REPORT OF TESTING/EXAMINATION OF LIFTING MACHINE

(Unde Section 29, Rule 57-A of Rajasthan Factory Rule, 1951)

1. Certificate No. : QMSIL/2019-20/SI-LM/CPB/IOCL(C)-01

Name of the Organization : M/s Indian Oil Corporation Ltd.

Western Region Pipe Line (WRPL)
2. Address : Phagi Road Chaksu, Jaipur
3. Name of the Occupier : M/s Indian Oil Corporation Ltd. Western
Region Pipe Line (WRPL)
4. Distinguishing Mark : WCL-CPB-01
5. Description : Chain Pulley Block
6. Date of Inspection : 27.02.2019
7. Manufacturer’s Specification
a. Name & Year : NA
b. Serial No. : NA
c. Capacity : 5.0 Ton
8. Location in the Plant : Main Line Store
9. Wire rope size/chain : Two Link Chain
10. Condition of Assemblies/Sub Assemblies/Parts
a. Wire Rope/Load Chain : Normal
b. Gear : Normal
c. Brakes : NA
d. Rope/Chain Drum : NA
e. Hoisting Limit Switches : NA
f. Mono Rails
g. Hook : Normal
11. Next Date of Inspection : 26.02.2020
12. Load Available for Testing : 6.25 Ton
13. Defects/Repair if required : No
14. Recommendation : Advice to Check Safety Measures
Periodically
15. Safe Working Load Assessed : 10 Ton

I certify that I have thoroughly examined the lifting machine and the same is found safe. This report is a true report
of the Inspection.

Vishwani Kumar
Competent Person on Behalf of
M/s QMS India Limited, Jaipur No.
F_82/2018/2805, Dated 02.01.2019 (Sign with Seal)