SSM Managing Corporates

Third party Inspection

Date: 4/07/2019
R. No.: LNTCONS/Pitham./01/040719

Report of examination of the lifting machine/ chain/ rope/ lifting tackle

under section 29 of factories act.

1 Name of occupier of Factory. : M/s. Larsen & Toubro Limited.

(Construction)
2 Address of the Factory. : 60MLD WTP PLOT
Near Bala ji Factory Rau Pithampur (MP)

3 Distinguishing Number or Mark, if any and : REWA MAKE EOT: CRANE

description sufficient to identify the lifting Make; Rewa
machine, chains, ropes or the lifting tackle. Capacity: SWL 10 MT
Location SR. NO. : 4860-1
Span:11.0 Mtr
Raw Water PM (Simrol)

4 Date when lifting machine, chain, rope or lifting : 2018

tackle was first taken into use in the factory.
5 Date and number of the certificate relating to : New Equipment (First Time Use)
any test and examination made under Rule
62(1) and 66 together with the name and
address of the person who issued the certificate.
6 Date of each periodical thorough examination made : 04/07/2019, by Mr. Ranjit Dafe
under clause (a) (iii) of sub-section (1) of section 29
of the Act and Rule 65(2), and by whom it was
carried out.
7 Date of annealing or other heat treatment of the : Not available
chain and other lifting tackle made under
Rule 65(1) and by whom it was carried out.
8 Particulars of any defect affecting the safe : Thoroughly examined all the vital parts
working load found at any such thorough Of the Lifting Machine, Proof Load Test performed
examination or after annealing and steps Load Locking / Holding checked
taken to remedy such defects. Hook- Upper Lower-OK
No defect found
I certify that on 04/07/2019, I have thoroughly examined the above mentioned lifting machine/chain/rope/ lifting
tackle and that the above is a correct report of the result.

Next inspection required: 03-07-2020

Website: ssmmanagingcorportes.com
E-mail: tpissmindore@gmail.com,
ssmmanaging@gmail.com
Mobile: 94250-58476, 96300-90877

Ranjit Dafe (BE, Mech.)

(Competent Person)
Competency No.: CMI:1810128
Disclaimer: This report of examination reflects the condition of the machine/equipment as on date. This report shall not be c onstrued as any warranty or
guarantee of the equipment inspected, or as to the equipments' future operating capabilities.