S.k.heavy Lifters MH01 Ej 0107

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FORM 11

( See Rule 62 and 64 )


Report of examination of hoist, Lift, lifting machine, chains , ropes, and lifting tackles .
(Maharashtra Factories Rules-1963) Certificate No.: Y-007/2023/SKHL/L-03
1 Name of the occupier
M/s. S. K. HEAVY LIFTERS
2 Name and address of the Factory
Plot No. 291 , Victoria Over Bridge , RD Darukhana
Market , Mazgaon, Mumbai – 400 010.
3 1 Type Identification number and description of hoist, lift, lifting
machine, chains , ropes, and lifting tackles. HYDRAULIC MOBILE CRANE :

Regd. No. : MH01 EJ 0107


SWL : 25.0 Ton
Chassis No : LXGCPA3117A014077
Engine No. : D9123013636
Make : XCMG
Model : QY 25
Color : Yellow
Location : At the site
2 Date of construction or reconstruction and the date when the
hoist, lift, lifting machine, chains , ropes, and lifting tackles were 2019
first taken into use in factory.
2019
4 Date of last examination made under section 28 (1) ( a)
( ii ) and 29 (1) ( a) ( iii ) and by whom it was carried out . ------
5 Maintenance : ( List of parts, if any, which were inaccessible) Are the
following parts of the hoist or lift properly maintained and in good working
order? if not, state what defect has been found :-
a) Enclosures of hoist way or lift way Not applicable
b) Landing gates and cage gate/s -
c) Interlocks on the landing gates & cage gate/s -
d) Other gates fastening -
e) Cage and platform and fittings cage guides, buffers interior of
the hoist way or lift way
-
f) Over running devices -
g) Suspension ropes, chains and their attachments -
h) Safety gear, i.e., arrangements for preventing fall of platform -
or cage brakes -
i) Brakes -
j) Work of spur gearing -
k) Other electrical equipment
l) Other parts
-
(B) Date and the number of the certificate relating to any test and examination
made under sub rule ( 1 ) of rule 64 together with the name of the person Examined and tested by us & found okay.
who issued the certificate .
(C) (i) Date of annealing or other heat treatment of the chain and lifting tackle N/A
carried out under sub rule ( 5 ) of rule 64 and by whom it was carried out .
(ii) Particulars of any defect found at any such examination or after Disclaimer : This Certificate Neither Gives Any Performance Guarantee Nor Ensure
annealing and affecting the safe working load and of the steps taken to Against Any Failure of the equipment in future it indicates only the present status of the
remedy such defect . equipment on the day of inspection based on the test carried out.. Daily check the above
equipment and all its safety devices for its proper functioning and safe operation & favorable
Weather condition Before its use. , Maintenance & Safety of above equipment is in
Occupier’s scope follow manufacturer’s instructions for safe operation and maintenance.
6. Repairs, reneals or alterations ( if any ) required and the period within N/ A
which they should be executed and maximum safe working load subject to
repairs, renewals or alternations ( if any ) .

I/we certify that on 17. 07. 2023 , I/We thoroughly examined the above-mentioned Lifting machine/chain/rope/lifting tackle and that the
above is a correct report of the result .

Certificate Valid Up to : 16. 07. 2024

NDT SERVICES R B YADAV


1203 / B Wing Silver Dunes Apartment MBA, PGDESc., PDIS, DME, AIII ,
Hatiskar Marg Prabhadevi Mumbai - 25 eMOSIF ( IIT Bom. )
Mobile No. 09822010321/ 07620247851. CPC No. : MS/DISH/CPC/ Y – 007 / 2023
E-mail : [email protected]

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