Professional Documents
Culture Documents
LIFTING EQUIPMENT
This report complies with Lifting Operations and Lifting Equipment Regulations 1998 (SI 2301)
Date of report: February 29th, 2024 Report Number: PSIR.073.LG125.L2.II.2024
Description and identification number of item(s) including date of manufacture (if known) Safe working load(s) for last Date of last thorough
configuration it was examination:
thoroughly examined:
1. Gas Bottle Rack - Identification No. BSL 16627, 1 Ea. complete with lifting set February 15th, 2024
Payload
Manufacture : Dalian CIMC Logistics Equipment Co., Ltd. RPT/SPT/JKT/2024/II/3457B-
N/K Year Manufactured : March 2013 4/012 Rev1
2500 Kg
Serial No. / Tag No. : H000729 / BSL 16627 ( refer Cert. Lloyd Register Offshore Container Construction SHI1283288·17)
By PT. Siaptek
Dimension : 1270 mm (L) x 1150 mm (W) x 2285 mm (H)
Tare Mass : 700 Kg
Maximum Gross Weight : 2500Kg
Payload : 1800 Kg
4 Leg Wire rope sling - Identification No. WAL/14/0575/1, WAL/14/0575/2, WAL/14/0575/3, M/23/0515/1 & WAL/14/0575/4,
1 Ea.
Manufacture : PT. Wiguna Artha Lestari (WAL)
Working Load Limit (WLL)
N/K Year Manufactured : March 03rd, 2014 & May 08th,2023
Serial No. / Tag No. : WAL/14/0575/1, WAL/14/0575/2, WAL/14/0575/3, M/23/0515/1 & WAL/14/0575/4
11.30 tonne (0-25⁰ Angle)
Construction Wire Rope : GALV. 6 x 36 WS+IWRC RHRL mm (refer Cert. Offshore Container Lifting Slings No. 020595 & MPJ/C/23/0515)
Diameter & Length Wire Rope : 18 mm and 1700 (L) mm
Color Code : (Periode December 2023 to July 2024) GREEN
Shackle - Identification No. WAL/14/1028 up to WAL/14/1031
Manufacture : The Crosby Group
Working Load Limit (WLL)
N/K Year Manufactured : March 02nd, 2014
Serial No. / Tag No. : WAL/13/6560 up to WAL/13/6563
4.75 tonne
Type of Shackle : G.2130 Bolt Type Anchor Shackle
(refer The Crosby Group Certificate No. CC1-2014030200123)
Color Code : (Periode December 2023 to July 2024) GREEN
Note: Photographic Report is attached.
Is this the first examination after or after installation assembly at a new site Was the examination carried out :
or location? 1. Within an interval of 6 months? YES √ NO
If the answer to the above question is YES NO √ 2. Within an interval of 12 months? YES NO √
YES,
3. In accordance with an examination scheme? YES √ NO
Has the equipment been installed YES √ NO 4. After the occurrence of exceptional: YES NO √
correctly and would be safe to operate?
