Form No.

10
(Prescribed Under Rule 60I
Prescribed for Report of Examination of the Lifting Machines, Ropes and Lifting Tackles Particulars
Gertificate No c1 0&3A $7e-73
t. Name of occupier of Factory :- M/S Alliance comercial transport
C/O Larsen and toubro construction Ltd
Address of Factory :. MAHSR C4 section lll CH -264, Antroli, Surat

2 Distinguishing number or mark (if any)
and desription sufficient to identifu
the lifting machine lifting tackle, etc.
:- Mobile Crane (QR Code: QR012897)
Make: TIL limited; Serial no.:407867;
Model no.: TMS 750BMK1 1;
Reg. No.: AP 29 CB 4113; Main hoist rope dia.: 19 mrn;
Boom Length: 33.5 mtr.; No. Of falls: 04 fall
Tip load capacity: 1230 kg @ 33.5 mtr. boom length;
Maximum capacity: 40 I @ 3 mtr. radius and 10.6 mtr. boom length
with all sheave reeved '
Current Capacity: 20 T @ 3 mtr. radius @ 10.6 mtr. boom length
with 4 no. of falls

3 Date when the lifting machine, chain, :- Manufacturing Date: 2013

rope or lifting tackle was first used in
the factory.

4. Date of each Examination made under :- Last time inspection done by us on 16.08.2023
section 29 (1) (a) (iii) and by whom it Certificate no. : (G"10-231 170-46)
was carried out.

5. Date and number of the certificate :- Record Not Available.

relating to any test and examination
made under sub-rule (1) of rule 60
together with the name of the person
who issued the certificate.

6. Date of annealing or other heat - Not Applicable due to Material of Construction

treatment of the chain and lifting tackle
carried out under sub-rule (5) of rule 60
and by whom it was carried out.

7 Particulars of any defect found at any Load test done on 1.8 T @ 11.8 mtr. radius @ 22.4 mlr. boom length
such examination or after annealing No defects noticed.safe to use at SWL Capacity.
and affecting the safe working load and
the steps taken to remedy such defect.

I / We certify that on 15.02.2023,1 / We thoroughly examined the above-mentioned lifting machine /

chain / rope / lifting tackle and that the above is a correct report of the result.
certificate Valid Up to: 14.08.2023.

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607/R-Square, Veena Nagar, Opposite Kamgar Hospital, i\'j'I P Anupam Kumar Shukla
LBS Road, Mulund (West), Mumbai - 400 080. ME, ADIS, ADFSEE
Plot No. 58, Muktinagar Colony, O. P. Road, Vadodara - 390 015.
Chartered Engineer; Competent Person
Phone : 9920059762, Mob : 9321905149
E-mail : uniquo@yahoo.com, customercare@uniquo.in
MtE, FtV CLA
Member: ASME, IRED, IAENG
cERr.AUDrr. NoDN 036 ZED Master Trainer