ANNUAL THOROUGH EXAMINATION OF ALL LIFTING MACHINES, CHAINS, ROPES & LIFTING

TACKLES UNDER Clause (a) (iii) of Sub-section (1) of Section 29 (Rule 62 of CG Factories Rules 1962)
REPORT NO: AA/24-25/1206 Dated : 09.04.2024 Next Testing Due on: 08.04.2025
1 Name of occupier of the factory/Estt. M/s JAI SAVARIYA SAITH ENGINEERING
2 Address of the factory/Estt. Contractor - M/s LNV Technology (P) Ltd.
Under Contract - Ambuja Cement Ltd., Rawan, Baloda Bazar-
Bhatapara (C.G.)
3 Distinguishing no. or mark & full description of make, WIRE ROPE SLINGS: SWL 3.2T to 5T capacities, As
year of manufacture, capacity detailed in Annexure 1 (Location : Line 3 Project Site,
Ambuja Cement)

4 Date of first use of device Year 2024

5 Date & no. of certificate relating to any test & Manufacturer's test certificate available
examination made under rule 62(1) & 66, name &
address of the examiner who issued the certificate
6 Date of periodical thorough examination made under Being externally examined for the first time by Competent
clause a (iii) of sub-section (i) of section 29 of the act Person, IHS
& rule (65)2 and by whom it was carried out
7 Date of annealing or other heat treatment done under Annealing not required
rule (65)(i) and by whom it was carried out.
8 Particulars of defects affecting the Safe Working Load Any physical defect, that could affect the SWL of above
found at such thorough examination and steps taken to equipment; was not observed at the time of testing/
remedy such defects. examination.
9 Date of examination 09.04.2024
10 No. of lifting device 12 (Twelve) Nos. only
11 Details of test Thorough physical examination and overload test at 1.25
times of Safe Working Load of the wire rope slings was
carried out.
12 Result of examination The physical condition and operation of above Wire Rope
Slings found satisfactory during its testing/examination.
Twist/clink/damage not observed in slings during its
testing/exam. SWL Recommended: As per Annexure 1

I certify that I have thoroughly examined the above mentioned lifting machine/chain/sling/lifting tackle and that the above is a
correct report of the results obtained during such tests/examinations.

CONTACT (Er. AJAY KUMAR AGRAWAL), BE (Mech)

J-2, Saket Apartment, Agrasen Chowk, Competent Person under Factories Act
BILASPUR (CG) 7587448777, 9300489218 Recognized by : The Chief Inspector of Factories
email : [email protected] Directorate, Industrial Health & Safety, Govt of CG
Licence No. : DIHS/CG/RPR/CC/2023/4047092136 Dated 20.04.2023
1. ID No., SWL, test date to be displayed on each equipment.

2. This certificate is only a equipment fitness certificate issued after examination & testing as per statutory provisions & it should not be treated as a
Quality Assurance Certificate pertaining to design, material of construction or welding etc.
3. Any correction in details appearing on this certificate should be informed within 06days. Issued subject to condition that equipment is maintained
in proper condition.
4. This certificate does not guarantee load stability of supporting structure.
 ANNEXURE 1 : DETAILS OF TEST CONDUCTED ON LIFTING TACKLES/MACHINES
M/s JAI SAVARIYA SAITH ENGINEERING, Site: Ambuja Cement Limited, PO Rawan, Distt: Balodabazar (CG)

