБ 10-611-03. Правила устройства и безопасной эксплуатации подъемников (вышек)

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