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CERTIFICATE OF A THOROUGH
EXAMINATION OF LIFTING EQUIPMENT
1*
2*
date of issue
2*
13 Sep 2015
DAC/GM/130915/005
IB-053
This Certificate complies with the requirements of the Lifting Operations and Lifting Equipment Regulations 1998
22 Measuring units (for Loads / Weights) shall be in either/both Metric kilograms or pounds
3* Identification of the issuing IB Name and address of the IB issuing / endorsing the
4* Identification of the client Lifting equipments Owners/ Contractors name and address,
certificate,
KTL Offshore ME FZC, Plot 2M-09. Hamriyah Free Zone PO Box 42452, Sharjah, UAE
KTL Offshore ME FZC, Plot 2M-09. Hamriyah Free Zone PO Box 42452, Sharjah, UAE
7 The address of the premises at which the Inspection was made,
5* Description of the inspection work ordered,
KTL Offshore ME FZC, Plot 2M-09. Hamriyah Free Zone PO Box 42452, Sharjah, UAE
Annual Certification of lifting equipment.
6* Date(s) of inspection and Type of Inspection,
8 Manufacturer or Supplier of equipment name and address,
13 Sep 2015, Visual and Dimensional Inspection of Lifting Gear with DAC required 6
monthly SWL test.
9* Identification of the object(s) inspected and, where applicable, identification of the
10 Unique Identification Numbers, brief description and SWL of the equipment,
specific components that have been inspected and identification of locations,
ALLSAFE
SN. 20859
11 Any reservations or restrictions on the use or Maximum Capacity of the equipment,
Nil.
13* Identification or brief description of the inspection method(s) and procedure(s) used,
mentioning the deviations from, additions to or exclusions from the agreed methods and
procedures,
Visual and Dimensional inspection referencing:BS EN 1492 Part 1
14 Identification of equipment used for measuring/testing,
Measure Serial Number KTL-002 Calibrated on 7th Nov 2015
15 Where applicable, and if not specified in the inspection method or procedure, reference
to or description of the sampling method and information on where, when, how and by
whom the samples were taken,
Nil.
17 The Due date of next Thorough Inspection,
Webbing Sling
WLL 8t
Length 3m
12* Information on what has been omitted from the original scope of work,
Nil.
Test Load Applied and duration held (as applicable)
Nil
KTLO (ME) FZC PO, DO, SO information
MESO Surveillance Visit 2015
16* If any part of the inspection work has been subcontracted, the results of this work shall be
clearly identified,
Nil.
18 The Due date of next Proof Load Test, if applicable,
Not Applicable / At surveyors discretion
20 Details of any major Repairs / Alterations carried out on the equipment, provided that the
clients inform IBs inspector of any modifications or structural repairs,
Nil.
In accordance with written inspection scheme and recommendation from previous inspection reports.
Was the examination carried out:
YES
NO
YES
NO
YES
NO
NO
YES
YES
NO
YES
NO
YES
N
O
N
O
Identification of any part found to have a defect which is or could become a danger to persons and a description of the defect: (If none state NONE)
NONE
Is the above a defect which is of immediate danger to persons?
Is the above a defect which is not yet but could become a danger to persons? (If YES state the date by when)
YES by:
Particulars of any major repair, renewal or alteration required to remedy the defect identified above:
NONE
Particulars of any tests carried out as part of the examination: (If none state NONE)
NONE
YES
N
O
hereby certify the equipment described in this certificate was tested and examined on 13.09.15 and found free from defects likely to affect safety and that the above particulars
are correct.
Gaudenfel F. Mahinay
Name
Signature
13 Sep 2015
Date
Company Stamp
S Morrison
TS Manager
Name
13 Sep 2015
Signature
Date
Company Stamp
26 The inspection certificate/report shall not be reproduced except in full without the approval of the inspection body and the client,
The Certificate / Report becomes invalid, if any alteration/major repair / modification made upon the equipment described herein, in which case it must be re-examined and re-tested.
30 This certificate is issued subject to the condition that it is understood that nothing herein contained shall be deemed liable to relieve
any designer, manufactures, seller, supplier, repairer or operator of any warranty, express or implied and KTL Offshore (ME) FZC liability
shall be limited to the acts or omissions of its employees, agents and subcontractors. Under no circumstances whatsoever shall KTL
Offshore (ME) FZC nor their engineer be liable for any damage to any person or occurring by reason of negligent operation or defects in
materials, machinery, equipment or other items than such defects ascertainable by normally accepted standards and only those items
actually inspected by KTL Offshore (ME) FZC and which are only covered by this certificate. Any person not a party to the contract
pursuant to which this document is delivered may not assert claim against KTL Offshore (ME) FZC for any liability arising out of errors or
omissions which may be contained in this said document and in connection with any activities for which it may provide. This certificate
shall not be reproduced in full without the approval of KTL Offshore (ME) FZC.
ISO9001:2008
ISO17020
KTLME-FORM-TS-005B