5. Months between examination (if known):
Particulars of any repair, renewal or alteration required to remedy the defect identified above: (If none state NONE)
None
Particulars of any tests carried out as part of the examination: (If none state NONE)
None Cross Referenced Report Number:
Is the above a defect which is not yet but could become a danger to persons? (If YES state the date
YES by: dd-mm-yy NO √
by when)
PHOTOGRAPHIC REPORT
Fig. 1 Description of Gas Bottle Rack Fig. 2 Maximum Gross Weight (MGW) 2500 Kg Fig. 3 Manufacturer Inspection Data Plate
(Identification No. BSL 16627) (Identification No. BSL 16627) (Identification No. BSL 16627)
Fig. 4 Third Party Inspection Data Plate Fig. 5 Data plate of wire rope sling lifting set Fig. 6 Latest inspection date wire rope sling lifting
(Identification No. BSL 16627) (Identification No. BSL 16627) (Identification No. BSL 16627)
Fig. 7 4 Leg wire rope sling - Leg 1 Fig. 8 4 Leg wire rope sling - Leg 2 Fig. 9 4 Leg wire rope sling - Leg 3
(Identification No. M/23/0515/1) (Identification No. WAL/14/0575/2) (Identification No. WAL/14/0575/3)
Page 2 of 4
PHOTOGRAPHIC REPORT
Fig. 10 4 Leg wire rope sling - Leg 4 Fig. 11 Shackle lifting set - Shackle 1 Fig. 12 Shackle lifting set - Shackle 2
(Identification No. WAL/14/0575/4) (Identification No. WAL/14/1028) (Identification No. WAL/14/1029)
Fig. 13 Shackle lifting set - Shackle 3 Fig. 14 Shackle lifting set - Shackle 4 Fig. 15 Front Side Condition Gas Bottle Rack
(Identification No. WAL/14/1030) (Identification No. WAL/14/1031) (Identification No. BSL 16627)
Fig. 16 Side Condition Gas Bottle Rack Fig. 17 Marking of Color Code GREEN Fig. 18 Lifting Sets Color Code GREEN (Identification
(Identification No. BSL 16627) (Identification No. BSL 16627) No. BSL 16627)
Page 3 of 4
PHOTOGRAPHIC REPORT
Fig. 19. Top Side Condition Gas Bottle Rack Fig. 20 Pad Eyes/Lifting Point Condition Fig. 21 Additional Marking identification LNG 012
(Identification No. BSL 16627) (Identification No. BSL 16627) Condition (Identification No. BSL 16627)
Page 4 of 4
Satisfactory
Comment
Item No. Description Remarks
Photos
Safety
C NC
A. Certification Information
Issued by Lloyd Register refer Cert.
A1 Certificate for Offshore Container (Certificate of Conformity) √ √ Offshore Container Construction No.
SHI1283288·17
Issued by PT. Wiguna Artha Lestari
(WAL) refer Cert. Offshore Container
A2 Certificate for Offshore Container Lifting Slings (Certificate of Conformity) √ √ Lifting Slings No. 020595 & PT.
Mitra Pradana Jaya Cert. No.
MPJ/C/23/0515
Issued by Kiswire refer Cert. No 2012-
08-016 /RW11177, USHA Martin
Cert. No. E-2223-0919, The Crosby
Certificate for Lifting Set Components
A3 √ √ Group Welded Master Link Assembly
(Certificate of Conformity) Cert. No.CC1-2014030200109, The
Crosby Group Cert. No. CC1-
2014030200123)
Remarks
Signature:
Form No.: BP-ICL-OP-02-A Rev. 1
Client Certification Package
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
Section 1:
Approval Certificates
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
1 loyrl's
l{eg.sfer Offshore Container Construction Certificate
Name of Manufacturer: Address:
Dalian CIMC Logistics Equipment Co., Ltd . Ill B-2, Free Trade Zone, Dalian, Liaoning, China
This is to certify that the under noted Offshore Container, wh ich was manufactured and tested in accordance w ith the requirements of Lloyd's Register
Group Container Certification Scheme, has been inspected and found to be in accordance with the approved drawings and th e prototype container
identified as follows:
Container Model No.: Manufacturer's Serial No. I Owners No. Date of Manufacture:
OBR004 H000729 I BSL16627 MARCH 2013
Specification of lifting set. This certificate is only valid when the container is fitted with approved lifting set.
Min. shackle bolt diameter: Max. angle of legs (from vertical): Enhancement factor
22 miT' 45 ° 2.880
Proof testing:
This offshore conta iner, or another offshore container from the same fabrication series, has been subjected to the following proof test:
Manufacturer's Serial No. of container tested: Total test loa d (2.5R): Test date:
H000728 6,250 kg 04 March 2013
The container also complies with the following requirements and regulations:
EN12079-1 :2006 & DNV2.7-1:2006 IN SUPPORT OF IMO MSC/Circ.860 (1998) .
Remarks:
"'00
A s u bs'd'~ ' Y o l he Lloyd' s Reg1ster Grou p L11n1ted
se
...<::;
Lloyd's Register Group Limited, its affiliates and subsidiaries and their respective officers, employees or agents are, individually and co llectively, referred to in this clause as ......:::>
'Lloyd's Register'. Lloyd's Register assumes no responsibility and shall not be liable to any person f or ar.y loss, damage or expense caused by reliance on the informa tion or 0
advice in this docu ment or howsoever provided, unless that person has signed a contract w ith the relevant Lloyd's Register entity for the provision of t his infor mation or
advice and in that case any responsibility or liability is exclusively on the terms and conditions >et out in that contract.
