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REPORT OF EXAMINATION AND TEST OF ESCALATOR/MOVING WALKS

Report No: Job No:
IB-085
Client Name & Address

UNIT INFORMATION
Type of Inspection & Test Performed: Escalator/Moving walks ID:

Manufacturer: Manufacturing Year:

Equipment Reference/Serial Number: Degree of Inclination:

Width of Step: Rise:

Theoretical Capacity: Rated Speed:

Normal Direction of Travel: Attending Maintenance Company:

INSPECTION STATUS
Date of Previous Inspection: ASC Test Method No:
Date of Inspection & Test: ASC Test Equipment No:
Next Inspection & Test Due On: Standard Reference& Regulation:
Inspector Name: Authorized Name:

Inspector Signature: Authorized Signature:

After the inspection and testing of the equipment described in this report, the equipment found to contain defects likely to affect
safety Due to the highlighted items/large number of defects mentioned in the subsequent pages(Recommendation Section)
The Equipment is not Satisfactory for Intended Use.

This Report is granted subject to the condition that is understood and agreed that nothing herein contained shall be deemed to relieve any designer, manufacturer, seller, supplier,
repairer or operator of any warranty, express or implied, and Admiral Safety Consultants liability shall be limited to the acts or omissions of its employees, agents and
subcontractors. Under no circumstances whatsoever shall Admiral Safety Consultants nor their Engineer be liable for any injury or damage to any person or occurring by
reason of negligent operation or any defect in materials, machinery, equipment or other items other than such defects ascertainable by normally accepted standards and only
those items actually inspected by Admiral Safety Consultants and which are covered only by this Report. Any person not a party to the contract pursuant to which this
document is delivered may not assert claim against Admiral Safety Consultants for any liability arising out of errors or omissions which may be contained in said document and
in connection with any activities for which it may provide. This Report shall not be reproduced except in full without the approval of Admiral Safety Consultants and Receiving
client

ADMIRAL SAFETY CONSULTANTS, TRADE LICENCE NO. 741090, AL-GARHOUD, P.O.BOX 125218, DUBAI -UAE, TEL: 04-2899389, FAX: 04-2840557 Page 1 of 2

Doc.No.ASC-F-50A(Rev.03) (1/06/2019)
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Report No: Job No:

Ite
m REMARKS AND RECOMMENDATION
No.
A REMARKS:
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Doc.No.ASC-F-50A(Rev.03)(1/06/2019)