GA1 Master

• GA1 Report of Thorough Inspection

• Year 2018 Revision 2.

• Client / Owner Name and Address for whom examination was conducted.

• Tick to confirm that above address is where examination conducted
• If not ticked this is where examination conducted
  Address

• Prepared by QFT

Test Conforming to HSA & Lloyds Lifting Inspection Test Guidelines.

Description

• Description of item under test.

  Select 360* Dumper Site Dumper Artic Dumper Hydrema Telehandler Telehandler with Man Basket Forktruck Harness Sling Chain Chain Hoist HGV Taillift Garage Lifting Patient Hoist Paver Skid Steer Vibrating Roller Attachments Man Basket Attachments Lifting Arms Bulldozer Describe Below

  • 360*
  • Dumper Site
  • Dumper Artic
  • Dumper Hydrema
  • Telehandler
  • Telehandler with Man Basket
  • Forktruck
  • Harness
  • Sling
  • Chain
  • Chain Hoist
  • HGV Taillift
  • Garage Lifting
  • Patient Hoist
  • Paver
  • Skid Steer
  • Vibrating Roller
  • Attachments Man Basket
  • Attachments Lifting Arms
  • Bulldozer
  • Describe Below

• Description of Item under Test.

• Visual & Functional Inspection Only – No Internal Parts Inspected
  Parts not accessible for examination; Enclosed _ Restricted Places_ Mechanical Parts Hydraulic System

Plant Equipment

• Date Inspection Conducted

  Date

• Plant Manufacturer Name. --- Serial Number & or ID Number. / Date of Manufacture --- Number Plate & or Unique Plant Number

• SWL of @ configured with attachments.

• Testing Or Thorough Examination

  Select Testing if yes specify Thorough Examination 6 Mth. Thorough Examination 12 Mth. Visual & Functional Test carried out. Defect which is danger to persons Defect which could become danger to persons

  • Testing if yes specify
  • Thorough Examination 6 Mth.
  • Thorough Examination 12 Mth.
  • Visual & Functional Test carried out.
  • Defect which is danger to persons
  • Defect which could become danger to persons

• Photo of "Appliance" & "SWL Plate"

  Media

• Pass or Fail or more action required?

  Select Pass Pass but Minor Repair Required Fail

  • Pass
  • Pass but Minor Repair Required
  • Fail

• Repair Required.

• Repair Required Photo

  Media

• Signed by Owner to confirm acceptance as above; and commit to below.

  Sign

• I will

  Select Keep this report safe and available for inspection Undertake identified repairs as directed if required. Arrange for a thorough examination or test as prescribed

  • Keep this report safe and available for inspection
  • Undertake identified repairs as directed if required.
  • Arrange for a thorough examination or test as prescribed

• Retest required before end of

  Date

• QFT certify that

  Select The test / thorough examination were conducted as prescribed We have identified defects which are or could become danger to persons The test / thorough examination were conducted by competent person The particulars in this report of thorough examination are correct

  • The test / thorough examination were conducted as prescribed
  • We have identified defects which are or could become danger to persons
  • The test / thorough examination were conducted by competent person
  • The particulars in this report of thorough examination are correct

• Test Performed By

  Sign

Advisory notes

• 1. This is not a certificate of roadworthiness.
  2. The current test certificate & where applicable, EC declaration of conformity, to be attached to the register of lifting equipment and lifting accessories.