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FORM – XVII

(See Regulation 392(4)

QUESTIONNAIRE FORM FOR REPAIRER OF BOILERS / ECONOMISER / STEAM /


LINE / FEED WATER LINES ETC., UNDER THE INDIAN BOILER
REGULATIONS, 1950

1 Registered name of the firm and its : Sri Harish Ramakrishna Aithal
permanent address M/s Ananya Engineering and Construction
Laxmi, 1st Floor, Jalligudda Road, Ashoka
Nagar Post, Kotttara Chowki, Mangalore –
575 006
2 Year of establishment : 2011
3 Classification applied for :
(a) IIIrd Class < Boiler Pressure 17.5 : -
kg/cm2
(b) IInd Class > Boiler Pressure 17.5 : -
kg/cm2 to 40.0 kg/cm2)
(c) Ist Class > Boiler Pressure 40.0 : Ist Class -
kg/cm2 to < 100.00 kg/cm2
Special Class > Boiler Pressure -
100.00 kg/cm2
4 Type of jobs executed by the firm : Erection of ,process equipments and
earlier, with special reference to t heir process Piping, oil piping in Petroleum
maximum working pressure, Refining industries and chemical industries
temperature and the material involved,
with documentary evidence.
5 Whether the firm has ever been : – No –
approved by nay Boilers’ Directorate /
Inspectorate ? If so, give details
6 Whether having rectifier / generator, : Yes . The details are enclosed in annexure
grinder, general tools and tackles, dye “A”
penetrant kit, expander and measuring
instruments or any other tools and
tackles under regulation 392(5)(i)
7 Detailed list of technical personnel : Yes . The details are enclosed in annexure
with Xerox copy of the Welders’ “B”
current certificate permanently
employed with the firm
8 How many working sites can be : One
handled by the firm simultaneously ?
9 Whether the firm is prepared to : Yes
execute the jot strictly in conformity
with the regulations and maintain a
high standard of work ?
10 Whether the firm is prepared to accept : Yes
full responsibility for the work done
and is prepared to clarify any
controversial issue if required ?
11 Whether the firm is in a position to : Yes
supply materials to required :
specification with proper test
certificate if asked for ?
12 Whether the firm has an internal : Yes. It has well defined quality control
quality control system of their own ? standard monitored by qualifies personnel
If so, give details
13 Qualification and experience of the : The details are enclosed in annexure “C”
personnel employed

Date: Signature of the authorized


Place Signatory of the firm with stamp

Note: 1 The recognition of the firm as a repairer shall be for a period of two years, thereafter
they shall apply for renewal of their recognition at least two months before the
expiry of the said period.
2 In case the repairer is found indulging in violating the provisions of the Act /
Regulations knowingly or unknowingly, the firm shall be blacklisted under
intimation to Chief Inspectors or Directors of Boilers of all the States / Union
territories and renewal shall not be done in any case.
Annexure “A”
The details having rectifier / generator, grinder, general tools and tackles, dye penetrant kit,
expander and measuring instruments or any other tools and tackles under regulation 392(5)(i)
S.No Name Make Qty
rectifier
rectifier
generator
grinder
Spanner
dye penetrant kit
expander
and measuring instruments
Annexure “B”
The list of technical personnel 392(5)(i)
S.No Name designation Age
Annexure “C”
Qualification and experience of the personnel employed 392(5)(i)
S.No Name Qualification Experience
M/s Ananya Engineering and Construction
Laxmi, 1st Floor, Jalligudda Road, Ashoka Nagar Post, Kotttara Chowki, Mangalore – 575 006

Ref. No: AEC/IBR/2016-17 Date: 10.01.2017

To

The Director of Boilers


Government of Karnataka
Department of Factories, Boilers, Industrial Safety and Health
Room No.201, Karmika Bhavan
Bannergatta Road
Bangalore – 560 029

Sir,

Sub: Recognising our firm as first class boiler repairer under regulation 392 of
Indian Boiler Regulation 1950 and its latest amendments – Reg.

With reference to above cited subject, we wish to inform your good self that we are
carrying out the fabrication and erection of process piping, oil piping and Non-IBR Steam piping
in process industries and oil refineries in accordance with various International Standards. Also
we have erected process equipment in process industries and oil refineries. Also we are carrying
out the cleaning of waste heat recover boilers installed in oil refineries.

With our technical background and technical staff, we intent to take up the work related
to boilers, economizer and steam lines. Hence, we seek your recognition as first class boiler
repairer under regulation 392 of Indian Boiler Regulation 1950 and its latest amendments. We
have sufficient tools, tackles, machines and equipment prescribed under Regulation 392(5)(i) of
IBR 1950 and also we have well defined quality standards to be enforced while carrying out the
works related to boilers, economizer and steam lines under Indian Boiler Regulation 1950. Also
we have qualified technical personnel to execute the works related to boilers, economizer and
steam lines under Indian Boiler Regulation 1950. In this regard we are submitting FORM –
XVII.

We respectfully request your good self to recognize our firm as first class boiler repairer
under regulation 392 of Indian Boiler Regulation 1950 and its latest amendments.

Yours faithfully

(Harish Ramakrishna Aithal)