make a duct jack inspection form
Duct Jack Safety Inspection Checklist
Date: 2026-01-27
Inspector: [INSPECTOR NAME]
Location/Area: [LOCATION/AREA]
Department: [DEPARTMENT]
Purpose
To ensure duct jacks are safe to operate and comply with safety regulations. This checklist should be used before each use of a duct jack.
Instructions for Use
- Inspect the duct jack before each use, following this checklist.
- Ensure the load does not exceed the jack's rated capacity.
- Position the jack on a level, stable surface.
- Use appropriate cribbing or blocking to support the load.
- Never work under a load supported only by a jack.
- Lower the load slowly and in a controlled manner.
Frequency
This checklist should be completed: Before each use
Safety Checklist
General Condition
Inspect the overall condition of the duct jack.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Check for any visible damage to the jack body, such as cracks, dents, or corrosion. Check: Jack body is free from visible damage that could compromise its structural integrity. If failed: Remove the jack from service and send for repair or replace. | _________________ | ||
| Inspect the base of the jack for stability and any signs of damage. Check: Base is stable, undamaged, and provides a firm footing. If failed: Do not use the jack if the base is unstable or damaged. Repair or replace the jack. | _________________ | ||
| Verify that the jack has a legible and permanently marked load rating. [1] Check: The rated load is legibly and permanently marked in a prominent location on the jack. If failed: If the load rating is missing or illegible, remove the jack from service. | _________________ | ||
| Ensure all labels and warnings are present and readable. Check: All safety labels and operating instructions are attached and can be easily read. If failed: Replace any missing or damaged labels before using the jack. | _________________ |
Hydraulic System (if applicable)
Inspect the hydraulic components of the duct jack.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Check for hydraulic fluid leaks around the cylinder, hoses, and fittings. Check: No visible hydraulic fluid leaks are present. If failed: Repair any leaks before using the jack. If leaks cannot be repaired, remove the jack from service. | _________________ | ||
| Inspect hydraulic hoses for cuts, kinks, or abrasions. Check: Hoses are in good condition with no signs of damage. If failed: Replace any damaged hoses before using the jack. | _________________ | ||
| Verify that the hydraulic pump operates smoothly and maintains pressure. Check: The pump operates smoothly without unusual noises or resistance, and the jack holds its rated load without drifting. If failed: If the pump is not functioning correctly, remove the jack from service and repair. | _________________ | ||
| Ensure hydraulic jacks exposed to freezing temperatures are supplied with adequate antifreeze liquid. [1] Check: Hydraulic jacks contain adequate antifreeze liquid. If failed: Add antifreeze liquid as needed. | _________________ |
Mechanical Components
Inspect the mechanical parts of the duct jack.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Inspect the screw mechanism for damage, wear, or corrosion. Check: Screw mechanism is clean, lubricated, and free from damage. If failed: Clean and lubricate the screw mechanism. Replace if damaged or excessively worn. | _________________ | ||
| Check the condition of the lifting saddle or attachment point. Check: Lifting saddle is secure and shows no signs of wear or damage. If failed: Replace the lifting saddle if damaged. | _________________ | ||
| Verify that the jack has a positive stop to prevent over-travel. [1] Check: Jack has a functional positive stop to prevent over-travel. If failed: Repair or replace the jack if the positive stop is missing or non-functional. | _________________ |
Operation and Functionality
Verify the operational performance of the duct jack.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Test the jack under a light load to ensure smooth and controlled lifting and lowering. Check: Jack lifts and lowers smoothly without jerking or binding. If failed: If the jack does not operate smoothly, remove it from service and repair. | _________________ | ||
| Confirm that the jack holds the load securely without slippage. Check: The jack maintains its height under load without any noticeable sinking or slippage. If failed: If the jack slips under load, remove it from service and repair. | _________________ | ||
| Ensure the jack is properly lubricated at regular intervals. [1] Check: Jack is properly lubricated at regular intervals. If failed: Lubricate the jack as needed. | _________________ |
Work Environment
Assess the surrounding work environment for potential hazards.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Ensure the work area is free of obstructions and tripping hazards. Check: The area around the jack is clear, providing safe access and operation. If failed: Clear any obstructions or hazards from the work area. | _________________ | ||
| Verify that the surface is level and stable. Check: The jack is placed on a level and stable surface capable of supporting the load. If failed: Relocate the jack to a level and stable surface. | _________________ | ||
| Confirm sufficient lighting is available. [2] Check: There is sufficient lighting to perform the work safely. If failed: Improve lighting as needed. | _________________ |
Personal Protective Equipment (PPE)
Verify the use of required personal protective equipment.
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Ensure that operators wear appropriate PPE, including safety glasses and gloves. [2] [2] Check: Operators are wearing safety glasses and gloves. If failed: Provide and enforce the use of required PPE. | _________________ | ||
| Verify that steel-toed shoes/boots are worn. [2] Check: Operators are wearing steel-toed shoes/boots. If failed: Provide and enforce the use of steel-toed shoes/boots. | _________________ |
General Requirements
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Ensure all operators are trained on the proper use of duct jacks. Check: Operators have received documented training on safe jacking procedures. If failed: Provide training to all operators before they use the equipment. | _________________ | ||
| Inspect jacks that are subjected to abnormal load or shock immediately before and immediately after use. [1] Check: Jacks are inspected before and after use. If failed: Perform the required inspections. | _________________ | ||
| Ensure repairs are made on disabled jacks before they are used again. [1] Check: Repairs are made on disabled jacks before they are used again. If failed: Do not use disabled jacks until they are repaired. | _________________ |
Failed Item Procedures
- Any jack that fails inspection must be immediately removed from service.
- Tag the failed jack with a 'Do Not Use' tag.
- Repair or replace the jack before returning it to service.
- Ensure repairs are made by qualified personnel using approved parts. [4] [4]
Documentation Requirements
Maintain records of all inspections, repairs, and maintenance performed on duct jacks. [3]
Checklist Completion
Overall Status: ☐ Pass ☐ Fail ☐ Corrective Actions Required
Inspector Signature: Date:
Supervisor Review: Date:
Corrective Actions Completed By: Date:
References and Standards
- 29 CFR 1910.244 - Jacks
- 29 CFR 1926.305 - Jacks, levers, and blocking
This checklist must be retained for [RETENTION PERIOD].
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Important Safety Note:
Always verify safety information with your organization's specific guidelines and local regulations.