Title Page
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Project: -
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Report of Thorough Examination
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Date of thorough examination: -
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Date of report: -
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Report No: -
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Date of last thorough examination: -
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Description of equipment
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Name & address of hirer/user
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Makers name: -
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Date of manufacture: -
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Owners No & Serial No: -
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Location of equipment: -
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Mast height: -
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Number of landing gates: -
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Number of tie levels: -
Examination
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Safe Working Load: -
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Test load applied: -
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Drop test carried out with: -
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Examination after installation/assembly: -
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Periodic examination 6 Monthly: -
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Periodic examination 12 Monthly: -
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Examination following alteration/repair Or exceptional circumstances: -
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State if any parts were inaccessible: -
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Particulars of other tests carried out during this thorough examination: -
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Is the equipment installed correctly: -
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Is the equipment safe to operate: -
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Particulars of any defects, repair, renewal or alteration required which is or could become a danger to persons: -
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I hereby declare that the equipment described in this report was thoroughly examined and was found to be free from any defect likely to affect safety, (unless otherwise stated above) and that the particulars are correct.
This document is to be used as a 6 or 12 month LOLER examination certificate. -
Name of Hoist Engineer: -
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Job title/qualification: -
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Address of competent person or his employer: Express Site Solutions LTD, 32 Crown Road, Enfield, EN1 1TH
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The next thorough examination will be due on or before: -
