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ALMANSOORI INSPECTION SERVICES

LIFTING EQUIPMENT THOROUGH EXAMINATION REPORT


This report complies with the requirements of the Lifting Operations and Lifting Equipment Regulations 1998

Report Number: 5010051897-SH-001 Date of Report: 26-Mar-2022


Job Allocation No: 5010051897 Type of Inspection: Visual
Name and Address of Owner Place of Inspection Sub location
ADVANCED ENERGY SYSTEMS ADES-157 Mast Middle sect. FA
Due Date of Next Date of Last Proof Load Due Date of Date of Last
Date of Inspection
Inspection Test Next Proof Load Test Inspection

26-Mar-2022 25-Sep-2022 08-Jan-2020Cert: CC5- N/A 07-Oct-2021


2020010800460
Safe Working Proof Load
Owner ID Description of Lifting Equipment Qty. Load Applied
(Specify Units) (Specify Units)

Shackles
4.75 t N/A

ADES-523 1 Manufacture Year of


3/4" Bolt Type Anchor Shackle Name Manufacturing
CROSBY 08-Jan-2020
Applicable Reference Standards : RR-C 27 1D TYPE IV, 13889 / ASME B30 26
Applicable Reference Regulations: G.I 7.029
Colour Code: Green till the end of September, then Orange
NDT Details (if Any): N/A
Test Equipment Details: N/A
Is this the first examination after installation or assembly at a new site or location? : Yes ☐ No ☒
If the answer to the above question is YES has the equipment been installed correctly? Yes☐ No☐ N/A ☒
Was the examination carried out Within an interval of 6 months? Yes☒ No☐
Was the examination carried out Within an interval of 12 months? Yes☐ No☒
Was the examination carried out In accordance with an examination scheme? Yes☒ No☐
Was the examination carried out After the occurrence of exceptional circumstances? Yes☐ No☒
Identification and description of defect ,if any of any part found to have a defect which is or
None
could become a danger to persons : (If none, state NONE)
Is the above an existing or imminent danger to persons? Note-This is a reportable defect Yes☐ No☒
Is the above a defect which is not yet but could become a danger to persons? Yes☐ No☒
(If YES State the day by) Date:
Particulars of any repair, renewal or alteration required to remedy the defect identified above: None
Particulars of any tests carried out as part of the examination(If none state NONE) Visual
IS THIS EQUIPMENT SAFE TO USE? Yes☒ No☐
Remarks (if Any) :
Inspected By Stamp QA/QC Stamp
Name: Mohamed Yasir
Qualification: LEEA & NDT Level II

Signature:
Name and address of employer of persons making and authenticating this report:
AlMansoori Inspection Services ,P.O.Box: 109442 ,Abu Dhabi,UAE, Email:mis@almansoori.biz, Web: www.almansoori.biz

This certificate is granted subject to the condition that is understood and agreed that nothing herein contained shall be deemed to relieve any designer, manufacturer,
seller, repairer or operator of any warranty, expressed or implied and AlMansoori liability shall be limited to the wilful negligence or deliberate omissions of its
employees. Under no circumstances whatsoever, shall AlMansoori be liable for any injury or damage to any person occurring by reason of negligent operation or
any defect in materials, machinery, equipment or other items other than those defects ascertainable by normally accepted testing standards and only those items
actually inspected by AlMansoori and which are covered by this certificate.
F. 836
Rev. 03
28.11.2018

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