THE LIFTING OPERATIONS AND LIFTING EQUIPMENT

REGULATIONS (NORTHERN IRELAND) 1999

Report of Thorough Examination of Lifting Equipment

Policy / Contract No: 41032078 Schedule: L1 ES Item No: FLT2

Employer (or plant owner): MOORES ANIMAL FEEDS LTD

Occupier: MOORES ANIMAL FEEDS LTD

Address at which the examination was made: 116 CARNALBANAGH ROAD BROUGHSHANE BALLYMENA BT42 4NT

Item Status Specific risk of injury to persons identified. (AN)

1. Client No / Serial No FLT2 / SLPTLT3D5E0893480

2. Description of equipment Diesel Fork Lift Truck Telescopic

3. Location Yard

4. Name of manufacturer JCB teletruck 30D

5. Year of manufacture 2005

6. Safe working load 3000 kg @ 0.5 m to 4 m height

7. Type of examination / Frequency /

PERIODIC / 6 monthly / No Scheme (DL2-EPM)
Written scheme

8. Results
(a) Defects which require corrective action
before further use or before a specified
date
The lower bracket on the offside carriage ram is cracked at the welds and should be
restored to manufacturers specification before further use.
On-site report issued No. 330219-030

(b) Defects requiring corrective action as The driver's seat is damaged and should be repaired or renewed.
soon as reasonably practicable A weld between the offside of the carriage and the boom head is cracked and should be
restored to manufacturers specification.
Thr rear worklight is not operating and should be restored to working order.

(c) Observations None.

9. Date of previous thorough examination 11/12/2018

10. Latest date by which the next thorough examination should be carried out 20/12/2019

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I declare that the above equipment has been thoroughly examined on 20/06/2019 and, provided that you remedy any defects stated above,
this equipment is safe to operate. This declaration is made on the understanding that the equipment is used correctly and suitably
maintained. Where applicable, to review the current state of the art for safety on Lifts and Escalators, attention is drawn to BS EN 81-80
(Lifts) and BS EN 115 part 2 (escalators).

Authenticated by: Robert Hamill Contact: andrew.hamill@uk.zurich.com

Designation: Engineer Surveyor Telephone: 07875 888 324

Report No: 16210490/28 Date Authenticated: 20/06/2019