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develop me a duct jack annual inspection form in accordance with the 1926 construction standards
Generated on: January 27, 2026
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Duct Jack Annual Inspection Checklist
Date: 2026-01-27
Inspector: [INSPECTOR NAME]
Location/Area: [LOCATION/AREA]
Department: [DEPARTMENT]
Purpose
To ensure duct jacks are in safe operating condition and comply with OSHA 29 CFR 1926 standards. This inspection should be conducted annually by a qualified person.
Instructions for Use
- 1. Visually inspect the duct jack for any signs of damage or wear.
- 2. Perform functional testing to ensure the jack operates correctly and safely.
- 3. Check the hydraulic system (if applicable) for leaks and proper operation.
- 4. Check the screw mechanism (if applicable) for damage and proper operation.
- 5. Record the inspection findings and any corrective actions taken.
- 6. Ensure that the inspection is performed by a qualified person.
- 7. Maintain inspection records for a minimum of 12 months. [1926.1412(f)(7)]
Frequency
This checklist should be completed: Annually
Safety Checklist
General Requirements
These requirements apply to all duct jacks regardless of type or application.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Rated Capacity Check: The manufacturer's rated capacity is legibly marked on the jack and is not exceeded. [1926.305(a)(1)] If failed: Remove the jack from service if the rated capacity is illegible or if the jack is being used beyond its capacity. Ensure the jack is appropriately labeled or replaced. | _________________ | ||
| Positive Stop Check: The jack has a positive stop to prevent overtravel. [29 CFR 1926.305(a)(2)] If failed: Remove the jack from service and repair or replace the stop mechanism. | _________________ | ||
| Lubrication Check: The jack is properly lubricated at regular intervals. [29 CFR 1926.305(d)(1)(iii)] If failed: Lubricate the jack according to the manufacturer's recommendations. Establish a lubrication schedule. | _________________ | ||
| Inspection Frequency Check: The jack is thoroughly inspected at times which depend upon the service conditions. Inspections are not less frequent than once every 6 months for constant or intermittent use at one locality. [29 CFR 1926.305(d)(1)(iv)(a)] If failed: Adjust the inspection schedule to meet the requirements based on usage.. Document all inspections. | _________________ | ||
| Post-lifting security Check: After the load has been raised, it is cribbed, blocked, or otherwise secured at once. [1926.305(d)(1)(i)] If failed: Provide cribbing and blocking materials. Train employees on proper blocking procedures. | _________________ | ||
| Freezing Temperatures Check: Hydraulic jacks exposed to freezing temperatures are supplied with an adequate antifreeze liquid. [1926.305(d)(1)(ii)] If failed: Add appropriate antifreeze liquid. Check the antifreeze protection level. | _________________ | ||
| Repair Parts Check: Repair or replacement parts are examined for possible defects. [1926.305(d)(1)(v)] If failed: Reject any defective parts. Use only approved replacement parts. | _________________ | ||
| Jacks Out of Order Check: Jacks which are out of order are tagged accordingly and not used until repairs are made. [1926.305(d)(1)(vi)] If failed: Tag out the jack and remove it from service until repaired. Ensure repairs are performed by qualified personnel. | _________________ |
Visual Inspection
Inspect the jack for any signs of physical damage or wear.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Cracks Check: No cracks are present in the jack body, base, or lifting mechanism. If failed: Remove the jack from service and repair or replace it. | _________________ | ||
| Deformation Check: No deformation is present in the jack body, base, or lifting mechanism. If failed: Remove the jack from service and repair or replace it. | _________________ | ||
| Corrosion Check: No excessive corrosion is present on the jack. If failed: Clean and lubricate the jack. If corrosion is severe, remove the jack from service and replace it. | _________________ | ||
| Welds Check: All welds are intact and show no signs of cracking or failure. If failed: Remove the jack from service and repair or replace it. | _________________ | ||
| Steps, ladders, handrails, guards Check: Originally equipped steps, ladders, handrails, guards are present and in usable/safe condition. [1926.1412(f)(2)(xx)] [1926.1412(f)(2)(xxi)] If failed: Repair or replace any missing or damaged steps, ladders, handrails or guards. | _________________ |
Functional Testing
Test the jack to ensure it operates correctly and safely.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Lifting Check: The jack lifts the rated load smoothly and without excessive effort. If failed: Check the hydraulic fluid level or the screw mechanism for damage. Repair or replace as necessary. | _________________ | ||
| Holding Check: The jack holds the load without leaking down or slipping. If failed: Check the seals and valves for leaks. Repair or replace as necessary. | _________________ | ||
| Lowering Check: The jack lowers the load smoothly and in a controlled manner. If failed: Check the release valve for proper operation. Repair or replace as necessary. | _________________ | ||
| Positive Stop Check: The positive stop prevents overtravel during lifting. If failed: Adjust or repair the positive stop mechanism. | _________________ | ||
| Functional Testing Check: Functional testing is conducted to determine that the equipment as configured in the inspection is functioning properly. [1926.1412(f)(3)] If failed: Repair or replace any components that are not functioning properly. | _________________ |
Hydraulic System (if applicable)
Inspect the hydraulic system for leaks and proper operation.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Leaks Check: No hydraulic fluid leaks are present in the cylinder, hoses, or fittings. If failed: Tighten fittings or replace damaged hoses or seals. | _________________ | ||
| Fluid Level Check: The hydraulic fluid level is within the recommended range. If failed: Add hydraulic fluid as needed. | _________________ | ||
| Cylinder Condition Check: The cylinder is free from damage, such as dents or scoring. If failed: Repair or replace the cylinder. | _________________ | ||
| Hoses and Fittings Check: Hoses and fittings are in good condition and properly secured. If failed: Replace damaged or worn hoses and fittings. Ensure proper securement. | _________________ |
Screw Mechanism (if applicable)
Inspect the screw mechanism for damage and proper operation.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Thread Condition Check: The threads are clean and free from damage. If failed: Clean and lubricate the threads. Repair or replace if damaged. | _________________ | ||
| Screw Movement Check: The screw moves smoothly without binding or excessive play. If failed: Clean and lubricate the screw mechanism. Repair or replace if binding or excessive play is present. | _________________ | ||
| Lubrication Check: The screw mechanism is properly lubricated. If failed: Lubricate the screw mechanism according to the manufacturer's recommendations. | _________________ |
General Requirements
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Qualified Inspector Check: Inspection performed by a qualified person who is capable of identifying existing and predictable hazards. [1926.1412(f)(1)] If failed: Ensure the inspector has the necessary training and experience. | _________________ | ||
| Removal from Service Check: Where a wire rope is required to be removed from service under this section, either the equipment (as a whole) or the hoist with that wire rope must be tagged-out, in accordance with $ 1926.1417(f)(1), until the wire rope is repaired or replaced. [1926.1413(a)(4)(iii)(B)] If failed: Tag out the equipment and remove it from service until the wire rope is repaired or replaced. | _________________ |
Failed Item Procedures
- If any deficiency is identified, an immediate determination must be made by the qualified person as to whether the deficiency constitutes a safety hazard or, though not yet a safety hazard, needs to be monitored in the monthly inspections. [1926.1412(f)(4)]
- If the qualified person determines that a deficiency is a safety hazard, the equipment must be taken out of service until it has been corrected. [1926.1412(f)(5)]
- If the qualified person determines that, though not presently a safety hazard, the deficiency needs to be monitored, the employer must ensure that the deficiency is checked in the monthly inspections. [1926.1412(f)(6)]
Documentation Requirements
The following information must be documented and maintained for a minimum of 12 months: [1926.1412(f)(7)]
- The items checked and the results of the inspection. [1926.1412(f)(7)(i)]
- The name and signature of the person who conducted the inspection and the date. [1926.1412(f)(7)(ii)]
Checklist Completion
Overall Status: ☐ Pass ☐ Fail ☐ Corrective Actions Required
Inspector Signature: Date:
Supervisor Review: Date:
Corrective Actions Completed By: Date:
References and Standards
- OSHA 29 CFR 1926 Subpart I - Tools - Hand and Power [1926.305]
- OSHA 29 CFR 1926.1412 - Inspections
- OSHA 29 CFR 1926.1413 - Wire rope--inspection
This checklist must be retained for [RETENTION PERIOD].
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