DOLE-OSHC

CHETO Accreditation No.

1410-21100821-0033

ELECTRIC POWERED ARTICULATED PLACING BOOM TESTING AND INSPECTION

DATE OF INSPECTION: JULY 16, 2022 REPORT NUMBER: IND-MWIDE-002-82

OWNER PLACE OF INSPECTION REFERENCE STANDARD

MEGAWIDE CONSTRUCTION CORPORATION University Tower 5 Project, ISO 21573

España, Manila
20 N.Domingo St., Brgy. Valencia, Quezon City

CLIENT REPRESENTATIVE MAKER MANUFACTURING DATE

MR. REYLAN JURILLA PUTZMEISTER 2011

COMPANY I.D NO. MODEL NO. DELIVERY SERIAL NO.

PRESSURE(MAX.)

PB-04 MXR 30-3 2176 Psi 181800046

EQUIPMENT DETAILS:
ELECTRIC POWERED ARTICULATED PLACING BOOM
TEST DESCRIPTION:
• DURING FUNCTIONAL TEST, PLACING BOOM WAS TESTED WITHIN RATED PRESSURE (HYDRAULIC &
DELIVERY), ENGINE ON PERMISSIBLE SPEED. NO ABNORMAL CONDITION WAS OBSERVED.
• REVIEW OF MAINTENANCE RECORDS
• CHECK THE SET UP OF STATIONARY CONCRETE PUMP. MAST MOUNTING WERE BEING UTILIZED.
• THERE WERE NO SIGN OF WEAR AND TEAR ON CONCRETE PUMP STRUCTURE.
• CHECK ALL THE SAFETY DEVICE AND ENSURE IT IS AVAILABLE AND FUNCTIONING
• CHECK ALL THE HYDRAULIC HOSE FOR LEAKS.
• NO LEAKAGE ON HYDRAULIC DEVICES AND NO CRACKS AROUND THE DIESEL TANK.

THE EQUIPMENT WAS FOUND SAFE AND FIT FOR OPERATION.

Inspection Rating: A1- FIT TO USE

VALIDITY
This report is valid only for one (1) year from the inspection date and at the present configuration, location, and equipment
application. The equipment must be subjected to another inspection after any change, alteration, or modification.

LAST INSPECTION DATE NEXT INSPECTION DATE LAST LOAD TEST NEXT LOAD TEST DATE
DATE
JULY 15, 2023
NO INFORMATION (OR NEXT CONFIGURATION NOT APPLICABLE NOT APPLICABLE
CHANGE)

This intervention is governed by the general terms and conditions of RGC Engineering and Consultancy Services. Any person not a party to the
contract pursuant to which this document is delivered may not assert a claim against RGC Engineering and Consultancy Services for any liability
arising out of errors or omissions which may be contained in said document, or for errors of judgment, fault or negligence committed any of its agents in
the establishment or issuance of this document, and in connection with any activities for which it may provide.

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 DOLE-OSHC
CHETO Accreditation No.
1410-21100821-0033

ANNEX TO ARTICULATED PLACING BOOM WITH CONCRETE PUMP TESTING AND INSPECTION

DATE OF INSPECTION: JULY 16, 2022 REPORT NUMBER: IND-MWIDE-002-82

PASSED
FAILED REMARKS
NO. DESCRIPTION
N/A

1. GENERAL COMPONENTS, STRUCTURE AND PROCEDURES

Appearance of the placing boom has been

PASSED GOOD CONDITION
presented with articulated boom
Concrete pump assembly for Dent/Bend/Cracks PASSED GOOD CONDITION
Marking, ID No. Manufacturer, rated pressure PASSED READABLE
Operator’s control station/ pendant PASSED GOOD CONDITION
Maintenance records PASSED AVAILABLE
Emergency stop PASSED GOOD CONDITION, WORKING
Lubrication points PASSED GOOD CONDITION, SUFFICIENT
Articulated boom cylinders PASSED GOOD CONDITION, NO SIGNS OF LEAK
GOOD CONDITION, SUFFICIENT, NO
Hydraulic System PASSED SIGNS OF LEAK
Agitator Gear Box PASSED GOOD CONDTION, SUFFICIENT
Water box PASSED GOOD CONDITION
Transfer tube PASSED GOOD CONDITION
Centralized lubrication system PASSED GOOD CONDITION
Housekeeping PASSED GOOD CONDITION
Delivery line PASSED GOOD CONDITION
Compressor PASSED GOOD CONDITION
Fuel Tank if available only as back up supply PASSED GOOD CONDITION
Engine start-up/ off PASSED GOOD CONDITION
Control Cabinet PASSED GOOD CONDITION
Remote control/ pendant PASSED GOOD CONDITION
Tires N/A NOT APPLICABLE
Outriggers, Mast mounting, tie beams collar PASSED GOOD CONDITION

COMMENTS / RECOMMENDATIONS:

1. Ensure the implementation of a Preventive Maintenance Schedule (PMS) program to extend the economic life of
the equipment;
2. Before using the equipment, a Standard Operating Protocol including visual inspection must be performed;
3. Proper handling and good housekeeping must be maintained at all times;
4. A portable fire extinguisher must be readily available and accessible by the operator;
5. Equipment operator must be equipped with basic Personal Protective Equipment (PPE) including safety belt in
compliance to safety regulations; and

THIS IS TO CERTIFY THAT the below signed competent surveyor thoroughly examined & tested the equipment per
Safety Standard Compliance procedure. Above Equipment was found SAFE AND FIT for operation.

SAFE FOR USE NOT SAFE FOR USE

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 DOLE-OSHC
CHETO Accreditation No.
1410-21100821-0033

ANNEX TO ARTICULATED PLACING BOOM TESTING AND INSPECTION

DATE OF INSPECTION: JULY 16, 2022 REPORT NUMBER: IND-MWIDE-002-82

ONSITE INSPECTION PHOTOS

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 DOLE-OSHC
CHETO Accreditation No.
1410-21100821-0033

TECHNICAL INSPECTOR OPERATION MANAGER PROFESSIONAL MECHANICAL

INDUSTRIAL SERVICES TECHNICAL REVIEWER ENGINEER

Name : JOHN DOMINIC SIM Name : NELVAN E. ELTAGON Name : RENANTE G. CALAGO
Date : JULY 16, 2022 Date : JULY 16, 2022 Reg. No. : 0004828 / Sept. 10, 2024
Signature : Signature: PTR : 8853957 / Makati City
Signature :

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