Form FRA F 6180.49A FRA F 6180.49A Locomotive Inspection and Repair Record

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U.S. Department
of Transportation

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LOCOMOTIVE INSPECTION AND REPAIR RECORD

Federal Railroad
Administration

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. All responses to this collection of information are mandatory. A
federal agency may not conduct or sponsor, and a person is not required to, nor shall a person be subject to a penalty for failure to comply with, a collection of information unless
that collection of information displays a currently valid OMB Number. The OMB Control Number for this information collection is 2130-0004. Anyone with comments regarding this
burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, may send them to: Information Clearance Officer, Federal
Railroad Administration, 1200 New Jersey Ave, S.E., MS-25, Washington, D.C. 20590.

Reporting year 20_____

If loco. renumbered
give previous no.

Check if new loco.

1. OPERATED BY

OMB No. 2130-0004

RR CODE

3. MODEL NO.

4. LOCO. NO.

9. STEAM GEN.

GEN. #1

5. YR. BUILT

6. PROPELLED BY

7. HORSEPOWER

Working Pressure

8. TYPE OF SERVICE:
ROAD
YARD

GEN. #2

TYPE OF AIR BRAKE

10. MAXIMUM PISTON TRAVEL

RR CODE

2. OWNED BY (Railroad)

PASSENGER
OTHER

Working Pressure

11. OUT OF USE CREDIT

Inches

PLACE

12. LAST PERIODIC INSPECTION DATE
PERIODIC INSPECTIONS
13.

DATE
MO DAY YR

14.

*

15. ITEM CODE:

1

BRAKES

16.

15. ITEMS *

PLACE

2

RUNNING GEAR

3

CAB EQUIP.

18. H&H TEST PRESSURE

TESTS

TYPE

INTERVAL NOT
MORE THAN

METER

368 calendar days

HAMMER
AND
HYDRO

736 calendar days

AIRBRAKE
229.27

368 calendar days

AIRBRAKE
229.29

NUMBER OF
CALENDAR
DAYS _________

21.

PERSON
CONDUCTING

PERSON
CONDUCTING

4

16.

15. ITEMS *

MECH. EQUIP.

5

PERSON
CONDUCTING

ELECT. EQUIP.

19. WAIVER PART - 229

22.

TEST DATE
AND PLACE

23.

6

17.

STEAM GEN.

CERTIFIED BY

7

SAFETY APPL.

20. WAIVER - OTHER

CERTIFIED BY

24.

PREVIOUS TEST
DATE AND PLACE

In accordance with the Locomotive Inspection Act, 36 State, 913, as amended and the regulations issued pursuant to that Act, the parts and
appurtenances of the locomotive unit have been inspected and all defects disclosed by the inspection have been properly repaired.

Certification of true copy.
I certify that this is a true copy of the inspection and repair record of locomotive no. ___________________
ATTENTION: A false entry on this form is punishable by fine or imprisonment (U.S. Code. Title 18. Sec. 1001).

_____________________________________________
(Officer-in-charge)
DATE
FORM FRA F6180-49A (3-85)

GOVERNMENT PROPERTY DO NOT REMOVE

OMB Approval expires 10/31/2014