Schedule 11 Forms
(subsections 29.3, 31.1 and 31.2)
Form MO 32/1
CERTIFICATE OF TEST AND EXAMINATION OF DERRICKS, CRANES AND CARGO LIFTS
| Articles | | Angle to the | | | | |
|---|
| Situation | Distinguishing numbers or marks | Description | horizontal of derrick or crane for purpose of test* | Proof load applied | Date of test | Safe working load | Method used in applying the proof load |
| | | | | | | |
| | | | | | | |
| | | | | | | |
| Name and address of testing establishment............................................................................................................................................................................................................................................................................................................................................................................................. |
|---|
<table cellspacing="0" cellpadding="0" style="border-collapse:collapse"><tbody><tr><td colspan="2" style="width:484.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; page-break-after:avoid; font-size:10pt"><span>I, ...................................................................., a competent person for Marine Order 32 (Cargo Handling Equipment), certify that on the date shown in the column headed ‘Date of test’ in the table above:</span></p><p style="margin-top:6pt; margin-left:25.2pt; margin-bottom:6pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I tested the articles of material handling equipment identified in that table, in the manner specified in Schedule 4 to Marine Order 32 for the testing establishment mentioned above and am in all respects satisfied that each article identified is of sufficient strength to carry the safe working load specified in the column headed ‘Safe working load’ in the table, relating to that article; and</span></p><p style="margin-top:6pt; margin-left:25.2pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I made a thorough examination of each article identified and am in all respects satisfied from the examination that each such article withstood the proof test without injury or deformation.</span></p></td></tr><tr><td style="width:236.95pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:24pt; font-size:10pt"><span>Position</span></p></td><td style="width:236.95pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:24pt; font-size:10pt"><span>Technical qualifications</span></p></td></tr><tr><td style="width:236.95pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; font-size:10pt"><span>Address .......................................................................</span><br><span>.....................................................................................</span></p></td><td style="width:236.95pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Signature</span></p><p style="margin-top:6pt; text-align:right; font-size:10pt"><span>....../....../......</span></p><p style="text-align:right; font-size:10pt"><span>Date</span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="border:0.75pt solid #000000; border-collapse:collapse"><tbody><tr><td colspan="2" style="width:484.75pt; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; page-break-after:avoid; font-size:10pt"><span>I, ...................................................................., a competent person for Marine Order 32 (Cargo Handling Equipment), certify that on the date shown in the column headed ‘Date of test’ in the table above:</span></p><p style="margin-top:6pt; margin-left:25.2pt; margin-bottom:6pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I tested the articles identified in the table, in the manner specified in Schedule 4 to Marine Ordert 32, for the testing establishment mentioned above; and</span></p><p style="margin-top:6pt; margin-left:25.2pt; margin-bottom:6pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I am in all respects satisfied that each article identified is of sufficient strength to carry the safe working load specified in the column headed ‘Safe working load’ in the table, relating to that article; and</span></p><p style="margin-top:6pt; margin-left:25.2pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I made a thorough examination of each article identified; following application of the proof load, each such article was found to have withstood the load without injury or deformation and to be free from cracks, flaws and other defects.</span></p></td></tr><tr><td style="width:236.95pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:18pt; font-size:10pt"><span>Position</span></p></td><td style="width:236.95pt; border-top:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:18pt; font-size:10pt"><span>Technical qualifications</span></p></td></tr><tr><td style="width:236.95pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="font-size:10pt"><span>Address .......................................................................</span></p><p style="font-size:10pt"><span>.....................................................................................</span></p></td><td style="width:236.95pt; border-top:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:6pt; font-size:10pt"><span>Signature</span></p><p style="margin-top:6pt; margin-bottom:6pt; text-align:right; font-size:10pt"><span>....../....../......