Chainpully Block 3 Ton-GOOD WILL ENGG

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Certificate No.

: SSS/07-22 /CPB - 3T
FORM NO. 32
(See Rule 63)
PRESCRIBED FOR REPORT OF EXAMINATION FOR CRANES AND OTHER LIFTING MACHINES
i. Name of the Occupier of factory : M/s. GOODWILL INFRA & CRANES
ii. Address of the factory/Owner of the Equipment : M/s. GOODWILL INFRA & CRANES
# 3, Ground Floor, Manjunatha Nilaya,
Horamavu post, Bangalore- 560043
Inspected @ Site : Shapoorji pallonji & Co. Pvt Ltd
Goraguntepalya, Yeshwanthpur, Bangalore – 560022
C / P – N.V. SRINIVAS RAO - 8088021889
iii. Distinguishing number of mark (if any) and : CHAIN PULLEY BLOCK
description sufficient to identify the lifting machine, LOCAL ID No. : CPB- 2
chain, rope or the lifting tackle Make : Reputed, Cap : 3 Ton
Sr. no, Model ,YOM etc – are as per MFR manual
Grade 80 Load Chain, Chain Dia : 8 mm
Type: Chain Pulley Block Arrangement- 1 / 2 Fall Type
Total qty inspected : 01 no , Cleared : 01 no
iv. Date when lifting machine, chain, rope or tackle was :
first taken into use in the factory used Equipment/Machinery
v. Date and number of the certificate relating to any :
test and examination made under rule 64 (5) and 64
(6) together with the name and address of the person First Inspection
who issued the certificate
vi. Date of each periodical through examination made : On 28/07/2022 Thoroughly Inspected by
under clause (a) (ii) of sub-section (1 or section 29 or SUSUM S. SRINIVAS, B.E. (Mech), MIE, CE.FIV
the Act and Rule 64 (7) and by whom it was carried As Competent Authority.
out.
vii. Particulars of any defects affecting the safe working : Detailed visual inspection has been carried out, Performance Check
load found at such through examination or after and load Test Was carried out it was Found Satisfactory.
analyzing and of the step taken to remedy such DEFECTS : NIL, FIT FOR USE,
defects Recommended SWL : 2 Tons

I certify that on 28-07-2022 thoroughly examined the above mentioned lifting machine, chain / rope / lifting tackle and that
is a correct report of the result. Next Certification Due on 27-01-2023, or in case any major maintenance problems.

Recommendations / Remarks / Notes / Observations:

1. Visual Check : Condition of the Chain Block, its Construction, dimensional check, deformation free of Load
Chain, end fittings, Guide Pulleys, all movements with and without Load, Load Hoisting and Breaking, Load
Lowering & raising and Load holding performance – Satisfactory.
2. Advised to De-rate the safe working load by 10%, since the equipment is old.
3. Recommended to lift the load only after proper balancing using tested slings.
4. Disclaimer: Any operational/usage failure, because of improper usage over loading un-even loading, improper
commands, improper preventive maintenance, Not Noticing the leakages if any in the Gear Box, any alterations /
changes in the equipment original requirements, etc., the responsibility entirely lies on the occupier.
5. Validity: 6 months from the date of issue.

Name & Address of the Competent person:


SUSUM S. SRINIVAS, B.E. (Mech.) MIE, CE, FIV
Authorisation No. PVPSMC/FYA/CR-31/2021–22, Date: 23-11-2021
Chartered Engineer, Membership No.: M-160031-6
Approved Valuer: Plant & Machinery-Membership No.: F-27586
# 32/2, 3rd Cross, Cashier Layout, Tavarekere, B.T.M. 1 Stage,
Bangalore – 560 029, (M) : 9036396077
E Mail: [email protected] Seal and Signature

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