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Test Certificate

No. 8345

DEPARTMENT OF EMPLOYMENT AND PRODUCTIVITY FACTORIES ACT 1961

Docks Regulations 1934, Regulations 19(a) and 22(a)

PULLEY BLOCKS: Certificate of test and examination, before being taken into use. (This form may also be used for the purposes of section 26(1)(e) of the Factories Act 1961)

CHAINS, CHAIN SINGS, ROPE SLINGS (except a fibre rope sling,) OR SIMILAR GEAR, RINGS, LINKS,

HOOKS, PLATE CLAMPS, SHACKLES, SWIVELS AND EYE-BOLTS.

Form prescribed by the Secretary of State for CERTIFICATEOF TEST AND EXAMINATION

(1) Particulars

(2) Name and address of maker, supplier or repairer.

(3) Name and address of firm, company, association or person undertaking the test and examination.

(4) Name, position and qualification of person who

carried out the test and examination. Chief of Department

(5) I certify on behalf of the firm, company, association or person named in (3) and (4) above thet the ithems Described herein were tested and thereafter examined and were found to be free from cracks, flows or other Defects.

Signature………………………………………….

Date.

__________________________________________________________________________________________________

Distinguishing

No or Mark

(i)

Description of item . This should Include size, material and particulars

of any heat treatment

(ii)

Number Tested and Exam-ined (iii)

Date of test and examination (iv)

Proof Load Applied (specify units) (v)

Safe working load (specify units) (h)

Danløft CE 12.05 WLL.6800kg

Wire Rope Slings 24 mm x 110 mtr. Soft eyes both ends

2 12.2005 10,2 ton 6,8 ton

F 97

This form is based on the standard international form of

certificate approved

by the international Labour Organisation for the test and