LAXMI ENGINEERS

#101 Pratap Nilayam, Pragathi Nagar, Hyderabad-500090, Telangana State, INDIA.

Email Id: laxmiengineers62@gmail.com, laxmiengineers62@yahoo.com
Mobile Number:9948130043,8019983405,9676231139

FORM NO - 38
(Prescribed under Rule 55 & 55A)
(Report of Examination of Hoist or Lift or Lifting Machinery / Tackle)
Ref. No.DERRIC/5T/T1
Name of the Occupier ( or Factory) : M/s.HABEEB DAFEDAR
Situation address of Factory Hyderabad, Telangana State-500084
1 (a) Type of Hoist or Lift or Lifting Machinery/ : Derrick Poles, Qty:5 No,
Tackle and identification number or description. 5 Pieces each (LENGTH 43CMSX45CMS WIDTH),
Present Height: 12.5M, Capacity: 5 T,
With Single & Double Sheave Pulleys, Guy ropes,
with 13mm Rope dia.
(b) Date of Construction or Reconstruction (if ascertainable) : -
2 Design and Construction( Are all parts of the Hoist or Lift or Satisfactory
Lifting Machinery / Tackle of good mechanical construction,
sound material and adequate strength as far as ascertainable.) :

3 Distinguished Number of mark (if any) and : ID No 1: 555, ID No 2:556, ID No 3:557,

Description sufficient to Identify the Lifting Machine, Chain ID No 4:558, ID No 5:559.
ropes or the Lifting Tackle. Location: : My home Sayuk, Tower II, On Terrace.
4 Maintenance: Are the following parts of the Hoist or Lift
properly maintained and in good working order? If not, state : Not applicable
what defects have been found
a) Enclosure of Hoist way or Lift way : --------
b) Landing gates and cage gate(s) : --------
c) Interlocks on the landing gate(s) and cage gate(s) : --------
d) Other gates, fastenings : --------
e) Cage and Platform and fittings, guiders, buffers, interior of : --------
the Hoist way or Lift way
f) Over-running devices : --------
g) Suspension ropes or chain and their attachments : --------
h) Safety gear i.e. arrangements for prevention : --------
fall of platform or cage brakes
i) Brakes : --------
j) Worm or spur gearing : --------
k) Other electrical equipment : --------
l) Other parts : --------
5 What parts (if any) were inaccessible : Nil
6 (a)Repairs renewals or alternations (if any) required and the Nil
period within which they Should be executed. :
(b) Particulars of the parts of Hoists or Lifts or Lifting Nil
Machinery / Tackle rejected after the examination. :
7 Maximum safe working load subject to repairs, renewals or Capacity: 3T
alterations (if any) specified in Column(6) :
8 Others :
The Derrick Poles are in good working condition. Hence it is fit
for use lifting loads upto its rated capacity 3T each.
I/We certify that on 18/03/2024. I/We thoroughly examined this Hoist / Lift /Lifting Machine/ Tackle and the above is a correct report
of the result . This certificate is Valid Up to:17/09/2024.

Name of the Competent Person: B.Naveen Bhargav

Regn No: L. Dis A4/1310/2023, Valid : 08-04-2024 Signature