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JC International Limited

RC. 413243
Port Harcourt Office: Plot 5 JC Street, Off Peter Odili Road, P.O. Box 6427 Trans Amadi Port Harcourt, Rivers State. Tel: +234-84-489909 Lagos Office: 56A Bourdillon Road, P.O. Box 52224 Ikoyi. Tel: +234-1-842-5813 E-mail: service@jcinternationalng.com Website: www.jcinternationalng.com

VERTICAL MAST FORKLIFT INSPECTION REPORT


ID. No: Not seen Manufacturer: Owner:
LINDE

Report no- 6515


Legends: S Satisfactory Unsatisfactory Not Applicable

Serial No: 136617 Model: H 70D -01 Location: new general store

SWL: 2000kg Date Manufactured: 2013 Place of Test: new general store Date of last test: not seen Date of Next Inspection: 18/11/2014 STATUS: Fit for use

U N/A

Nigerdock nig ltd


Date of Inspection: 19/11/2013 Inspector: KELECHI EMERIBE Contract No: Description: VERTICAL MAST FORKLIFT Specification: ASME B56.6

CHASIS Steering Axle Hydraulic System Wheels Tyres Brakes Light Indicator Gauges Suspension ok ok ok ok ok ok ok ok ok

FORKS OK Forks Blade OK

NDE

Tilt Cylinder OK Hydraulic System OK Fork Heels OK


Signature/Date 13/11/2013

Inspectors Name/Qualification Kelechi Emeribe LEEA Qualified Lifting Equipment Tester and Examiner.

SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 1 of 4

JC International Limited
RC. 413243

CHECKLIST FOR FORKLIFT INSPECTION


Name & Address of the Owner Niger Dock Nig PLC Name & Address of the Manufacturer: Flexi Hiload Type
Flexi Hiload 1250AC

Date of thorough examination 19/11/13 Date of last thorough Inspection Not seen
Relevant Standard

Survey Requested By ALLISTAR


Date of last load test and Insp.

Location: New General Store Serial No: 136617 Test Load Applied 2200KG Date of last Proof load Test Not seen
Tilt Cylinder Creep in 5 minutes

ASME B56.6 Capacity: 1250AC

Owner ID: Not Seen

Model No: 1250AC


Relief Valve Adjustment

19/11/2013 License No. Not seen


Date of next Thorough Insp.

N/A Validity of this certificate 12 months


Comments:

18/11/14.

Comments noted and alterations or repairs required before Forklift are put into service (if none enter NONE)

FIT FOR USE

Page 2 of 4

JC International Limited
RC. 413243

SECTION

NEEDED CORRECTIONS (if any) DEFECTS NOTED

General: Wheels Tyres Mast and Fork-carrier Load Chain Side Rollers Roll-over cage Forks Horn and Safety Devices Hydraulic System Electrical System Engine Compartment Exhaust System Cooling System Steering Operational Controls Gauges in Cab Fire Extinguisher Maintenance

ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok Ok Ok

Inspectors Name/Qualification

Signature/Date

KELECHI EMERIBE
19/11/2013 LEEA QUALIFIED LIFTING EQUIPMENT TESTER AND EXAMINER, SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 3 of 4

JC International Limited
RC. 413243

Section 1
1.1 a) b) c) d) e) f) g) h) i) j) k) l) m) n) o) p) q) r) s) t) u) v) w) x)

Operators Cab

NA

Operators Cab Condition: Access / Handholds/Steps Non-slip surfaces House keeping Door(s) Glass Window Wiper Heater/Air Conditioner Wiring Mirrors Seat/Seats Belts Instruments and gauges Roof access Load Capacity Chart Operators Manual

Warning Decals Power Line Warning Decal Hand Signal Chart Lights Control Linkage Beams float & pad Cylinder Outriggers Operators Seat Fire extinguisher

Page 4 of 4

JC International Limited
RC. 413243

CERTIFICATE OF TEST AND THOROUGH EXAMINATION


STATUTORY INSTRUMENTS 1998 NO. 2307 The Lifting Operations and Lifting Equipment Regulations 1998 STATUTORY INSTRUMENTS 1992 NO. 3073 The Supply of Machinery (Safety) Regulations 1992 STATUTORY INSTRUMENTS 1998 NO. 2306 The Provision and use of Work Equipment Regulations 1998

Client: Inspection Location: Inspector: Forklift Type: Forklift Manufacturer: Model Number: Serial Number: SWL Tested to Certificate Number: Inspection Date: Next Date of Examination:

Niger Dock Nig PLC NEW GENERAL STORE. KELECHI EMERIBE.


