SIMO Research Engineers Pvt. Ltd.

FIELD INSPECTION REPORT OF SAFETY CERTIFICATE

(U/R 43) Sheet 1 of 6

Owner’s Name: ___________________________________ Owner’s & Attender’s Mob. No. : _________________

Owner’s Address [ for rule 43 ]: ________________________________________________________________________
Owner’s E-mail Id: ___________________________________________ Licence From: __________________________
Test Place : _______________ Billing Details: In the name of :
__________________________________________________
GST No.:______________________________ GST Add.: __________________________________________________________
Inspection / Test date _______________ Pressure:______Kg/cm2 (hydraulically) and ______ Kg/cm2 (pneumatically)

1. VEHICLE PARTICULARS :
Vehicle Registration No. :

Make, Model, Year of mfg. : Running

Gear No.
Engine No. : Make
Chassis No :
Unladen weight (as per R.C. : Kgs Double Axle / Triple Axle
/W.S. ) Other
Details:
Maximum laden weight : Kgs
2. VESSEL AND FITTINGS
A. Identification No. :
Fabricator's Name :
Particulars of Inspection Certificate :

Design code : IS: 2825, 1969, Cl-1 + SMPV(U) Rules,1981 / 2016

Design pressure (Kg/cm2g ) :
Design Temperature (°C)
Water capacity [ in litres ] :
Name of the gas to be transported :
Initial Hydrotest done on (date) :
At pressure :
By (Inspection Agency) :
Last Hydraulic test done on (date) :
At Pressure :
By (Inspection Agency) :
Ultrasonic Thickness Measurement Shell (in mm) Dish end (in mm)
Thickness readings observed (final) [ Please :
refer attached sheet for thickness details]

B. FITTINGS PARTICULARS No. 1 No. 2 No. 3

Safety Valves
Identification No. :
Manufacturing Date :
Make :
Set Pressure (PSIG) :
Tested on (Date) :
Test pressure (PSIG) :
By (Competent Authority) :
Discharge flow rate :
SIMO Research Engineers Pvt. Ltd. Vessel no.: Sheet 2 of 6

Whether housed in weld caps : Weld cap / Shroud

If not, detail of the protection provided.
ii) Level gauge
a) Maximum Level gauge / Magnetic Level gauge : Make: Location: Top of the vessel
Sl. No.: Mfg. Date:

b) Rotogauge : Make: Location: Side / on the manhole of the vessel

Sl. No.: Mfg. Date:
Pressure Gauge Make: Range: Dial size:
Pressure gauge EFCV : Make:
Sl. No.: Mfg. Date:
Temperature gauge [ 0C] : Make: Range: Dial size:
Internal EFCV Details No. 1 No. 2 No. 3
Location : Liquid / Vapour line Liquid / Vapour line Liquid / Vapour line
Identification No. :
Make : CEMPL / EPM / REGO CEMPL / EPM / REGO CEMPL / EPM / REGO
Size : 2” NPT / 1.5 “ NPT 2” NPT / 1.5 “ NPT 2” NPT / 1.5 “ NPT
Manufacturing date :
Closing flow rate : GPM GPM GPM
Date of last test :
Discharge valve) Liquid / Vapour line Liquid / Vapour line Liquid / Vapour line
Type : Ball valve Ball valve Ball valve
Make :
Size : 2” NPT / 1.5 “ NPT 2” NPT / 1.5 “ NPT 2” NPT / 1.5 “ NPT
Drainage pipe ( Size) : 1” NPT / 2” NPT Plugged

4. VEHICLE DESIGN PARTICULARS

Fire resisting shield (nature of construction) : Rear side of drivers cabin acts as a fire resisting shield, All steel construction

Gap between driver's cabin and vessel (Min. 15 cms.) :

Fuel tank capacity: : Litres [ whether steel / fibre construction ]
Battery and cut-off switch : 1 x 12V / 2 x 12V battery
(Nature, capacity & location) Cut-off switch: Yes / No, Inside drivers cabin

Particulars of wiring :
Whether properly fixed and protected Yes / No
Earthing points (Construction & Location) : Discharge valves / Base plates
Electrical wiring particulars : OK / Not OK
Clearance between end of vessel and end :
of rear bumper (Min. 7.5 cms.)

Guard railing around vessel : 40 / 50 NB MS Pipe N.A.