REPORT NO: AA/24-25/1206 Dated : 09.04.2024 Next Testing Due on: 08.04.2025 Location : Line 3, Project Site, Ambuja Cement
S.N. NAME OF EQUIPMENT LOCAL NO. (GIVEN) LOCATION ROPE DIA ROPE CAPACITY OVERLOAD DATE OF SWL TEST
LENGTH TEST AT TESTING RECOMM. RESULT
1 WIRE ROPE SLING JSSE/WRS-01 Line 3, Project Site 25mm 6M 5T 6.25T 09.04.2024 5T O.K.
2 WIRE ROPE SLING JSSE/WRS-02 Line 3, Project Site 25mm 6M 5T 6.25T 09.04.2024 5T O.K.
3 WIRE ROPE SLING JSSE/WRS-03 Line 3, Project Site 25mm 6M 5T 6.25T 09.04.2024 5T O.K.
4 WIRE ROPE SLING JSSE/WRS-04 Line 3, Project Site 25mm 6M 5T 6.25T 09.04.2024 5T O.K.
5 WIRE ROPE SLING JSSE/WRS-05 Line 3, Project Site 20mm 3M 3.2T 4T 09.04.2024 3.2T O.K.
6 WIRE ROPE SLING JSSE/WRS-06 Line 3, Project Site 20mm 3M 3.2T 4T 09.04.2024 3.2T O.K.
7 WIRE ROPE SLING JSSE/WRS-07 Line 3, Project Site 20mm 3M 3.2T 4T 09.04.2024 3.2T O.K.
8 WIRE ROPE SLING JSSE/WRS-08 Line 3, Project Site 20mm 3M 3.2T 4T 09.04.2024 3.2T O.K.
9 WIRE ROPE SLING JSSE/WRS-09 Line 3, Project Site 20mm 6M 3.2T 4T 09.04.2024 3.2T O.K.
10 WIRE ROPE SLING JSSE/WRS-10 Line 3, Project Site 20mm 6M 3.2T 4T 09.04.2024 3.2T O.K.
11 WIRE ROPE SLING JSSE/WRS-11 Line 3, Project Site 20mm 6M 3.2T 4T 09.04.2024 3.2T O.K.
12 WIRE ROPE SLING JSSE/WRS-12 Line 3, Project Site 20mm 6M 3.2T 4T 09.04.2024 3.2T O.K.

TOTAL WIRE ROPE SLINGS 12

REMARKS :
1. Total no. of Wire Rope Slings : 12 (Twelve) nos. only (Wire Rope Slings Passed for use : 12nos, Rejected- NIL)
2. General physical condition & operation of the above wire rope slings verified and found satisfactory during testing/examination.
3. It was verified that the eye and strands were intact and without any cut, and no welds or blurrs visible on wire ropes.
4. Rope Diameter was measured on maximum diameter size from atleast 3 places and no elongation was observed, as diameters found consistent without any variation.
5. Other parameters of wire rope slings were verified as per BIS : 2266 : 2019. Breaking was verified by releasing the pull chain at test load of 1.25 times of SWL.
 ANNUAL THOROUGH EXAMINATION OF ALL LIFTING MACHINES, CHAINS, ROPES & LIFTING TACKLES
UNDER Clause (a) (iii) of Sub-section (1) of Section 29 (Prescribed under CG Factories Rules 1962)

REPORT NO: AA/24-25/1207 Dated : 09.04.2024 Next Testing Due on: 08.04.2025
1 Name of occupier of the factory/Estt. M/s JAI SAVARIYA SAITH ENGINEERING
2 Address of the factory/Estt. Contractor - M/s LNV Technology (P) Ltd.
Under Contract - Ambuja Cement Ltd., Rawan, Baloda Bazar-
Bhatapara (C.G.)
3 Distinguishing no. or mark & full description of make, TURN BUCKLES : SWL 5T to 10T capacities, with
year of manufacture, capacity right handed & left handed thread made up of alloy steel,
As detailed in Annexure 2 (Location : Line 3 Project Site,
Ambuja Cement)
4 Date of first use of device Being deployed for use at current site for 1st time.
5 Date & no. of certificate relating to any test & Manufacturer's test certificate available
examination made under rule 62(1) & 66, name &
address of the examiner who issued the certificate
6 Date of periodical thorough examination made under Being externally examined for the first time by Competent
clause a (iii) of sub-section (i) of section 29 of the act Person, IHS
& rule (65)2 and by whom it was carried out
7 Date of annealing or other heat treatment done under Annealing not required
rule (65)(i) and by whom it was carried out.
8 Particulars of defects affecting the Safe Working Load Any physical defect, that could affect the SWL of above
found at such thorough examination and steps taken to equipment; was not observed at the time of testing/
remedy such defects. examination.
9 Date of examination 09.04.2024
10 No. of lifting device 03 (Three) Nos. only
11 Details of test Thorough physical examination and overload test at 1.25
times of Safe Working Load of the Turn Buckles was
carried out.
12 Result of examination The physical condition and operation of above Turn
Buckles were found satisfactory during its
testing/examination. The right handed thread & left handed
thread movement, screw rotation, rotation of bolt & main
body were found working properly during its testing/exam.
SWL Recommended: As per Annexure 2
I certify that I have thoroughly examined the above mentioned lifting machine/chain/sling/lifting tackle and that the above is a correct
report of the results obtained during such tests/examinations.

CONTACT (Er. AJAY KUMAR AGRAWAL), BE (Mech)

J-2, Saket Apartment, Agrasen Chowk, Competent Person under Factories Act
BILASPUR (CG) 7587448777, 9300489218 Recognized by : The Chief Inspector of Factories
email : [email protected] Directorate, Industrial Health & Safety, Govt of CG
Licence No. : DIHS/CG/RPR/CC/2023/4047092136 Dated 20.04.2023
1. ID No., SWL, test date to be displayed on each equipment.

2. This certificate is only a equipment fitness certificate issued after examination & testing as per statutory provisions & it should not be treated as a
Quality Assurance Certificate pertaining to design, material of construction or welding etc.
3. Any correction in details appearing on this certificate should be informed within 06days. Issued subject to condition that equipment is maintained
in proper condition.
4. This certificate does not guarantee load stability of supporting structure.
 ANNEXURE 2 : DETAILS OF TEST CONDUCTED ON LIFTING TACKLES/MACHINES
M/s JAI SAVARIYA SAITH ENGINEERING, Site: Ambuja Cement Limited, PO Rawan, Distt: Balodabazar (CG)

REPORT NO: AA/24-25/1207 Dated : 09.04.2024 Next Testing Due on: 08.04.2025 Location : Line 3, Project Site, Ambuja Cement
S.N. NAME OF LIFTING LOCAL NO. LOCATION TYPE/SPECS. CAPACITY OVERLOAD TEST DATE OF TESTING SWL TEST
TACKLE (GIVEN) AT RECOMM. RESULT

1 TURN BUCKLE JSSE/TB-01 Line 3, Project Site Double Thread 10T 12.5T 09.04.2024 10T O.K.

2 TURN BUCKLE JSSE/TB-02 Line 3, Project Site Double Thread 5T 6.25T 09.04.2024 5T O.K.

3 TURN BUCKLE JSSE/TB-03 Line 3, Project Site Double Thread 5T 6.25T 09.04.2024 5T O.K.

TOTAL TURN BUCKLES 3

REMARKS :
1. Total no. of Turn Buckles : 03 (Three) nos. only (Turn Buckles Passed for use : 03nos, Rejected- NIL)
2. General physical condition & operation of the above items verified and found satisfactory during testing/examination.
 ANNUAL THOROUGH EXAMINATION OF ALL LIFTING MACHINES, CHAINS, ROPES & LIFTING
TACKLES UNDER Clause (a) (iii) of Sub-section (1) of Section 29 (Rule 62 of CG Factories Rules 1962)
REPORT NO: AA/24-25/1208 Dated : 09.04.2024 Next Testing Due on: 08.04.2025
1 Name of occupier of the factory/Estt. M/s JAI SAVARIYA SAITH ENGINEERING
2 Address of the factory/Estt. Contractor - M/s LNV Technology (P) Ltd.
Under Contract - Ambuja Cement Ltd., Rawan, Baloda Bazar-
Bhatapara (C.G.)
3 Distinguishing no. or mark & full description of make, BOW SHACKLES: Made of forged steel, SWL 12T to
year of manufacture, capacity 17T capacities, forged, quenched and tempered with alloy
pin, As detailed in Annexure 3 (Location : Line 3 Project
Site, Ambuja Cement)

4 Date of first use of device Year 2024

5 Date & no. of certificate relating to any test & Manufacturer's test certificate available
examination made under rule 62(1) & 66, name &
address of the examiner who issued the certificate
6 Date of periodical thorough examination made under Being externally examined for the first time by Competent
clause a (iii) of sub-section (i) of section 29 of the act Person, IHS
& rule (65)2 and by whom it was carried out
7 Date of annealing or other heat treatment done under Annealing not required
rule (65)(i) and by whom it was carried out.
8 Particulars of defects affecting the Safe Working Load Any physical defect, that could affect the SWL of above
found at such thorough examination and steps taken to equipment; was not observed at the time of testing/
remedy such defects. examination.
9 Date of examination 09.04.2024
10 No. of lifting device 08 (Eight) Nos. only
11 Details of test Thorough physical examination and overload test at 1.25
times of Safe Working Load of the Bow Shackles was
carried out.
12 Result of examination The physical condition and operation of above Bow
Shackles found satisfactory during its testing/examination.
Twist/abrasion/damage not observed in these bow shackles
during its testing/exam. SWL Recommended: As per
Annexure 3
I certify that I have thoroughly examined the above mentioned lifting machine/chain/sling/lifting tackle and that the above is a correct
report of the results obtained during such tests/examinations.

CONTACT (Er. AJAY KUMAR AGRAWAL), BE (Mech)

J-2, Saket Apartment, Agrasen Chowk, Competent Person under Factories Act
BILASPUR (CG) 7587448777, 9300489218 Recognized by : The Chief Inspector of Factories
email : [email protected] Directorate, Industrial Health & Safety, Govt of CG
Licence No. : DIHS/CG/RPR/CC/2023/4047092136 Dated 20.04.2023
1. ID No., SWL, test date to be displayed on each equipment.

2. This certificate is only a equipment fitness certificate issued after examination & testing as per statutory provisions & it should not be treated as a
Quality Assurance Certificate pertaining to design, material of construction or welding etc.
3. Any correction in details appearing on this certificate should be informed within 06days. Issued subject to condition that equipment is maintained
in proper condition.
4. This certificate does not guarantee load stability of supporting structure.
 ANNEXURE 3 : DETAILS OF TEST CONDUCTED ON LIFTING TACKLES/MACHINES
M/s JAI SAVARIYA SAITH ENGINEERING, Site: Ambuja Cement Limited, PO Rawan, Distt: Balodabazar (CG)

REPORT NO: AA/24-25/1208 Dated : 09.04.2024 Next Testing Due on: 08.04.2025 Location : Line 3, Project Site, Ambuja Cement
S.N. NAME OF LIFTING LOCAL NO. LOCATION PIN DIA CAPACITY OVERLOAD TEST DATE OF TESTING SWL TEST
TACKLE (GIVEN) AT RECOMM. RESULT

1 BOW SHACKLE JSSE/BS-01 Line 3, Project Site 35mm 12T 15T 09.04.2024 12T O.K.

2 BOW SHACKLE JSSE/BS-02 Line 3, Project Site 35mm 12T 15T 09.04.2024 12T O.K.

3 BOW SHACKLE JSSE/BS-03 Line 3, Project Site 35mm 12T 15T 09.04.2024 12T O.K.

4 BOW SHACKLE JSSE/BS-04 Line 3, Project Site 35mm 12T 15T 09.04.2024 12T O.K.

5 BOW SHACKLE JSSE/BS-05 Line 3, Project Site 46mm 17T 21.25T 09.04.2024 17T O.K.

6 BOW SHACKLE JSSE/BS-06 Line 3, Project Site 46mm 17T 21.25T 09.04.2024 17T O.K.

7 BOW SHACKLE JSSE/BS-07 Line 3, Project Site 46mm 17T 21.25T 09.04.2024 17T O.K.

8 BOW SHACKLE JSSE/BS-08 Line 3, Project Site 46mm 17T 21.25T 09.04.2024 17T O.K.

TOTAL BOW SHACKLES 8

REMARKS :
1. Total no. of Bow Shackles : 08 (Eight) nos. only (Bow Shackles Passed for use : 08nos, Rejected- NIL)
2. General physical condition & operation of the above items verified and found satisfactory during testing/examination.
 ANNUAL THOROUGH EXAMINATION OF ALL LIFTING MACHINES, CHAINS, ROPES & LIFTING
TACKLES UNDER Clause (a) (iii) of Sub-section (1) of Section 29 (Rule 62 of CG Factories Rules 1962)
REPORT NO: AA/24-25/1209 Dated : 09.04.2024 Next Testing Due on: 08.04.2025
1 Name of occupier of the factory/Estt. M/s JAI SAVARIYA SAITH ENGINEERING
2 Address of the factory/Estt. Contractor - M/s LNV Technology (P) Ltd.
Under Contract - Ambuja Cement Ltd., Rawan, Baloda Bazar-
Bhatapara (C.G.)
3 Distinguishing no. or mark & full description of make, D-SHACKLES: Made of forged steel, SWL 4.75T to
year of manufacture, capacity 9.5T, forged, quenched and tempered with alloy pin, As
detailed in annexure 4 (Location : Line 3 Project Site,
Ambuja Cement)
4 Date of first use of device Year 2024
5 Date & no. of certificate relating to any test & Manufacturer's test certificate available
examination made under rule 62(1) & 66, name &
address of the examiner who issued the certificate
6 Date of periodical thorough examination made under Being externally examined for the first time by Competent
clause a (iii) of sub-section (i) of section 29 of the act Person, IHS
& rule (65)2 and by whom it was carried out
7 Date of annealing or other heat treatment done under Annealing not required
rule (65)(i) and by whom it was carried out.
8 Particulars of defects affecting the Safe Working Load Any physical defect, that could affect the SWL of above
found at such thorough examination and steps taken to equipment; was not observed at the time of testing/
remedy such defects. examination.
9 Date of examination 09.04.2024
10 No. of lifting device 16 (Sixteen) Nos. only
11 Details of test Thorough physical examination and overload test at 1.25
times of Safe Working Load of the D-Shackle was carried
out.
12 Result of examination The physical condition and operation of above D-Shackle
found satisfactory during its testing/examination.
Twist/abrasion/damage not observed in these D-shackle
during its testing/exam. SWL Recommended: As per
Annexure 4
I certify that I have thoroughly examined the above mentioned lifting machine/chain/sling/lifting tackle and that the above is a correct
report of the results obtained during such tests/examinations.

CONTACT (Er. AJAY KUMAR AGRAWAL), BE (Mech)

J-2, Saket Apartment, Agrasen Chowk, Competent Person under Factories Act
BILASPUR (CG) 7587448777, 9300489218 Recognized by : The Chief Inspector of Factories
email : [email protected] Directorate, Industrial Health & Safety, Govt of CG
Licence No. : DIHS/CG/RPR/CC/2023/4047092136 Dated 20.04.2023
1. ID No., SWL, test date to be displayed on each equipment.

2. This certificate is only a equipment fitness certificate issued after examination & testing as per statutory provisions & it should not be treated as a
Quality Assurance Certificate pertaining to design, material of construction or welding etc.
3. Any correction in details appearing on this certificate should be informed within 06days. Issued subject to condition that equipment is maintained
in proper condition.
4. This certificate does not guarantee load stability of supporting structure.
 ANNEXURE 4 : DETAILS OF TEST CONDUCTED ON LIFTING TACKLES/MACHINES
M/s JAI SAVARIYA SAITH ENGINEERING, Site: Ambuja Cement Limited, PO Rawan, Distt: Balodabazar (CG)

REPORT NO: AA/24-25/1209 Dated : 09.04.2024 Next Testing Due on: 08.04.2025 Location : Line 3, Project Site, Ambuja Cement
S.N. NAME OF LIFTING LOCAL NO. LOCATION PIN DIA CAPACITY OVERLOAD TEST DATE OF TESTING SWL TEST
TACKLE (GIVEN) AT RECOMM. RESULT

1 D-SHACKLE JSSE/DS-01 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

2 D-SHACKLE JSSE/DS-02 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

3 D-SHACKLE JSSE/DS-03 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

4 D-SHACKLE JSSE/DS-04 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

5 D-SHACKLE JSSE/DS-05 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

6 D-SHACKLE JSSE/DS-06 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

7 D-SHACKLE JSSE/DS-07 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

8 D-SHACKLE JSSE/DS-08 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

9 D-SHACKLE JSSE/DS-09 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

10 D-SHACKLE JSSE/DS-10 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

11 D-SHACKLE JSSE/DS-11 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

12 D-SHACKLE JSSE/DS-12 Line 3, Project Site 22mm 4.75T 5.9T 09.04.2024 4.75T O.K.

13 D-SHACKLE JSSE/DS-13 Line 3, Project Site 32mm 9.5T 11.875T 09.04.2024 9.5T O.K.

14 D-SHACKLE JSSE/DS-14 Line 3, Project Site 32mm 9.5T 11.875T 09.04.2024 9.5T O.K.
 15 D-SHACKLE JSSE/DS-15 Line 3, Project Site 32mm 9.5T 11.875T 09.04.2024 9.5T O.K.

16 D-SHACKLE JSSE/DS-16 Line 3, Project Site 32mm 9.5T 11.875T 09.04.2024 9.5T O.K.

TOTAL D-SHACKLES 16

REMARKS :
1. Total no. of D Shackles : 16 (Sixteen) nos. only (D Shackles Passed for use : 16nos, Rejected- NIL)
2. General physical condition & operation of the above items verified and found satisfactory during testing/examination.
 ANNUAL THOROUGH EXAMINATION OF ALL LIFTING MACHINES, CHAINS, ROPES & LIFTING
TACKLES UNDER Clause (a) (iii) of Sub-section (1) of Section 29 (Rule 62 of CG Factories Rules 1962)
REPORT NO: AA/24-25/1210 Dated : 09.04.2024 Next Testing Due on: 08.04.2025
1 Name of occupier of the factory/Estt. M/s JAI SAVARIYA SAITH ENGINEERING
2 Address of the factory/Estt. Contractor - M/s LNV Technology (P) Ltd.
Under Contract - Ambuja Cement Ltd., Rawan, Baloda Bazar-
Bhatapara (C.G.)
3 Distinguishing no. or mark & full description of make, U-CLAMP, SWL 1MT each, As detailed in Annexure 5
year of manufacture, capacity (Location : Line 3 Project Site, Ambuja Cement)

4 Date of first use of device Year 2024

5 Date & no. of certificate relating to any test & Manufacturer's test certificate available
examination made under rule 62(1) & 66, name &
address of the examiner who issued the certificate
6 Date of periodical thorough examination made under Being externally examined for the first time by Competent
clause a (iii) of sub-section (i) of section 29 of the act Person, IHS
& rule (65)2 and by whom it was carried out
7 Date of annealing or other heat treatment done under Annealing not required
rule (65)(i) and by whom it was carried out.
8 Particulars of defects affecting the Safe Working Load Any physical defect, that could affect the SWL of above
found at such thorough examination and steps taken to equipment; was not observed at the time of testing/
remedy such defects. examination.

9 Date of examination 09.04.2024

10 No. of lifting device 50 (Fifty) Nos. only
11 Details of test Thorough physical examination and overload test at 1.25
times of Safe Working Load of the U Clamps was carried
out.
12 Result of examination The physical condition and operation of above U-clamps
found satisfactory during its testing/examination. No surface
defects or rust observed on the U-clamp surface during its
testing/exam. SWL Recommended: As per Annexure 5

I certify that I have thoroughly examined the above mentioned lifting machine/chain/rope/lifting tackle and that the above is a correct
report of the results obtained during such tests/examinations.

CONTACT (Er. AJAY KUMAR AGRAWAL), BE (Mech)

J-2, Saket Apartment, Agrasen Chowk, Competent Person under Factories Act
BILASPUR (CG) 7587448777, 9300489218 Recognized by : The Chief Inspector of Factories
email : [email protected] Directorate, Industrial Health & Safety, Govt of CG
Licence No. : DIHS/CG/RPR/CC/2023/4047092136 Dated 20.04.2023
1. ID No., SWL, test date to be displayed on each equipment.

2. This certificate is only a equipment fitness certificate issued after examination & testing as per statutory provisions &it should not be treated as a
Quality Assurance Certificate pertaining to design, material of construction or welding etc.
3. Any correction in details appearing on this certificate should be informed within 06days. Issued subject to condition that equipment is maintained in
proper condition.
4. This certificate does not guarantee load stability of supporting structure.
 ANNEXURE 5 : DETAILS OF TEST CONDUCTED ON LIFTING TACKLES/MACHINES
M/s JAI SAVARIYA SAITH ENGINEERING, Site: Ambuja Cement Limited, PO Rawan, Distt: Balodabazar (CG)

REPORT NO: AA/24-25/1210 Dated : 09.04.2024 Next Testing Due on: 08.04.2025 Location : Line 3, Project Site, Ambuja
S.N. NAME OF U ARM LOCAL NO. LOCATION CAPACITY OVERLOAD DATE OF SWL RECOM TEST RESULT
TACKLE DIA (GIVEN) TEST AT TESTING

1 U-CLAMP 10mm JSSE/UC-01 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
2 U-CLAMP 10mm JSSE/UC-02 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
3 U-CLAMP 10mm JSSE/UC-03 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
4 U-CLAMP 10mm JSSE/UC-04 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
5 U-CLAMP 10mm JSSE/UC-05 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
6 U-CLAMP 10mm JSSE/UC-06 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
7 U-CLAMP 10mm JSSE/UC-07 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
8 U-CLAMP 10mm JSSE/UC-08 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
9 U-CLAMP 10mm JSSE/UC-09 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
10 U-CLAMP 10mm JSSE/UC-10 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
11 U-CLAMP 10mm JSSE/UC-11 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
12 U-CLAMP 10mm JSSE/UC-12 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
13 U-CLAMP 10mm JSSE/UC-13 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
14 U-CLAMP 10mm JSSE/UC-14 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
15 U-CLAMP 10mm JSSE/UC-15 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
16 U-CLAMP 10mm JSSE/UC-16 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
17 U-CLAMP 10mm JSSE/UC-17 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
18 U-CLAMP 10mm JSSE/UC-18 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
19 U-CLAMP 10mm JSSE/UC-19 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
20 U-CLAMP 10mm JSSE/UC-20 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
21 U-CLAMP 10mm JSSE/UC-21 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
22 U-CLAMP 10mm JSSE/UC-22 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
23 U-CLAMP 10mm JSSE/UC-23 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
24 U-CLAMP 10mm JSSE/UC-24 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
25 U-CLAMP 10mm JSSE/UC-25 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
26 U-CLAMP 10mm JSSE/UC-26 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
27 U-CLAMP 10mm JSSE/UC-27 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
28 U-CLAMP 10mm JSSE/UC-28 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
29 U-CLAMP 10mm JSSE/UC-29 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
30 U-CLAMP 10mm JSSE/UC-30 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
31 U-CLAMP 10mm JSSE/UC-31 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
32 U-CLAMP 10mm JSSE/UC-32 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
33 U-CLAMP 10mm JSSE/UC-33 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
34 U-CLAMP 10mm JSSE/UC-34 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
35 U-CLAMP 10mm JSSE/UC-35 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
36 U-CLAMP 10mm JSSE/UC-36 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
 37 U-CLAMP 10mm JSSE/UC-37 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
38 U-CLAMP 10mm JSSE/UC-38 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
39 U-CLAMP 10mm JSSE/UC-39 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
40 U-CLAMP 10mm JSSE/UC-40 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
41 U-CLAMP 10mm JSSE/UC-41 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
42 U-CLAMP 10mm JSSE/UC-42 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
43 U-CLAMP 10mm JSSE/UC-43 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
44 U-CLAMP 10mm JSSE/UC-44 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
45 U-CLAMP 10mm JSSE/UC-45 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
46 U-CLAMP 10mm JSSE/UC-46 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
47 U-CLAMP 10mm JSSE/UC-47 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
48 U-CLAMP 10mm JSSE/UC-48 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
49 U-CLAMP 10mm JSSE/UC-49 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.
50 U-CLAMP 10mm JSSE/UC-50 Line 3, Project Site 1MT 1.25MT 09.04.2024 1MT O.K.

TOTAL U-CLAMPS 50

Total no. of U-Clamps : 50 (Fifty) nos. only (O.K.- 50nos, Rejected- Nil)
Remarks: General physical condition of U-clamps found satisfactory during testing/examination.
 ANNUAL THOROUGH EXAMINATION OF ALL LIFTING MACHINES, CHAINS, ROPES & LIFTING
TACKLES UNDER Clause (a) (iii) of Sub-section (1) of Section 29 (Rule 62 of CG Factories Rules 1962)
REPORT NO: AA/24-25/1211 Dated : 09.04.2024 Next Testing Due on: 08.04.2025
1 Name of occupier of the factory/Estt. M/s JAI SAVARIYA SAITH ENGINEERING
2 Address of the factory/Estt. Contractor - M/s LNV Technology (P) Ltd.
Under Contract - Ambuja Cement Ltd., Rawan, Baloda Bazar-
Bhatapara (C.G.)
3 Distinguishing no. or mark & full description of make, POLYESTER WEB SLINGS: SWL 3T to 6T
year of manufacture, capacity capacities, As detailed in Annexure 6 (Location : Line 3
Project Site, Ambuja Cement)

4 Date of first use of device Year 2024

5 Date & no. of certificate relating to any test & Manufacturer's test certificate available
examination made under rule 62(1) & 66, name &
address of the examiner who issued the certificate
6 Date of periodical thorough examination made under Being externally examined for the first time by Competent
clause a (iii) of sub-section (i) of section 29 of the act Person, IHS
& rule (65)2 and by whom it was carried out

7 Date of annealing or other heat treatment done under Annealing not required
rule (65)(i) and by whom it was carried out.
8 Particulars of defects affecting the Safe Working Load Any physical defect, that could affect the SWL of above
found at such thorough examination and steps taken to equipment; was not observed at the time of testing/
remedy such defects. examination.
9 Date of examination 09.04.2024
10 No. of lifting device 08 (Eight) Nos. only
11 Details of test Thorough physical examination and overload test at 1.25
times of Safe Working Load of the polyester web slings
was carried out.
12 Result of examination The physical condition and operation of above Polyester
Web Slings found satisfactory during its
testing/examination. Twist/clink/damage not observed in
slings during its testing/exam. SWL Recommended: As
per Annexure 6
I certify that I have thoroughly examined the above mentioned lifting machine/chain/sling/lifting tackle and that the above is a correct
report of the results obtained during such tests/examinations.

CONTACT (Er. AJAY KUMAR AGRAWAL), BE (Mech)

J-2, Saket Apartment, Agrasen Chowk, Competent Person under Factories Act
BILASPUR (CG) 7587448777, 9300489218 Recognized by : The Chief Inspector of Factories
email : [email protected] Directorate, Industrial Health & Safety, Govt of CG
Licence No. : DIHS/CG/RPR/CC/2023/4047092136 Dated 20.04.2023
1. ID No., SWL, test date to be displayed on each equipment.

2. This certificate is only a equipment fitness certificate issued after examination & testing as per statutory provisions & it should not be treated as a
Quality Assurance Certificate pertaining to design, material of construction or welding etc.
3. Any correction in details appearing on this certificate should be informed within 06days. Issued subject to condition that equipment is maintained
in proper condition.
4. This certificate does not guarantee load stability of supporting structure.
 ANNEXURE 6 : DETAILS OF TEST CONDUCTED ON LIFTING TACKLES/MACHINES
M/s JAI SAVARIYA SAITH ENGINEERING, Site: Ambuja Cement Limited, PO Rawan, Distt: Balodabazar (CG)

REPORT NO: AA/24-25/1211 Dated : 09.04.2024 Next Testing Due on: 08.04.2025 Location : Line 3, Project Site, Ambuja Cement

S.N. NAME OF EQUIPMENT LOCAL NO. (GIVEN) LOCATION WIDTH LENGTH CAPACITY OVERLOAD DATE OF SWL RECOMM. TEST RESULT
TEST AT TESTING

1 POLYESTER WEB SLING JSSE/PWS-01 Line 3, Project Site 150mm 6M 6T 7.5T 09.04.2024 6T O.K.

2 POLYESTER WEB SLING JSSE/PWS-02 Line 3, Project Site 150mm 6M 6T 7.5T 09.04.2024 6T O.K.

3 POLYESTER WEB SLING JSSE/PWS-03 Line 3, Project Site 150mm 6M 6T 7.5T 09.04.2024 6T O.K.

4 POLYESTER WEB SLING JSSE/PWS-04 Line 3, Project Site 150mm 6M 6T 7.5T 09.04.2024 6T O.K.

5 POLYESTER WEB SLING JSSE/PWS-05 Line 3, Project Site 75mm 3M 3T 3.75T 09.04.2024 3T O.K.

6 POLYESTER WEB SLING JSSE/PWS-06 Line 3, Project Site 75mm 3M 3T 3.75T 09.04.2024 3T O.K.

7 POLYESTER WEB SLING JSSE/PWS-07 Line 3, Project Site 75mm 3M 3T 3.75T 09.04.2024 3T O.K.

8 POLYESTER WEB SLING JSSE/PWS-08 Line 3, Project Site 75mm 3M 3T 3.75T 09.04.2024 3T O.K.

TOTAL POLYESTER WEB SLINGS 8

REMARKS :
1. Total no. of Polyster Web Slings : 08 (Eight) nos. only (Polyester Web Slings Passed for use : 08nos, Rejected- NIL)
2. General physical condition & operation of the above polyster slings verified and found satisfactory during testing/examination.
3. It was verified that the eye and strands were intact and without any cut, and no welds or blurrs visible on wire ropes.
4. Other parameters of polyster slings were verified as per BS : 3481 Part 2, 1983, Breaking was verified at test load of 1.25 times of SWL.