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Type	TC NO	Date	Action

FORM 38

(Prescribed under Rule 61)

Report of examination of Hoist or Lift Lifting Machine / Tackles

TC NO:

Date:

1	Name of the Occupier (or Factory) Situation address of Factory	:
	(a) Type of Hoist or Lift or Lifting Machinery/ Tackle and identification number or description.	:
	(b) Date of Construction or Reconstruction (if ascertainable)	:
2	Design and Construction (Are all parts of the Hoist or Lift or Lifting Machinery / Tackle of good mechanical construction, sound material and adequate strength as far as ascertainable)	:
3	Distinguished Number of mark (if any) and Description sufficient to Identify the Lifting Machine, Chain ropes or the Lifting Tackle.	:
4	Maintenance: Are the following parts of the Hoist or Lift properly maintained and in good working order? If not, state what defects have been found	:
	a) Enclosure of Hoist way or Lift way	:
	b) Landing gates and cage gate(s)	:
	c) Interlocks on the landing gate(s) and cage gate(s)	:
	d) Other gates, fastenings	:
	e) Cage and Platform and fittings, guiders, buffers, interior of the Hoist way or Lift way	:
	f) Over-running devices	:
	g) Suspension ropes or chain and their attachments	:
	h) Safety gear i.e. arrangements for prevention fall of platform or cage brakes	:
	i) Brakes	:
	j) Worm or spur gearing	:
	k) Other electrical equipment	:
	l) Other Parts	:
5	What parts (if any) were inaccessible?	:
6	Repairs, renewals or alterations (if any) required and the period within which they should be executed	:
	Particulars of the parts rejected after examination	:
7	Maximum safe working load subject to repairs, renewals or alterations (if any) specified in 6.	:
8	Others	:

I / We Certify that on I / We thoroughly examined this hoist or lift or Lifting Machine / Tackle and that the above is a correct report of the result. Valid Up to

                        Digitally signed by

                        Date:

Disclaimer: The test report is prepared as per the condition of the machines at the time of inspection. The Competent Person is not responsible for any incidents/accidents to machines during operation later due to any failure in mechanical, electrical system, and operations due to operator negligence or improper maintenance of the machine. (No part of the system opened for inspection). If it's a mobile crane, valid only if proper base outriggers are used and level position.