(Applicable for small tankers – upto 25.0 MT GVW) Condition:
No of `’I’' bolts / `’U’' bolts provided & no. of base :
plates
Lock nut provided or not : Yes / No
Padding particulars : Yes / No
Condition of chassis and its fittings - : Satisfactory / Not Satisfactory
Manhole cover thk. & no. of studs &nuts : mm
Particulars of fire extinguishers provided : 2 nos. DCP type, 09 Kgs (each), Make:
Whether height barrier provided / Condition : Yes / No ; Satisfactory / Unsatisfactory
Spark Arrestor Details [ MAKE, SERIAL NO. & CCOE’S APPROVAL :
NO. ]
EMERGENCY-KIT Details [ MAKE, SERIAL NO. & CCOE’S :
APPROVAL NO. ]
SIMO Research Engineers Pvt. Ltd. Vessel no.: Sheet 3 of 6

NOTE: ALL DISTANCE SHOULD BE MEASURED IN

5. PARTICULARS OF VEHICLE’s DISTANCE MILIMETER ONLY
MEASUREMENT
1] FRONT OVERHANG

2] REAR OVERHANG

3] WHEEL BASE OF PRIME MOVER

4] KING PIN OFF-SET DISTANCE

5] OVERALL LENGTH OF THE VESSEL

6] OVERALL LENGTH OF THE VEHICLE

7] CIRCUMFERENCE OF VESSEL

8] OUTER / INNER DIAMETER OF VESSEL

9] DISTANCE BETWEEN [ WL – WL ] / [ TL – TL ] WL – WL = TL - TL =

10] EXACT POSITION OF ROTOGAUGE i] SIDE OF THE VESSEL ii ] ON THE MANHOLE iii] _______________________

11] MEASUREMENT OF DISHED END [ SHAPE: (TORRI / HEMI) SPHERICAL

]

12] CHESSIS EXTENTION:[ REQD. TO BE CHECKED FOR EACH VEHICLE ]

13] SRV NOZZEL LOCATION: [ WHETHER BACK / MIDDLE / FRONT ]
14] LOCATION OF LADDER [ FRONT SIDE / MIDDLE / BACK SIDE ]:

15] LOCATION OF EXHAUST PIPE [ FRONT/ DRIVER’S SIDE OF PRIME MOVER] / [ NEAR THE FRONT WHEEL /
NEAR THE REAR WHEEL OF PRIME MOVER ]
16] WHETHER THERMAL SHIELD PROVIDED BY CHASSIS i] satisfactory II] unsatisfactory
MANUFACTURER FOR ENTIRE EXHAUST PIPING SYSTEM
17] HEIGHT BARRIER [ BOX TYPE OR NOT ]

18] ELECTRICAL WIRING [ THROUGH THE CONDUIT PIPE OR NOT ]

19] EARTHING STRIPS [ CONNECTED OR NOT ] i] between the flanges ii] between the base plates iii] any other places

20] WHETHER ACME ADAPTOR WITH CAP PROVIDED OR NOT [FOR EACH
LIQUID & VAPOUR INLET / OUTLET PIPE LINE ]
21] WHETHER AT LEAST 6 METERS LONG EARTHING CABLE PLACED
BEHIND THE DRIVER’S CABIN OR NOT
22] WHETHER “PRIME MOVER TO VESSEL” EARTHING CABLE PROVIDED
OR NOT
23] WHETHER OPEN & CLOSE DIRECTION FOR DISCHARGE VALVE
PROPERLY ARROWED & PAINED OR NOT]
24] WHETHER BRAKE LIGHTS & PARKING LIGHTS ARE IN WORKING
CONDITION
25] EXACT POSITION AND ORDER OF FIXED LEVEL GAUGE AND SRV’S. P.M. FLG/SRV FLG/SRV FLG/SRV FLG/SRV R.G.
26] EXACT POSITION AND ORDER OF IEFCV [ LIQUID LINE & VAPOUR P.M. LIQ. / VAP. LIQ. / VAP. LIQ. / VAP. R.G.
LINE]

1) Existing Licence No.: Valid upto:

2) Rule 43 to be issued due to: (a) New Vessel, (b) Change of Ownership, (c) Change of Prime Mover [ Horse], (d) Change
of Trailer Chassis [ Running Gear ], (e) Change of Product, (f) Change of Registration No., (g) Change of Jurisdiction, (h)
Accidental Vehicle (i) for Vessel Modification (j) Change of Chassis for fixed Chassis vehicle (i) for any other reason [ Please
Spacify]

3) Any other notable remarks:_________________________________________________________________________

