6

Doc.No: SE-07-020
Doc.Type: Checklist / template
Page: 1 of 2
Author (sign): NAH Rev. date: 01.01.2020
Service protocol Cantilever -
Approved (sign): AZA (central) Rev. no: 8
Verified (sign): AZA
Conventional Davit First publ.date: 11.01.2011

Work Order No. 4676449 Station No. STBD NO#1 LB Date 01-11-2023

Guidance for filling in this form: SE-04-087

Status: OK Acceptable Condition.

NOK Repair, maintenance or replacement necessary.
NA This item is not applicable for this equipment.

ITEM DESCRIPTION OK NOK NA ITEM DESCRIPTION OK NOK NA

GENERAL REMOTE CONTROL SYSTEM
A01 Certificates OK CI20 Remote Control wire OK
A02 Records of previous OK CI21 Adjustment OK
reports & test results
WINCH OK NOK NA CI22 Connections OK
H10 Operating instructions OK CI23 Damages/condition OK
H11 Winch general OK CI24 Remote control blocks & tackle OK
H12 Foundation bolts OK CI25 Remote control drum OK
H13 Gear oil OK CI26 Remote control station NA
H14 Winch drums OK DAVIT OK NOK NA
H15 Bearings/seals OK J01 Davit structure OK
H16 Leakages OK J02 Bolted sections OK
H17 Identification plate OK J03 Painting OK
H18 Lubrication OK J04 Boarding/maintenance OK
platforms/ladders
CH19 Brake arm OK J05 Deck welds OK
CH20 Centrifugal brake OK J06 Pivot points OK
CH21 Holding brake/ Disc brake OK J07 Fall wire sheaves OK
CH22 Hand crank OK J08 Identification plate OK
CH23 Gear OK J09 Operational instructions OK
CH24 Pay off wheel/devices NA CJ10 Roller wheel bearings OK
CH25 Free wheel OK CJ11 Davit fall wire blocks OK
CH26 Free wheel oil OK CJ12 Davit horn/Pad eyes OK
CH27 Sight glasses OK CJ13 Pudding blocks NA
ELECTRICAL OK NOK NA CJ14 Gripe wire release hooks NA
CI01 Safety OK CJ15 Gripe hang off pad eyes OK
I02 Electrical motor OK CJ16 Davit locking pins OK
I03 Connections OK HYDRAULICS OK NOK NA
I04 Start cabinet OK K01 Hydraulic cylinders NA
I05 Hoisting/emergency stop OK K02 Hydraulic pipes NA
I06 Limit switches OK K03 Hydraulic pipes mounting NA
brackets
FALL WIRE OK NOK NA K04 Hydraulic hoses NA
I10 Fall wires OK K05 Hydraulic hose connections NA
I11 Damages/condition fall OK K06 Control valve operation NA
wires
I12 Lubrication OK K07 HPU NA
I13 Connections OK K08 Gauges NA
I14 Wedge sockets/ OK K09 Filter element NA
turnbuckles / clamps
 6
Doc.No: SE-07-020
Doc.Type: Checklist / template
Page: 2 of 2
Author (sign): NAH Rev. date: 01.01.2020
Service protocol Cantilever -
Approved (sign): AZA (central) Rev. no: 8
Verified (sign): AZA
Conventional Davit First publ.date: 11.01.2011

CI15 Adjustment OK K10 Oil level NA

CI16 Suspension chains, D- OK K11 Dead ship operation switch NA
Rings
K12 Accumulator NA

ITEM DESCRIPTION O NOK NA

K
SECURING & MAINTENANCE
CK30 Maintenance pendants OK
CK31 Gripe wires/lashings OK
CK32 Deck pins out riggers OK
CK33 Lifeline between davit heads NA
CK34 Shackles OK
OPERATION TEST O NOK NA
K
K20 Operating pressure NA
K21 Winch/ up / down OK
K22 Davit/ in/ out OK
K23 Brake test OK
K24 Oil level OK
O NOK NA
TESTING K
Testing for annual & five year OK
K40 is to be in accordance with
MSC.402(96)

SIGNATURE ----------------------- DATE 01-11-2023