‫الــفـــريــــق الســتــشــــارات الســـالمــــة‬

TEAM SAFETY CONSULTANTS

EXAMINATION AND TEST OF
LIFTING GEARS, LIFTING APPLIANCES AND LIFTING EQUIPMENT
Job No.: Certificate/ Report No.:

Client Name & Address Name & Address of Maker or Supplier of Equipment:

Location: Reference Regulation: Survey Requested by:

Date of Previous Test: Previous Test Done by.: Type of Inspection:

DESCRIPTION
ID / No Qty Tested Load Safe Working Load
(Make/Name, Model, Type, Dimension, Date of Manufacture, etc)

Tsc Test Method No. Tsc Test Equipment No. Date of Inspection Date of Issue: Date of Expiry:

TSC/TM/ TSC/EQ/

Name and position of person who

EQUIPMENT STATUS:
Carried out the inspection and test:
SATISFACTORY

NOT SATISFACTORY

_______________

Inspection Engineer

TSC-F-91A (Rev.06) (20/04/2019) Page 1 of 2

 TSC Approved by:
Labor Ministry, Dubai Municipality
Civil Defense – Dubai & Jebal Ali Free Zone Authority (Trakhees)
Member of Lifting Equipment Engineers Association (LEEA),
ISO 9001:2015 (QMS) Certified Company
Member of Scaffold & Access Industry Association (SAIA)
Institution of Occupational Safety and Health (IOSH)
Emirates International Accreditation Center ( EIAC- Dubai Municipality)
Accreditation Certificate No – 004 IB

TEAM SAFETY CONSULTANTS, TRADE LICENSE NO.500714, AL – GARHOUD, P.O.BOX: 112349, DUBAI – UAE, TEL: 042828868, FAX: 04-2865265

Continuation of Job No.: Certificate No.:

REMARKS AND RECOMMENDATION

TSC-F-91A (Rev.06) (20/04/2019) Page 2 of 2