_________________________________________________________________________________________________

………………………………… ……………………………………….
Signature for on behalf of Signature of customer
SIMO Research Engineers Pvt. Ltd. with company seal
 Sheet 4 of 6

UTM REPORT

Vessel No.: Tanker No.:

Date of Test:

OBSERVED SHELL & DISHED END PLATE THICKNESS (in mm)

ORIENTATION IN DEGREE
(00) (450) (900) (1350) (1800) (2250) (2700) (3150)

SHELL
END
SHELL
END
SHELL
END

DISHED
END-1
DISHED
END-1
DISHED
END-2
DISHED
END-2

Signature for & on behalf Signature of Customer

of SIMO Research Enginners Pvt. Ltd. With Company Seal

Please take good snap of following details listed below: 13] pics of Spark Arrestor [ if applicable]
14] pics of Safety kit
1] pics of front view of Prime mover 15] pics of top Weld Cap
2] pics of rear view of Prime Mover 16] pics of IEFCV’s
3] pics of Exhaust pipe 17] pics of Fuel ( Oil ) tank
4] pics of Prime Mover from Driver’s side 18] pics of Manhole
5] pics of Engine no. 19] pics of King-pin
6] pics of Chassis no. 20] pics of Fire Extinguisher
7] pics of Running Gear 21] pics of Height Barrier
8] pics of rear side of the vessel 22] pics of Lifting Lug
9] pics of vessel name plates. [ both ] 23] pics of Ball Valves
10] pics of Pressure Gauge 24] pics of Drainage pipe
11] pics of Temparature Gauge 25] pics of Jacks & Props, Ladder,Fire Screen etc.
12] pics of Rotogauge
 Sheet 5 of 6

2-D DRAWING OF PRIME MOVER

REMARKS:
 Sheet 6 of 6

SIMO Research Engineers Pvt. Ltd.

FIELD INSPECTION REPORT OF SAFETY CERTIFICATE (U/R 43)
[1] OWNER’S DETAILS

OWNER ATTENDER
COMPANY MOB. NO.
MOB. NO. E-MAIL ID
E-MAIL ID

[2] VEHICLE & RUNNING GEAR PARTICULARS

NEW P.M. OLD P.M.

MAKE & MODEL MAKE & MODEL
ENGINE NO. R.G. NO. Double / Triple Axle
CHASSIS NO. R.G. MAKE

[3] VESSEL PARTICULARS

VESSEL NO. DESIGN PRESSURE

FABRICATOR’S NAME DESIGN TEMPARATURE
TPIA HYDROTEST PRESSURE
COC NO. & ISSUE DATE WATER CAPACITY
FIRST HYDROTEST DATE PRODUCT

[4] FITTING PARTICULARS

SRV NOS.
MAKE
MANUFACTURING DATE
SET PRESSURE
DISCHARGE FLOW RATE
IEFCV NOS.
LOCATION LIQ. LINE / VAP. LINE LIQ. LINE / VAP. LINE LIQ. LINE / VAP. LINE
SIZE 2” NPT / 1.5” NPT 2” NPT / 1.5” NPT 2” NPT / 1.5” NPT
MAKE
MANUFACTURING DATE
DIFFERENTIAL PRESSURE
CLOSING FLOW RATE
DISCHARGE VALVE
MAKE
SIZE 2” NPT / 1.5” NPT 2” NPT / 1.5” NPT 2” NPT / 1.5” NPT
FIXED LEVEL GAUGE MAKE: SL.NO.: MFG. DT.:
ROTAGAUGE MAKE: SL.NO.: MFG. DT.:
PRESSURE GAUGE MAKE: RANGE: SIZE:
P.G. [3/4” NPT EFCV] MAKE: SL.NO.: MFG. DT.:
TEMPARATURE GAUGE MAKE: RANGE: SIZE:
SPARK ARRESTOR MAKE: SL.NO.: WHETHER INBUILT
/PROVIDED
SAFETY KIT MAKE: SL.NO.:

[5] OTHER PARTICULARS

FUEL TANK CAPACITY: STEEL / FIBRE FRONT GAP

NO. OF BATTERY / IES 1 / 2 X 12 V DRAIN SIZE: 1” / 2” NPT REAR GAP
FIRE EXTINGUISHER MAKE: WL-WL [ tank ]
NO. OF STUD & NUTS “I” / “U” SIZE OF STUD: CIRCUMFERENCE [ tank ]

[6] REMARKS [ if any ]