SHACKLE INSPECTION REPORT

CUSTOMER DETAILS

CUSTOMER

Date

ADDRESS

ORDER NO

CONTACT

TEL NO:

DESCRIPTION OF UNIT

UNIT:

SERIAL NO:

WLL:

LENGTH/SIZE/REACH

PLANT

LOCATION:

PREVIOUS INSPECTION DATE *

NEXT INSPECTION DATE *

EQUIPMENT CONDITION

ID TAG/MARKINGS LEGIBLEGOODFAIRBAD

ID TAG/MARKINGS LEGIBLE Remarks

PIN WEAR >10%GOODFAIRBAD

PIN WEAR >10% Remarks

PIN CONDITION (BENDING/DAMAGED THREADING)GOODFAIRBAD

PIN CONDITION (BENDING/DAMAGED THREADING) Remarks

SHACKLE BODY WEAR >10%GOODFAIRBAD

SHACKLE BODY WEAR >10% Remarks

SHACKLE BODY CONDITION(FORMATION)GOODFAIRBAD

SHACKLE BODY CONDITION(FORMATION) Remarks

NUT & SPLIT PINGOODFAIRBAD

NUT & SPLIT PIN Remarks

OVERALL CONDITION (CRACKS/NICKS ETC)GOODFAIRBAD

OVERALL CONDITION (CRACKS/NICKS ETC) Remarks

NOTES

NOTES:

RESULTS

Visual InspectionYESNO

RESULTSPASSFAIL

INSPECTOR NAME & SURNAME

POSITION/ TITLE;

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CUSTOMER REPRESENTATIVE:

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Consent *

THE CUSTOMER ACKNOLEDGES THAT DEFECTIVE EQUIPMENT WILL NOT BE USED UNTIL REPAIRS ARE DONE AND THE UNIT IS INSPECTED AND/OR TESTED

This Is To Certify That The Below Mentioned Unit Has Examined/Inspected in Accordance With SANS 2972 And Meets Safety Standards In Accordance With The OHS Act And The MHS Act.Confirm