""'::;
I-
VI
;:;
Form 5216F (2012.08)
...
"'
VI
Q
>
~
Client Certification Package
Section 3:
Lifting Set COC
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
Section 2:
Lifting Set Certificates
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
TYPE
EX NO . RW12086-18
LUBRICATION A-3
~------~-----------------------------------------------
M40570
IS09'JOI REO!STERro
. , AI ® 82 , •• '''" "~ · 1.8 •, . .
~ ,, . , •- ; ~
oo>o _,
1- t . t.
•-·---- 48 ....... ...,....,.
'"'~ - ..t.'.t: .- _, """i- . .
' "" '" "~
........
•.oR....-.,
r:
9
~-~m . 0
KISWIRE
COMPANY WITH
QUALITY SYSTEM
CERTIFIED BY DNV
= ISO 9001 :2008 =
thelraslayOraup
2801 Dawson Rd
Tulsa, OK 74110
www.thecrosbygroup.com
Certificate of Conformance
Certificate Number: CC1-2014030200109
Location oflssue: PT Wiguna Artha Lestari
Rukan Citta Graha 2-I, JL Panjang Arteri Kedoya No. 26
Jakarta, 11520 Indonesia
Phone: 62 215 816996 Fax: 62 215-816677
We hereby certify that the above described material was manufactured and processed in a manner compatible to
meeting the load ratings when used under normal and proper applications.
Mentioned products are in conformity to the Crosby literature available at time of manufacturing, including the
following trademarked features:
CE:
All Crosby plants are ISO 9001 :2008 certified for quality and consistency of the processes.
Section 4:
Shackle Set COC
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
Certificate of Conformance
Certificate Number: CC1-2014030200123
Location of Issue: PT Wiguna Artha Lestari
Rukan Citta Graha 2-I, JL Panjang Arteri Kedoya No. 26
Jakarta, 11520 Indonesia
Phone: 62 215 816996 Fax: 62 215-816677
We hereby certify that the above described material was manufactured and processed in a manner compatible to
meeting the load ratings when used under normal and proper applications.
Mentioned products are in conformity to the Crosby literature available at time of manufacturing, including the
following trademarked features:
All Crosby plants are ISO 9001 :2008 certified for quality and consistency of the processes.
Date:
March 02,2014 Signature:
Date oflssuance Don Conner, Crosby Quality Assurance Manager
Client Certification Package
Section 5:
3rd Party NDT Report
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
*Key
A B C D E F ND SNCR NF SC
See Non-
Exceptional Other written
Installation 6 Monthly 12 Monthly 5 Yearly No defect conformance Not found Scrapped
circumstance scheme
report
Serial Number Description SWL
14/0575/1-4 4 Leg Wire Rope Sling To DNV2.7-1:2013. Legs Ø 18 mm X 1.700 mm. WLL:
M/23/0515/1 6X36 WS IWRC. Galv Fitted to A347 1 1/8" Master Link. 11.3 tonne @ 0-45°
Certificate No. : WAL/C/14/0575, MPJ/C/23/0515
Signed :
Signed :
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak Form No. F-OPR-SPT-07.17.02
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK) Tanggal Terbit Dokumen 28 Desember 2023
Website: www.siaptek.com | Email: info@siaptek.com Page 1 of 1
OFFSHORE CONTAINER CHECKLIST
Requires
Area Checked Satisfactory Not applicable Comments
attention
Document information
