F7, cvonn wo GROUP PURIFIER PUNE ol CHECK Doe Ref MS-DD-S000-HSE-PRO-0022 Form No: MS-DD-3000-HSE-FRN-OO_ Date: 10 Apa 2020 MANYAR SMELTER PROJECT _| Revision No: 00 Equipment No. Log Book: Y /N Date: Registration No.: Model Y_/_N. Owner's Manual: Y / N Classified Plant ‘Serial No.: NA) Not Applicable (X) Requires and / or Repair Pe Nat) GOOD iz. Sle) 1 | Name Plate Panel Electrical cables and plug Receptacle Battery Grounding Gauges Valves clelrlolalalo|s Pressure Relieve Valves 3 Fitting flanges connection Tanks 12 | Motor housing 13 | Outlet fitting 14 | Inlet fiting 15 | Hoses 16 | Drip pan + 2% containment 17 | Cover belt 18 | Oil Drain 19 | Frame condition 20 | Cover machine Remarks: Inspected By (competent person): Subcontractor ‘CONTRACTOR USE ONLY ‘Mobilization of the equipment based on the information provided is approved CI Not approved O Contractor Representative (Print Name) Contractor Representative Signature Date 7 Date: