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Test Certificate No. C-2395 |
Form T-4 |
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CERTIFICATE OF TEST AND EXAMINATION OF CHAINS,
RINGS, HOOKS,
SHACKLES, SWIVELS AND PULLEY BLOCKS |
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(FORM PRESCRIBED BY THE MINISTER OF TRANSPORT UNDER
THE REGULATIONS FOR THE PROTECTION AGAINST ACCIDENT OF WORKERS
EMPLOYED IN LOADING OR UNLOADING SHIPS) |
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Distinguishing
No. or Mark |
Description
of Gear * |
Number
Tested |
Date of Test |
Proof Load
Applied (t) |
Safe Working
Load (t) |
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.C-2395
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.C-2395
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3/4" x 3 ft CO chain sling, single leg, oblong master link each end
Below are samples of inspection
records. You may make entries on any certificate as long as you do
not change or cover-over the tombstone data.
In
use, Dec 13, 1997, JM
All
OK, Aug 3, 1998, PS
Lost
one overboard, Nov 5, 1998, PS
All
OK, July 31, 1999, KB
All
OK, Aug 24, 2000, AY
One
missing, two OK, July 3, 2001, MT
Replaced
tag on both, Oct 28, 2001, GR
One
transferred to CCGS C D Howe (with copy of certificate), Feb 13,
2002, SX
One
OK, July 5, 2002, PB
If a tag falls off a piece of
gear you may retag the gear as long as you can match it with a certificate.
You may stamp the gear with
certificate # and SWL for easier identification. |
.4 |
.Nov 21/97 |
28 tonnes |
14 tonnes |
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* The dimensions of the gear, the type of material of
which it is made and, where applicable, the heat treatment received
in manufacture should be stated unless Form T-6 is used for this
purpose. ( Form T-6 is the certificate made out and supplied by a
firm contracting to do annealing or heat treatment.) |
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(t) Metric Tonne of 1000 Kilograms |
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Makers or Suppliers:
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Sams Snitty Sling Shop, PO Box 78, Turbopump, BC, V6B 8E4 |
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Public Service, Association, Company or Firm making the
Test and Examination:
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Sams Snitty Sling Shop |
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Position of Signatory:
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Chief Tester |
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I certify that on the 21st day of Nov 1997, the above
gear was tested and examined by me in the manner set forth on the
reverse side of this certificate; that the examination showed that
the gear withstood the proof load without injury or deformation; and
that the safe working load on this gear is as shown in column
"Safe Working Load".
. |
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Signature: Sam
Theman
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Date: Nov
21, 1997. |
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(ONLY TO BE SIGNED BY A COMPETENT PERSON AS DEFINED ON
REVERSE SIDE) |
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Smythe &
Jones Inc.
5810 Skyway Drive
Burlington, Ontario, K0C 4R8 |
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CERTIFICATE OF PERFORMANCE |
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In
use, 13 Aug 01, SR
Cert
# stamped on master links.
One
destroyed, 24 Jan 2002, PB
1
OK, 01 May 01. JT
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CUSTOMER:
CCGS C D HOWE
Government Dock
Ottawa, Ontario, K1S 4P6
Order Number: F2500-01-0122
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A Certificate of Performance is
just another way of saying Test Certificate |
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This is to certify that your New 2 only 5/8" x
3'-01" single Leg chain sling with Oblong Master Link on one end
and SOF type Foundry Hook on other, has a Safe Vertical Lifting Load
of 18,100 lbs.
(serial No's: M-75402-1 &
M-75402-2) |
While it appears that the item
has not been proof-loaded the certificate does indicate a SWL, and it
is signed by a Competent Person.
Here are your
Certificate Numbers |
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Authorized Signature: |
J. Smythe |
It doesn't say if this signee is
an inspector but you must make some assumptions. |
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Date: |
August 7th, 2001 |
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