SERIAL NUMBER:

LIFTING CERTIFICATE 001320 -21

NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME LOCATION:•

TO DO IT SAFELY Gas Transmission :...Gurun
PETRONAS RGTSU
.. ..... ... .. ... ..
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RGTP ..... ..... .... .... ...

SECTION 1: REQUISITION

Operator Name: MOHAMAD NAIM BIN RAMLY Staff No/IC: 850514-11-5325

Department/Company: MS TIME Tel No:
016-9604553
Signature:
Date: 20 / 3 / 2023 DOSH Certificate No: TG/13/OK/02/67
SECTION 2: GENERAL INFORMATION

Work Location:
GRN AYER PUTIH CITY GATE Facility: AYER PUTIH CITY GATE
Equipment No:
- Date Required From :
20 / 3 / 2023 To:20/3/2023 (VALID FOR 7 DAYS)
Vehicle Entry Cert No:
- (outside compound) Signal Man (1):: M.HANIF RAMLI
Signal Man (Z):
Work Description:
To lift nested drone onto control building roof
SECTION 3: LOAD AND CRANE DATA

Load Description:
Nested Drone UAS Load Max !Ton): 55T
Load Dimension (L x W x H}:
1.4m x 1.1m 1.0m Load Est. Wt. !Ton): 0.2T
Load BTM Elev. (M}:
4.0m Load Max. lift (M): 4m Load Act. Wt. (Ton): 0.2T
Crane Model: KATO NK550VR 55T SL PMA 37702
Crane Capacity: PMANo.:
BoomLE(M): 43M
BoomHT(M):
Boom Angle r>: 40'-80'
Safety Factor:
Work Rad (M):
28m
SECTION 4: GROUND INFORMATION

Access Road Condition: SOLID TAR * As per attached JMS Lifting i!Le"VA~ 11 IIRTUI

Setup Area Condition:

SOLID SOIL

/~
Setup Site Clear (M): 3.0m
SECTION 4: RIGGING INFORMATION

Hitch Argmt: Hoisting Point --

Ii
!I A
- !

Yro:
SUngType: Webbing LOAD-1 TON
I Z.OManlt
I
I
sung Size (MM) : 50mm j COA200S I
l o]V I
I

---'--..
I
5m
SUng Length (M): 1.a IIEffR

No. of Sling:
4 sling _,
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Shackle Size (MM): D-shackle 75mm - WOflKINO RADIUS• I M ~!.R
.
r--
Shackle Capacity (Tons): 4.75T r-----7

D
n aYMaTIUCAL

Hitch Capacity (Tons):

N/A
::m:

I •
\ 1.uu~

--
p I Ill II I
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SECTION 4: LIFTING CATEGORY
L__J . , _ _ IMIITU:
L__-=:J
D Basic Uftlng
D Critical Uftlng CT] en
Remark:

SECTION 7: APPROVAL =

LIFT SUPERVISOR '

CAA

Signature
Mohd Akmal Bin Mohd Radzi
Signature
Name:
Name:
Date: 20 / 3 / 2023 Time: Date: 20 / 3 / 2023 Time:

Certificate Distribution -Original (White) : Displayed at Workslte I Copy No.1( Yellow}: Control Room/AA Office I Copy No.2 (Pink): RA