Form II

PART I

Initial and periodical load test of lifting appliances and their annual thorough examination.

[See Regulations 41 and 51]

"Thorough examination" means a detailed visual examination by a competent person; supplemented if necessary by other means such as a hammer test, carried out as carefully as the conditions permit, in order to arrive at a reliable conclusion as to the safety of the parts examined and if necessary for this purpose parts of the machines and gear must be dismantled.

(A)
Initial and periodical load tests of lifting appliances

Situation and Description of Lifting appliances tested with distinguishing number or marks if any

No. of certificate of test and examination of Competent person

I certify that on the date on which I have appended my signature the lifting appliance shown in Col. (1) was tested and no defects affecting its safe working condition were found other than those shown in Col. 5

Remarks (To be signed and dated)

Date and Signature With seal
2

Date and Signature With seal
3

(1)

(2)

(B)
Annual thorough examination

I certify that on the date to which I have appended my signature, the lifting appliance shown in Col. (1) was thoroughly examined and no defects affecting its safe working conditions were found other than those shown in Col. (12)

Remarks to be signed and dated

Date and Signature With seal

(1)

(2)

Note.-If all the lifting appliances are thoroughly examined on the same date it will be sufficient to enter in Column (1) "All lifting appliances". If not, the parts which have been thoroughly examined on the dates stated must be clearly indicated.

PART II

Initial and Periodical load test of loose gears and Annual thorough examination
[See Regulations 47 and 51]

List of Loose gear:

The following classes of loose gears namely-

1. Chains made of malleable cast iron;

2. Plate link chains;

3. Chains, rings, hooks, shackle and swivels made of steel;

4. Pitched chains;

5. Rings, hooks, shackles and swivels permanently attached to pitched chains, pulley blocks, container spreaders, rays, slings, baskets, etc. and any other similar gear.

6. Hooks and swivels having screw-threaded parts or case-hardened parts; and

7. Bordeaux connections.

Initial Test and periodical load test of loose gears
Distinguishing No. or marks		Description of loose gear tested and examined	No. of certificate I certify that on date to which of Test and exami- I have appended my signature the nation of competent loose gears shown Col. (1) & (2) person. were tested and no defects affecting the safe working condition were found other than those shown in col.(6)
			Date and Signature With seal with seal		Date and Signature With seal with seal
1		2	3	4	5
(1)
(2)
(3)
(4)
(5)
Annual thorough examination of loose gears
Remarks (To be signed and dated)		I certify that on the date to which I have appended my signature the loose gears shown in Col. (1) &(2) were thoroughly examined by me and no defects affecting their safe working condition were found other than those shown in Col. (10)
Date and Signature With seal with seal 6		Date and Signature With seal with seal 7	Date and Signature With seal with seal 8	Date and Signature With seal with seal 9	Date and Signature With seal with seal 10
(1)
(2)
(3)
(4)
(5)
(6)
PART III Annealing of Chains, Rings, Hooks, Shackles and Swivels (other than those exempted- (See Part-Il) [See Regulation 49 and 51]
12.5 mm and smaller chains rings, hooks, shackles and swivels in general useIf used with lifting appliance driven by power, must be annealed once at least in every 6 months. If used solely with lifting appliance worked by hand, must be annealed once at least in every 12 months.
Other chains, rings,hooks,shackles and swivels in general useIf used with lifting appliance driven by power, must be annealed once at least in every 12 months. If used solely with lifting appliance worked by hand, must be annealed once at least in every two years.
Note -It is recommended though not required by the Regulations-that annealing should be carried out in a suitably constructed furnace heated to temperature between 1100 and 1300 Fahrenheit or 600 and 700 Centigrade, for a period between 30 and 60 minutes.
Distingui shing No. or mark		Descripti on of gear annealed	No.of the certificate or test examination	I certify that on the dete to which I have appended my signature,the gear and described in Cols. (1) and (2) was effectually annealed under my super- and Vision,that after being so annealed Every article was carefully inspected And that on defects affecting its safe Working condition were found other Than with shown in column (7)	Remark ( to be signed dated)
		Date and signature with seal	Date and signature with seal	Date and signature with seal
1	2	3	4	5	6	7

Form II

FORM II

PART III