Certificate of Conformity (CoC) Certificate No : SHI1283288/17
Previous Inspection Report
Other (specify)
Physical markings
MGW, Payload, Tare Weight
Identification number(s)
Perimeter markings
Non-slip roof
ID number – roof & sides
Other markings (specify)
External visual examination
Lifting point alignment
Lifting point condition
Pad eyes measurement
Manufacturer Data Plate
Sides / roof
Corner posts
Surface condition
Undersides no access to perform
Forklift pockets
Doors
Surface condition
Hinge security / lubrication
Seals
Locking security
Internal visual examination
Floor plate and welds
Lashing points
Structural members
Damage / corrosion
Tie down points
Open top box drainage
Lifting sets component
Marking
Lifting sets component 4 Legs Sling After Repair ( 1 Legs Sling Exchange)
Certificate of Conformity (CoC)
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak Form No. F-OPR-SPT-07.22.03
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK) Tanggal Terbit Dokumen 28 Desember 2023
Website: www.siaptek.com | Email: info@siaptek.com Page 1 of 2
OFFSHORE CONTAINER CHECKLIST
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak Form No. F-OPR-SPT-07.22.03
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK) Tanggal Terbit Dokumen 28 Desember 2023
Website: www.siaptek.com | Email: info@siaptek.com Page 2 of 2
PHOTOGRAPHIC OF EXAMINATION
Fig. 3 View of inspection plate unit Fig. 4 View of inspection plate lifting sets
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak Form No. F-OPR-SPT-07.40.01
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK) Tanggal Terbit Dokumen 28 Desember 2023
Website: www.siaptek.com | Email: info@siaptek.com Page 1 of 1
Doc. ID : F-OPR-SPT-01.18.02
Revision No : 02
MAGNETIC PARTICLE INSPECTION REPORT
Effective Date 28 Desember 2023
Type of
Description Area Inspected Thickness (mm) Accepted Rejected Remarks
discontinuity
Pad Eye-01 25.43 P - - -
Gas Bottle Rack Pad Eye-02 25.44 P - - -
BSL 16627 / LNG 012 Pad Eye-03 25.48 P - - -
Pad Eye-04 25.41 P - - -
Pictures:
Pad Eye-01 Pad Eye-02 Pad Eye-03 Pad Eye-04
Registered :
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK)
Website: www.siaptek.com | Email: info@siaptek.com
Doc. ID : F-OPR-SPT-01.18.02
Revision No : 02
MAGNETIC PARTICLE INSPECTION REPORT
Effective Date 28 Desember 2023
Type of
Description Area Inspected Thickness (mm) Accepted Rejected Remarks
discontinuity
Pictures:
Registered :
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK)
Website: www.siaptek.com | Email: info@siaptek.com
Doc. ID : F-OPR-SPT-01.18.02
Revision No : 02
MAGNETIC PARTICLE INSPECTION REPORT
Effective Date 28 Desember 2023
Type of
Description Area Inspected Thickness (mm) Accepted Rejected Remarks
discontinuity
4 ea Safety Pin Bow Shackle
S/N:
All Body - P - - -
WAL/14/1028, WAL/14/1029,
WAL/14/1030, WAL/14/1031
Pictures :
Registered :
Dokumen ini dianggap bukan dokumen terkendali jika sudah diunduh atau dicetak
PT. Survey Inspeksi Audit Pratama Tekindo (SIAPTEK)
Website: www.siaptek.com | Email: info@siaptek.com
Client Certification Package
Section 6:
Inspector Certificates
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
Examination Diploma
ShoniHlam Hrista
passed the Fssociation's examination
in the subject ot
0ffshore Containers
held on
22 Januarg 2015
Chief Examlnea
Section 7:
DNV 2.7-1 Offshore Container Wallchart
PT TD ENERGY SERVICES
Heartline Center Building 5th Floor,
Jl. Permatasari No. 1000, Villa Permata – Lippo Karawaci Tangerang 15810
Phone : 6221-5565 8270 Fax : 6221 5565 7271
5.7T 10T 7600L 3m 6m 1.5m 2.5m 3.6m 4.8m 6.3m 8.3m 10.3m 12.3m 13.3m
1.900 x 1.600 x 1.220 - mm 2.280 x 1.950 x 1.250 - mm 2,995 x 2,438 x 2,591 - mm 2.991 x 2.438 x 2.591 - mm 6.058 x 2.438 x 2.591 - mm 1.500 x 1.200 x 1.430 - mm 2.500 x 1.200 x 1.430 - mm 3.658 x 1.200 x 1.100 - mm 4.800 x 1.200 x 1.430 - mm 6.300 x 1.200 x 1.430 - mm 8.300 x 1.200 x 1.430 - mm 10.300 x 1.200 x 1.430 - mm 12.300 x 1.200 x 1.430 - mm 13.300 x 1.200 x 1.430 - mm
1.670 x 1.370 x 864 - mm 2.050 x 1.720 x 909 - mm 2.381 x 2.284 x 2.261 - mm 5.448 x 2.284 x 2.261 - mm 1.352 x 1.052 x 1.040 - mm 2.350 x 1.052 x 1.065 - mm 3.458 x 1.000 x 814 - mm 4.652 x 1.052 x 1.065 - mm 6.152 x 1.052 x 1.065 - mm 8.152 x 1.052 x 1.015 - mm 10.152 x 1.052 x 1.015 - mm 12.152 x 1.052 x 1.015 - mm 13.152 x 1.052 x 1.015 - mm
5.700 kg 10.100 kg 12.000 kg 10.800 kg 14.200 kg 5.000 kg 6.100 kg 7.100 kg 10.000 kg 10.000 kg 12.500 kg 14.300 kg 14.300 kg 14.300 kg
1.130 kg 1.600 kg 6,167 kg 2.980 kg 4.380 kg 720 kg 1.070 kg 1.100 kg 1.690 kg 1.960 kg 2.430 kg 2.890 kg 3.350 kg 3.540 kg
4.570 kg 8.500 kg 5,833 kg 7.820 kg 9.820 kg 4.280 kg 5.030 kg 6.000 kg 8.310 kg 8.040 kg 10.070 kg 11.410 kg 10.950 kg 10.760 kg
1.91 M3 3.13 M3 7.600 L
CARGO BASKETS DRUM BASKETS MINI CONTAINERS ACID TANKS ISO TANKS CHEMICAL TANKS TOTE TANKS GAS BOTTLE RACKS OPEN TOP CONTAINERS WORKSHOP CONTAINERS LIFTING FRAMES
ENERGY SERVICES
14.3m 16.3m 18.3m 4.2m 6'x6'x8' 6'x5'x9' 7600L 25000L 4000L 2000L 3m 6m 3m 6,4M
14.300 x 1.200 x 1.430 - mm 16.300 x 1.200 x 1.430 - mm 18.300 x 1.200 x 1.430 - mm 4.200 x 1.920 x 1.876 - mm 1.830 x 1.830 x 2.438 - mm 1.880 x 1.600 x 2.820 - mm 2.991 x 2.438 x 2.591 - mm 6058 x 2.438 x 2.591 - mm 2.268 x 2.268 x 2.500 - mm 1.500 x 1.160 x 2.340 - mm 1.450 x 1.240 x 2.250 - mm 2.991 x 2.438 x 2.789 - mm 6.058 x 2.438 x 2.843 - mm 2.991 x 2.438 x 2.591 - mm 6,488 x 2,838 x 3,285 - mm
14.152 x 1.052 x 1.015 - mm 16.100 x 1.000 x 1.025 - mm 18.100 x 1.000 x 1.050 - mm 4.098 x 1.754 x 1.401 - mm 1.668 x 1.728 x2.176 - mm 1.720 x 1.500 x 2.570 - mm 1.257 x 1.105 x 1.924 - mm 1.198 x 1.016 x 1.986 - mm 2.831 x 2.338 x 2.421 - mm 5.848 x 2.302 x 2.526 - mm 2.828 x 2.352 x 2.107 - mm
14.300 kg 16.200 kg 14.300 kg 11.000 kg 5.000 kg 6.500 kg 25.000 kg 36.000 kg 8.000 kg 5.000 kg 3.320 kg 12.400 kg 19.000 kg 7.600 kg 25.000 kg
4.950 kg 1.550 kg 1.565 kg 4.100 kg 3.760 kg 1.970 kg 580 kg 820 kg 2.400 kg 4.850 kg 3.625 kg 5.880 kg
3.820 kg 4.550 kg 2.050 kg
20.900 kg 6.030 kg 4.420 kg 2.500 kg 10.000 kg 14.150 kg 3.975 kg 19.120 kg
10.480 kg 11.650 kg 9.350 kg 8.950 kg 3.450 kg 4.935 kg
7.600 L 25.000 L 4.000 L 2.082 x 2.040 - L 2,42 CU.M