</span></p><p style="margin-top:6pt; text-align:right; font-size:10pt"><span>Date</span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="border:0.75pt solid #000000; border-collapse:collapse"><tbody><tr><td colspan="2" style="width:484.75pt; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; page-break-after:avoid; font-size:10pt"><span>I, ...................................................................., a competent person for the purposes of Marine Order 32 (Cargo Handling Equipment), certify that on the date shown in the column headed ‘Date of test’ in the table above:</span></p><p style="margin-top:6pt; margin-left:25.2pt; margin-bottom:6pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I tested the articles identified in the table, in the manner specified in Schedule 4 to Marine Order 32, for the testing establishment mentioned above; and</span></p><p style="margin-top:6pt; margin-left:25.2pt; text-indent:-25.2pt; font-size:10pt"><span style="font-family:Symbol, serif"></span><span style="width:20.6pt; text-indent:0pt; display:inline-block"> </span><span>I made a thorough examination of each article identified; following application of the proof load, each such article was found to have withstood the load without injury or deformation and to be free from cracks, flaws and other defects.</span></p></td></tr><tr><td style="width:236.95pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-bottom:24pt; font-size:10pt"><span>Position</span></p></td><td style="width:236.95pt; border-top:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:24pt; font-size:10pt"><span>Technical qualifications</span></p></td></tr><tr><td style="width:236.95pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="font-size:10pt"><span>Address ......................................................................</span></p><p style="font-size:10pt"><span>.....................................................................................</span></p></td><td style="width:236.95pt; border-top:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-bottom:6pt; font-size:10pt"><span>Signature</span></p><p style="margin-top:6pt; margin-bottom:6pt; text-align:right; font-size:10pt"><span>....../....../......</span></p><p style="margin-top:6pt; text-align:right; font-size:10pt"><span>Date</span></p></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="border-collapse:collapse"><tbody><tr><td style="width:154.35pt; border-top:1.5pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Diameter of rope (mm)</span></p></td><td colspan="2" style="width:154.35pt; border-top:1.5pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Number of strands</span></p></td><td colspan="2" style="width:154.35pt; border-top:1.5pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Number of wires per strand</span></p></td></tr><tr><td colspan="2" style="width:236.95pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Lay</span></p></td><td colspan="3" style="width:236.95pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Core</span></p></td></tr><tr><td colspan="5" style="width:484.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Specification to which wires conform</span></p></td></tr><tr><td colspan="4" style="width:322.05pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Breaking tensile load of sample of the rope</span></p></td><td style="width:151.95pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:10pt"><span>Date of tensile test</span></p></td></tr><tr><td colspan="5" style="width:484.75pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt"><span style="font-size:10pt">Safe working load</span><span> </span><span>— </span><span style="font-size:10pt">subject to any stated qualifying conditions</span><br><span style="font-size:10pt">(such as minimum pulley diameter and direct tensile load)</span></p></td></tr><tr style="height:0pt"><td style="width:165.15pt"></td><td style="width:82.6pt"></td><td style="width:82.55pt"></td><td style="width:2.55pt"></td><td style="width:162.75pt"></td></tr></tbody></table>
```
<table cellspacing="0" cellpadding="0" style="border-collapse:collapse"><tbody><tr><td colspan="2" style="width:484.75pt; border-top:1.5pt solid #000000; border-right:1.5pt solid #000000; border-left:1.5pt solid #000000; padding-right:4.65pt; padding-left:4.65pt; vertical-align:top"><p style="margin-top:6pt; margin-left:17.85pt; margin-bottom:12pt; text-indent:-17.85pt; font-size:10pt"><span>I, ...................................................................., a competent person for the purposes of Marine Order 32 (Cargo Handling Equipment), certify that the above particulars are correct.</span></p></td><td style="vertical-align:top"></td></tr><tr><td style="width:343.6pt; border-left:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.4pt; padding-left:4.65pt; vertical-align:top"><p style="margin-top:6pt; margin-left:17.85pt; margin-bottom:6pt; text-indent:-17.85pt; font-size:10pt"><span>Signature .........................................................................................</span></p></td><td colspan="2" style="width:130.95pt; border-right:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:4.65pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-left:17.85pt; margin-bottom:6pt; text-indent:-17.85pt; font-size:10pt"><span>Date / /</span></p></td></tr><tr style="height:0pt"><td style="width:354.4pt"></td><td style="width:141.15pt"></td><td style="width:0.6pt"></td></tr></tbody></table>
```