FLEXI HILOAD 12502AC. FLEXI 12502AC. 136617

2000kg 2200kg 6515 19/11/13 18/11/14

This is to certify that I did Thorough Examination on the forklift in accordance with ASME B 56.6 and all statutory requirements as stated above. The records of examination are true without prejudice for the purpose it was designed for. Fit for use.
Inspectors Name/Qualification Signature/Date

KELECHI EMERIBE LEEA Qualified Lifting Equipment Tester and Examiner. FID, SNT Level 11 MT, PT, VT, ET, UT, in compliance 19
TH

November, 2013

JC International Limited
RC. 413243
Port Harcourt Office: Plot 5 JC Street, Off Peter Odili Road, P.O. Box 6427 Trans Amadi Port Harcourt, Rivers State. Tel: +234-84-489909 Lagos Office: 56A Bourdillon Road, P.O. Box 52224 Ikoyi. Tel: +234-1-842-5813 E-mail: service@jcinternationalng.com Website: www.jcinternationalng.com

VERTICAL MAST FORKLIFT INSPECTION REPORT


ID. No: Not seen Manufacturer: Owner:
LINDE

Report no- 6516


Legends: S Satisfactory Unsatisfactory Not Applicable

Serial No: 136618 Model: H 70D -01 Location: new general store

SWL: 2000kg Date Manufactured: 2013 Place of Test: new general store Date of last test: not seen Date of Next Inspection: 18/11/2014 STATUS: Fit for use

U N/A

Nigerdock nig ltd


Date of Inspection: 19/11/2013 Inspector: KELECHI EMERIBE Contract No: Description: VERTICAL MAST FORKLIFT Specification: ASME B56.6

CHASIS Steering Axle Hydraulic System Wheels Tyres Brakes Light Indicator Gauges Suspension ok ok ok ok ok ok ok ok ok

FORKS OK Forks Blade OK

NDE

Tilt Cylinder OK Hydraulic System OK Fork Heels OK


Signature/Date 19/11/2013

Inspectors Name/Qualification Kelechi Emeribe LEEA Qualified Lifting Equipment Tester and Examiner.

SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 1 of 4

JC International Limited
RC. 413243

CHECKLIST FOR FORKLIFT INSPECTION


Name & Address of the Owner Niger Dock Nig PLC Name & Address of the Manufacturer: Flexi Hiload Type
Flexi Hiload 1250AC

Date of thorough examination 19/11/13 Date of last thorough Inspection Not seen
Relevant Standard

Survey Requested By ALLISTAR


Date of last load test and Insp.

Location: New General Store Serial No: 136618 Test Load Applied 2200KG Date of last Proof load Test Not seen
Tilt Cylinder Creep in 5 minutes

ASME B56.6 Capacity: 1250AC

Owner ID: Not Seen

Model No: 1250AC


Relief Valve Adjustment

19/11/2013 License No. Not seen


Date of next Thorough Insp.

N/A Validity of this certificate 12 months


Comments:

18/11/14.

Comments noted and alterations or repairs required before Forklift are put into service (if none enter NONE)

FIT FOR USE

Page 2 of 4

JC International Limited
RC. 413243

SECTION

NEEDED CORRECTIONS (if any) DEFECTS NOTED

General: Wheels Tyres Mast and Fork-carrier Load Chain Side Rollers Roll-over cage Forks Horn and Safety Devices Hydraulic System Electrical System Engine Compartment Exhaust System Cooling System Steering Operational Controls Gauges in Cab Fire Extinguisher Maintenance

ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok Ok Ok

Inspectors Name/Qualification

Signature/Date

KELECHI EMERIBE
19/11/2013 LEEA QUALIFIED LIFTING EQUIPMENT TESTER AND EXAMINER, SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 3 of 4

JC International Limited
RC. 413243

Section 1
1.1 a) b) c) d) e) f) g) h) i) j) k) l) m) n) o) p) q) r) s) t) u) v) w) x)

Operators Cab

NA

Operators Cab Condition: Access / Handholds/Steps Non-slip surfaces House keeping Door(s) Glass Window Wiper Heater/Air Conditioner Wiring Mirrors Seat/Seats Belts Instruments and gauges Roof access Load Capacity Chart Operators Manual

Warning Decals Power Line Warning Decal Hand Signal Chart Lights Control Linkage Beams float & pad Cylinder Outriggers Operators Seat Fire extinguisher

Page 4 of 4

JC International Limited
RC. 413243

CERTIFICATE OF TEST AND THOROUGH EXAMINATION


STATUTORY INSTRUMENTS 1998 NO. 2307 The Lifting Operations and Lifting Equipment Regulations 1998 STATUTORY INSTRUMENTS 1992 NO. 3073 The Supply of Machinery (Safety) Regulations 1992 STATUTORY INSTRUMENTS 1998 NO. 2306 The Provision and use of Work Equipment Regulations 1998

Client: Inspection Location: Inspector: Forklift Type: Forklift Manufacturer: Model Number: Serial Number: SWL Tested to Certificate Number: Inspection Date: Next Date of Examination:

Niger Dock Nig PLC NEW GENERAL STORE. KELECHI EMERIBE.


