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CERTIFICATE No. SERVICE ORDER No. DATE OF EXAMINATION NEXT EXAMNINATION DUE:
RS22/AGSL/0502 TBA 02/05/2022 01/11/2022
IDENTI. No. DESCRIPTION OF EQUIPMENT QTY. TARE WT. SWL GROSS WT. LAST EXAM DATE
101 to 104 CROSBY SAFETY PIN BOW SHACKLES 4 N/A 4.75 TON N/A VISUAL
Is this the first examination after installation or assembly at a The examination was carried out Within an interval of:
new site or location? YES NO 6 monthly: 12 monthly: As Recommended N/A:
By client:
If the answer to the above question is YES has the equipment --In accordance with an examination scheme? YES
been installed correctly? YES NO
--After the occurrence of exceptional circumstances? N/A
Identification of any part found to have a defect which is or Is the above an existing or imminent danger to persons *Note-This is a
could become a danger to persons and a description of the reportable defect : YES NO
defect::(If none state NONE)……NONE………
Is the above a defect which is not yet but could become a danger to persons: (If YES state the date by when) YES BY: N/A
YES: NO:
Particulars of any repair, renewal or alteration required to Particulars of any tests carried out as part of the examination: (If
remedy the defect identified above: N/A none state NONE) NONE
MPI INSPECTION DETAILS
PROCEDURE:- RSWI 9.5.1 EQUIPMENT:- Perm. magnet METHOD:- Magnetic flow/wet/continuous
SPECIFICATON:- ASTM E 709 MEDIA:- white contrast paint INSPECTOR:- Jonah Ollawa
MATERIAL:- Carbon steel INDICATOR:- black mag. ink QUALIFICATION:- SNT LEVEL II (SNT-TC-1A)
TEST DETAILS: UNIT SLING: STANDARDS: EN 12079; BS EN 134134-2; EN 13889
TESTED BY: RIGZONE SERVICES PRIME LIFTING METHOD STATEMENT/RECOMMENDATION: The
CERTIFICATION NO.: RS/2018/EG/04/01 PLNL/160322/AGSL examination was conducted in a controlled manner and no
DATE: 15/04/2018 03/05/2022 defect was found as at the time of examination.
PROOFLOAD APPLIED 3,000 KG N/A LIFTING COLOUR CODE: BLUE
DETAILS/QUALIFICATIONS OF AUTHORISED EXAMINER: TYPE OF EXAMINATION PERFORMED: RESULT : IS THIS EQUIPMENT FIT FOR PURPOSE:
NAME: JONAH OLLAWA TEST: VISUAL: NDT: YES: NO:
QUALIFICATIONS: LEEA ; SNT-TC-1A
I hereby declare that the information is correct and the equipment has been thoroughly examined in accordance with appropriate provisions
and is free from defects affecting safety.