TC NO: SE/070922/17613

DATE OF INSPECTION- 07/09/2022

INSPECTION REPORT OF CONCRETE PUMP
NAME OF THE OCCUPIER MAHALAXMI CONSTRUCTION
ADDRESS OF FACTORY AT SITE-SECTOR-5, MLCP, LODHA PALAVA, KHONI,
DOMBIVALI, THANE.
EQUIPMENT DESCRIPTION
1) EQUIPMENT MAKE PUTZMEISTER INDIA PVT LTD
A) MODEL 1407-D
B) SR.NO 2118253151 (SEQ0704)
C) YEAR MFG 2018
2) PARTICULARS OF PRIME MOVER
TYPE DISESEL ENGINE OPERATED
MAKE KIRLOSKAR
MODEL HA 694
SERIAL NO. 06.1154/1820093
YEAR OF MFG. 2018
3) PIPE DIAMETER 125 MM

4) CONDITION OF EQUIPMENT
CYLINDER FOUND OK
HYD.PIPING FOUND OK
PRIME MOVER FOUND OK
5) CONDITION OF FITTINGS & APPLIANCES
SAFETY VALVE FOUND OK
STOP VALVE FOUND OK
PRESSURE GAUGE FOUND OK
HYD.LEVEL GAUGE FOUND OK
DIESEL LEVEL GAUGE FOUND OK
BATTERY & ITS CONECTION FOUND OK
OUT RIGGER FOUND OK
CONCRETE PIPE FOUND OK
CONTROL PANEL FOUND OK

6) All fittings and appliances properly maintained and in good condition. -YES
7) Any recommended repairs if required and period within which they should be executed: NO
8) Other observations / conditions subject to which the equipment is to be operated: by trained operator
9) Last date of examination of Equipment: 05/03/2022

This is to certify that the equipment has been thoroughly examined on 07/09/2022 including its fittings and that the
above report is a true report of my examination.
NEXT DUE- 06/03/2023
Signature:

J. C. PANCHAL ISO 9001-2015 CERTIFIED COMPANY

Qualification: BTECH (MECH), ADIS, COMPETENT PERSON Address: GALA NO-1, BHANJI UDYOG NAGAR,
CPC NO.-MS/DISH/CPC/P-054/2020 MIRA ROAD, THANE-401107, MOBILE-09833637246
Daily check the above equipment and all its safety devices for its proper functioning and safe operation & favourable weather
condition before using. Operation, maintenance & safety of above equipment is in occupier’s scope. Follow manufacturer’s
instructions for safe operation & maintenance. This certificate neither gives any performance guarantee nor ensures against any
failure of the equipment in future. It indicates only the present status of the equipment on the day of inspection based on the
test carried out. Only allow authorized operator to operate equipment.
SAFETY CONSULTANCY, SAFETY INSPECTION, TESTING & CERTIFICATION OF EQUIPMENTS.