Chartered Engineer, Competent Person,TPI Inspection, Calibration & Certification Services
Report No.: AE/MC/VAGRA/2024/001 Date: 20/05/2024
FORM NO. 10
(Prescribed under Rule 60)
Report of Examination of the Lifting Machines, Ropes and Lifting Tackles
Registration No :
License No : NA
NIC Code No :
(As given in the license)
PARTICULARS
1. Name of Occupier of Factory : M/s. MADHAVI CONSTRUCTION
2. Address of the Factory : C/o.Jubilant Infrastucture Limited, Plot No.:5, GIDC
Industrial Estate Village:Vilayat,Ta:Vagra-392012
3. Distinguishing Number or Mark (if any) and : Electrical Wire Rope Winch Operated Bucket Lift
description sufficient to identify the lifting Sr No.:D24-007, Make:Safari,Model:STHE,Max.
machine, chain, rope or the lifting tackle Cap:600 Kg,SWL:500 Kg, Wire Rope Dia.:12 mm,
Bucket Size: (1455x800x650)mm,
Working Height:16.5 mtr., Last Landing Floor:2nd,
Installed at:Ground floor, Loc.:NIA Main Plant.
4. Date when lifting machine, chain, rope or : 20/02/2024
Lifting tackle was first used in the Factory
5. Date of each examination made under section : On 20/05/2024 by Mr. Pritesh Modi.
29(1)(a)(iii) and by whom it was carried out General condition of Equipment checked by visual
inspection & Found Ok.
Functional Load test Carried out at 600 Kg at Present
Working Height & Found ok.
6. Date and number of the certificate relating to : First Time by us.
Any test and examination made under sub-rule
(1) of rule 60 together with the name of the
Person who issued the certificate
7. Date of annealing or other heat treatment if the : Not Applicable
chain and lifting tackle carried out under Sub-
rule (5) of rule 60 and by whom carried out
8. Particulars of any defect found at any such : No Defects Noticed. Safe to Use at SWL Capacity.
Examination or after annealing and affecting the
safe working load and the step taken to remedy
such defect
Remarks: Routine checking of above equipment should be carried out by user for its proper functioning and
safe operation before use the equipment for lifting operation.
I certify that on 20/05/2024, I thoroughly examined the above mentioned lifting
machine/chain/rope/lifting tackle and that the above is a correct report of the result.
FOR ADITYA ENTERPRISE,
PRITESH MODI
Cert. No.: GUJ/DISH/CPT/A/0717/2018
Validity: 02/04/2024 to 01/04/2025
Issued By: Director Industrial Safety& Health, Gujarat State
NEXT DATE OF TESTING DUE ON 19/05/2025
Note: Equipment should be retested immediately after any repairing work carried out.
872/1, MOCHIWAD, CHAUTA BAZAR, ANKLESHWAR – 393001, (D) BHARUCH, GUJARAT
Mobile: 7575001352 E-mail: adityaenterprise@outlook.com
