Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)

TC. No: 5800-19/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : D-SHACKLE

description sufficient to identify lifting machine, Capacity – 25 Ton, SWL- 25 Ton
chain, rope or the lifting tackles. Clip Size – 48 mm, Body Size – 41mm,
Qty– 4 Nos.

4) Date when the lifting machine / tackle was : 2017

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.
 Examination Report of Lifting Machines / Lifting Tackles
(Under Section 29 of factory Act 1948)
TC. No: 5800-20/ JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : D-SHACKLE

description sufficient to identify lifting machine, Capacity – 10 Ton, SWL- 10Ton
chain, rope or the lifting tackles. Clip Size – 32 mm, Body Size – 28 mm,
Qty– 10 Nos.

4) Date when the lifting machine / tackle was : 2018

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-21/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : D-SHACKLE

description sufficient to identify lifting machine, Capacity – 5 Ton, SWL- 5 Ton
chain, rope or the lifting tackles. Clip Size – 22 mm, Body Size – 18 mm,
Qty– 10 Nos.

4) Date when the lifting machine / tackle was : 2018

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019
Dr. K K AGRAWAL (COMPETENT PERSON)
Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-22/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : D-SHACKLE

description sufficient to identify lifting machine, Capacity – 2 Ton, SWL- 2 Ton
chain, rope or the lifting tackles. Clip Size – 16 mm, Body Size – 12 mm,
Qty– 12 Nos.

4) Date when the lifting machine / tackle was : 2017

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
 TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-23/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : D-SHACKLE

description sufficient to identify lifting machine, Capacity – 1.0 Ton, SWL- 1.0Ton
chain, rope or the lifting tackles. Clip Size – 12 mm, Body Size – 8.0 mm,
Qty– 8 Nos.

4) Date when the lifting machine / tackle was : 2018

first taken to use in the factory
5) Date and number of the certificate relating to : As per Manufacturer’s T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.
I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-24/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : BOW-SHACKLE

description sufficient to identify lifting machine, Capacity – 10 Ton, SWL- 10Ton
chain, rope or the lifting tackles. Clip Size – 32 mm, Body Size – 28 mm,
Qty– 4 Nos.

4) Date when the lifting machine / tackle was : 2018

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.
8) Particulars of any defects affecting the safe : No defects observed.
working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-25/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : BOW-SHACKLE

description sufficient to identify lifting machine, Capacity – 5 Ton, SWL- 5Ton
chain, rope or the lifting tackles. Clip Size – 22 mm, Body Size – 18 mm,
Qty– 2 Nos.

4) Date when the lifting machine / tackle was : 2018

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out
7) Date of annealing or other heat treatment of : Not Applicable
the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-26/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : D-SHACKLE

description sufficient to identify lifting machine, Capacity – 3 Ton, SWL- 3Ton
chain, rope or the lifting tackles. Clip Size – 18 mm, Body Size – 15 mm,
Qty– 10 Nos.

4) Date when the lifting machine / tackle was : 2018

first taken to use in the factory
5) Date and number of the certificate relating to : Manufacturers T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.
6) Date of each periodical thorough examination : Tested by us 18-12-2018
made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-06-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.

Examination Report of Lifting Machines / Lifting Tackles

(Under Section 29 of factory Act 1948)
TC. No: 5800-27/JP/18-19
1) Name of Occupier (of Factory) : M/s Rotostat Services Private Limited

2) Address of the Factory : Site- IOCL, Refinery, Panipat, Haryana

3) Distinguishing number of mark if any and : WEBBING Polyester Sling Belt
description sufficient to identify lifting machine, S. No.- 16321010
chain, rope or the lifting tackles. Make - DEEP
Capacity – 10 Ton
Length– 10 Mtrs.
Qty– 2 No.

4) Date when the lifting machine / tackle was : As per Manufacturer’s T.C.
first taken to use in the factory
5) Date and number of the certificate relating to : As per Manufacturer’s T.C.
any test and examination made under rules (1)
and (7) together with the name and address of
the person who issued certificate.

6) Date of each periodical thorough examination : Tested by us on 18-12-2018

made under sub-clause (ii) of clause (a) of
subsection (1) of section 29 of the Act and
sub-rule (6) and by whom it was carried out

7) Date of annealing or other heat treatment of : Not Applicable

the chain and other lifting tackle made under
sub-rule (5) and by whom it was carried out.

8) Particulars of any defects affecting the safe : No defects observed.

working load found at any such thorough Over all in fair & safe working condition.
examination or after annealing and the steps Found Ok.
to taken to remedy such defects.

I/We certify that on 18-12-2018. I/We thoroughly examined the above mentioned Lifting Machine / Chain /
Rope / Lifting Tackle and the above is a correct report of the result.
TC Valid Up to: 17-07-2019

Dr. K K AGRAWAL (COMPETENT PERSON)

Competent Person U/S 21(2), 28, 29, 31 & 87
Approved by the CIF Haryana Vide Lic. No. 2345 Dated 02.06.2017 COUNTER SIGN
Disclaimer:- This report of examination reflects the conditions of the machine/equipment as on date. We accept no
liability/responsibility whatsoever in case of any accidents/mishap/on/with/due to this machine/equipment.