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Seating Capacity
Reg.No.
GJ16BS2412
Maker's Name
002 011-IERS
Wheel Base
oooooomm Model Name
Cubic capacity
LIEBHEER L TM 1400
000000
Cylinder No
Colour
06 Flnancer Name
Cylinder Validity YELLOW
Body Type TATA CAPITAL Fl
Month & Yr. of Mfg.
CRANE
December 2018

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Registration Authority
Owner's Sign
Bharuch
 GUJARAT MOTOR VEHICLE DEPARTMENT
State Transport Department
[BHARUCH}

VEtHCLE PARTICULARS

Application No: GJ20070349857648 Registration No: GJ16BS2412

Owner Name: BAPU !NAYATHUSHEN SonM/ife/Daughter of; ABDULREHMAN
Vehicle Class: Crane Mounted Vehicle Vi>hicle Maker: OTHERS
Month/Year of Manuf.: 12/2018
Present Address: 3 FIRDOSH SOCIETY,NR IDGAH JAKAT NAKA.,Bharuch,Gujarat-392001
Chassis No: SR/0022144 Engine No: NA
Co!or: YELLOW Vehicle Status ACTIVE
Owner Serial No: Body Type: CRANE No of Cylinders: 6
Horse Power: 0.00 Seat(inc. driver): 2 Unladen Wt(kg): 84000
Laden Wt(kg): 84000 Tax Amount: 17400 Cubic Capacity: 0.00
Vehicle Model LIEBHEER LTM 1400 Wheel Base O Floor Area 0.000
Registration Date: 03-Jul-2020 Regn Valid upto: 01-,lun-2035 Tax Paid upto: 30-Sep-2020
Fuel: DIESEL Fitness upto: 02-Jul-2022 Vehicle Norms Bharat Stage Ill (CEV)
Last Change of Address on: Last A!teration of Vehicle on
THIRD PARTY Insurance From THE NEW INOIA ASSURANCE CO. LTD. vide policy certificateicovernote no 22060044206500000010 is
valid from 03-Jul-2020 to 02-Jul-2021.

HP Otis:
1. Hypothecation-TATA CAPITAL FIMANC!AL SERVICES LTD, SURATSURAT,Surat-395007

Mobile No: 9167941552 Email Id:

Particular Fee Rs. 200/- paid vide cash receipt no GJ16R2007000 :16 dated 03-Jul-2020.

Other State/Transfer/Conversion Details

Previous Owner
Old State
Transfer Date

Printed On: 03-Jul-2020 12:58:30

 TAX RECEIPT

Transport Department, Government of Gujarat

Registration Authority BHARUCH, Gujarat

Transaction / Receipt No. : GJ220630V7396349 / GJ220630C2275720 Vehicle Class: Crane Mounted Vehicle

Received From: BAPU INAYATHUSHEN Payment Date: 2022-06-30 10:52:53.076336

Transaction Date: 30-Jun-2022 10:54 AM Vehicle No: GJ16BS2412

Chasis No: SR/00XXXXX Bank Reference Number: 202218133325869

GRN No: 9637326946222

transaction identification number GJY2206300705389

Amount(In Rebate+/E Penalty(In Surcharge(

Particular Period Amount1 Amount2 Total(In Rs)
Rs) xemption Rs) In Rs)

MV Tax 01-Jul-2022 to 31-Jul-2022 5800.0 0.0 0 0.0 0.0 0.0 5800

Total 0.0 0.0 5800

GRAND TOTAL (in Rs):5800/- (FIVE THOUSAND EIGHT HUNDRED ONLY)

Verify the receipt by clicking Status>>Verify Receipt on Vahan Online Services portal at https://parivahan.gov.in/vahanservice

For further query ,Please go to the zone RTO :

BHARUCH, Gujarat

Note::-
This is computer generated slip, Signature is not required. Can be verified from QRcode

Note::-**
Exemption, if any is added in Rebate column

1/1
 Trivedi & Associates Tecknical Services IP.\ Ltd.
AN ISO: 9001-2015 COMPANY CIN NO.: U74140bJ19/9p1co36514
IJ COMPETENT PERSON - FACTORY ACTS, SMPV (U) RULE (EXPLOSIVE), PETROLEUM RULE, INSPECTION I CONSULTING ENGINEER,
I GOVT. REG. VALUER, ENERGY AUDITOR, LIFT INSPECTION AGENCY, CALIBRATION AND STAMPING OF STORAGE TANKS & INSTRUMENTS
107-113, SID CUP Tower, Race Course, Vadodara-390 007. • Phone: 91-0265-2343511, 9879544010, Fax: 2350612 E-mail: info@trivediassociales.co.in • Visit us at: www.trivediassociates.co.in

FORM NO.: 10
(Prescribed under rule 60)
Prescribed for report Examination of the lifting machines, ropes and lifting tackles.

Gerti. No.: TC/MHC/2412/2022

1. Name of occupier of factory Total Crane

2. Address of factory Plot No. 162, Phase-2 Beside New Safari, Nr. Mipko
Chokdi, Narmada Nagar, Bharuch-392015, Gujrat
3. Distinguishing number of mark (if any) and Hydraulic Mobile Crane,
description sufficient to identify the lifting Make/Model: Liebherr/LTM-1400
machine, chain, rope or the lifting tackle. Sr. No.: SR/0022144
SWL Capacity: 400 MT,
Reg. No.: GJ-16-BS-2412
Min. Boom Length: 15.5 Mtrs.
Max. Boom Length: 50.0 Mtrs.
Wire Rope Dia: 23.5 mm,
No. of Falls: 08 Nos
Location :Total Crane - Workshop-GIDC Bharuch
4. Date when the lifting machine, chain, rope or Dec-2018
lifting tackle was first used in the factory.
5. Date of each examination made under Thorough visual inspection & operational checking
section 29(1)(a)(iii) and by whom it was carried out on 26/05/2022 by AMIYA K. PUJARI
carried out. Competent Person.

6. Date and number of the certificate relating to Not Known

any test 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 Due to Material of Construction.
chain and lifing tackle carried out under
sub-rule(5) of Rule 60 and by whom it was
carried out.

8. Particulars of any defect found at any such Safe to use as per load chart.
examination or after annealing and affecting All Safety devices to be kept in working condition
the safe working load and the steps taken to and to check & record regularly before use.
remady such defect.

I certify that on 26/05/2022 , I have thoroughly examined the above mentioned lifting Machine/Chain/
Rope/Lifting tackle and that the above is corr ct report of the result.

Sii:inature
Name of the Competent Person AMIYA
Qualification B.E. (M
Competency Certificate No. GUJ/DI /CPT/A/0872/2020,
Valid upto 18/09/2022
Issued By Director, Industrial Safety and
Health, Gujarat State
Next Inspection Recommended : 25/05/2023 AKP-B I AS I VP