Certificate No MSC/33070/R/22/04G

Items To Check Comments Corrective action

Structure (Body /Operator cabin) Satisfactory

Supports, Joints & Fastening Satisfactory
Steering Satisfactory
Brakes Satisfactory
Seat & Seat Belt Satisfactory
Fuel System Satisfactory
Horn Satisfactory
Operator Cabin Satisfactory
Engine Condition(installation & Leakage) Satisfactory
Transmission System Satisfactory
Roller Condition Satisfactory
Tires / Wheels Satisfactory
Proper Lubrication Satisfactory
Cooling System Satisfactory
Machinery Room / Electric Panels. Satisfactory
Reverse Warning Light and Alarm Satisfactory
Lights in Front and Rear Side Satisfactory
Electric Cables / Wires Satisfactory
Hydraulic System Satisfactory
Batteries & Terminals Satisfactory
Operation Panel Satisfactory
Emergency Stop Satisfactory
Exhaust System Satisfactory
Tool Box Satisfactory
Duty Chart Satisfactory
Fire Extinguisher Available
Maintenance N/A
General Condition Satisfactory
RESULT & REMARKS

Satisfactory At the time of inspection

Inspected By : SAHAT NAWAZ

Position : Inspection Engineer

 REGISTER CERTIFICATE OF TEST & EXAMINATION OF ROLLER

Certificate No MSC/33070/R/22/04G Job No MSCJ -21986

Name & Address Of Equipment Equipment. Maker Origin

BLACK TOP CONTRACTING LLC BOMAG GERMANY
U.AE Type Of Inspection
Location Reference Regulations THOROUGH
AL FAYAH, ABU DHABI, U.A.E BS EN 474-4:1996

Description
Name/Make/Model/Dimensions etc
Registered Empty Weight Remarks
No.

ROLLER

Model. BW211D40
Chassis No. 101582422478 W-95198 DXB 13.00 TON See at the back
side of the report
Year Of Mfg. 2013
Engine No. 11341462

DESCRIPTION OVERALL LENGTH OVERALL WIDTH GEAR TRANSMISSION

DETAILS Visual Check Visual Check Forward & Reverse

REMARKS Acceptable Acceptable Function Test
Inspection Date Date of Expiry Validation
03-07-2022 02-07-2023 One(01) Year
This Certificate Becomes Invalid, If Any Alteration/Repair /Modification Is Made.
THIS IS TO INFORM YOU: that the undersigned a surveyor or representative did attend to examine this machine
(equipment) to assure that it is in safe working condition. Examination indicate that the said equipment has no
indigenous defects or sighted deformation and in safe working condition. The said equipment is found to be
satisfactory for further use, provided there is continues maintenance applied and qualified operators employed. This
certificate is granted subject to the condition that is agreed & understood. Master Safety Consultancy L.L.C liability
shall be limited to the acts or premises of its employees, subcontractors. Under no circumstances whatsoever shall
Master Safety Consultancy L.L.C 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
normally. We hereby report that the all particulars in this report are correct at the time of test/inspection Daily
inspection & operational maintenance is the sole responsibility of the users.

Inspected By: SAHAT NAWAZ Approved By: Technical

Manager