CERTIFICATE

Of Thorough Inspection of Lifting Accessories

Certificate No : BVI-INY/LGI-JEL-102022-269 Date of Inspection : 26th October 2022

Name and Address of the Owner Place of inspection Technical referential

BV Work Instruction
PT. Jurong Engineering Lestari PT. Jurong Engineering Lestari GM IVS 002
Logistic Warehouse BS EN 1492-1
Balikpapan Baru
Balikpapan – Kalimantan Timur

Equipment Description :
Polyester Webbing Sling Double Ply
Size : 90mm (Width) x 6 meter (Length)
Safety Factor 7 : 1
Manufactured by : DOWSON
BS EN 1492-1

Safe Working
Type of equipment Serial Number ID Number Status (*) Comments
Load
Webbing Sling 2704-3T/6M-266 JEL-WB-383 3 ton Satisfactory Fit For Use

*: satisfactory, non satisfactory, non available,

Based on Thorough Visual Examination, Functional Test of the accessories describe above was found
satisfactory at the time of inspection

Date of Last Examination Date of Next Examination

(if applicable)
2nd January 2022 26th April 2023

Authorized name: Surveyor’s name:

Signature Signature

Harry Mosman Ariono

THIS IS TO CERTIFY THAT the above signed competent surveyor thoroughly examined the lifting equipment in the above
mentioned place as per technical referential mentioned above. The liabilities are as per Bureau Veritas General Conditions of
Services.

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