FLEXI HILOAD 12502AC. FLEXI 12502AC. 136618

2000kg 2200kg 6516 19/11/13 18/11/14

This is to certify that I did Thorough Examination on the forklift in accordance with ASME B 56.6 and all statutory requirements as stated above. The records of examination are true without prejudice for the purpose it was designed for. Fit for use.
Inspectors Name/Qualification Signature/Date

KELECHI EMERIBE LEEA Qualified Lifting Equipment Tester and Examiner. FID, SNT Level 11 MT, PT, VT, ET, UT, in compliance 19
TH

November, 2013

JC International Limited

RC. 413243

Port Harcourt Office: Plot 5 JC Street, Off Peter Odili Road, P.O. Box 6427 Trans Amadi Port Harcourt, Rivers State. Tel: +234-84-489909 Lagos Office: 56A Bourdillon Road, P.O. Box 52224 Ikoyi. Tel: +234-1-842-5813 E-mail: service@jcinternationalng.com Website: www.jcinternationalng.com

VERTICAL MAST FORKLIFT INSPECTION REPORT


ID. No: Not seen Manufacturer: Owner:
LINDE

Report no- 6282


Legends: S Satisfactory Unsatisfactory Not Applicable

Serial No: H2X396C00688 Model: H 70D -01 Location:


NIGERDOCK YARD

SWL: 7t Date Manufactured: 2012 Place of Test: Rigging Loft Date of last test: 21/11/2012 Date of Next Inspection: 12/11/2014 STATUS: Fit for use

U N/A

FL 15
Date of Inspection: 13/11/2013 Inspector: KELECHI EMERIBE Contract No: Description: VERTICAL MAST FORKLIFT Specification: ASME B56.6

CHASIS Steering Axle Hydraulic System Wheels Tyres Brakes Light Indicator Gauges Suspension ok ok ok ok U ok ok ok ok

FORKS OK Forks Blade OK

NDE

Tilt Cylinder OK Hydraulic System OK Fork Heels OK


Signature/Date 13/11/2013

Inspectors Name/Qualification Kelechi Emeribe LEEA Qualified Lifting Equipment Tester and Examiner.

SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 1 of 4

JC International Limited
RC. 413243

CHECKLIST FOR FORKLIFT INSPECTION


Name & Address of the Owner Niger Dock Nig PLC Name & Address of the Manufacturer: LINDE Type
VERTICAL MAST FORKLIFT

Date of thorough examination 13/11/13 Date of last thorough Inspection 21/11/2012


Relevant Standard

Survey Requested By ALLISTAR


Date of last load test and Insp.

Location: RIGGING LOFT Serial No: H2X396C00688 Test Load Applied 7700KG Date of last Proof load Test Not seen
Tilt Cylinder Creep in 5 minutes

ASME B56.6 Capacity: 7000kg

Owner ID: FL 15

Model No: H 70D-01


Relief Valve Adjustment

N/A License No. Not seen


Date of next Thorough Insp.

N/A Validity of this certificate 12 months


Comments:

12/11/14.

Comments noted and alterations or repairs required before Forklift are put into service (if none enter NONE)

The back tyres should be replaced before use.

Page 2 of 4

JC International Limited
RC. 413243

SECTION

NEEDED CORRECTIONS (if any) DEFECTS NOTED

General: Wheels Tyres Mast and Fork-carrier Load Chain Side Rollers Roll-over cage Forks Horn and Safety Devices Hydraulic System Electrical System Engine Compartment Exhaust System Cooling System Steering Operational Controls Gauges in Cab Fire Extinguisher Maintenance

ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok Expired Needs maintenance

Inspectors Name/Qualification

Signature/Date

KELECHI EMERIBE
13/11/2013 LEEA QUALIFIED LIFTING EQUIPMENT TESTER AND EXAMINER, SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 3 of 4

JC International Limited
RC. 413243

Section 1
1.1 a) b) c) d) e) f) g) h) i) j) k) l) m) n) o) p) q) r) s) t) u) v) w) x)

Operators Cab

NA

Operators Cab Condition: Access / Handholds/Steps Non-slip surfaces House keeping Door(s) Glass Window Wiper Heater/Air Conditioner Wiring Mirrors Seat/Seats Belts Instruments and gauges Roof access Load Capacity Chart Operators Manual

Warning Decals Power Line Warning Decal Hand Signal Chart Lights Control Linkage Beams float & pad Cylinder Outriggers Operators Seat Fire extinguisher

Page 4 of 4

JC International Limited
RC. 413243

CERTIFICATE OF TEST AND THOROUGH EXAMINATION


STATUTORY INSTRUMENTS 1998 NO. 2307 The Lifting Operations and Lifting Equipment Regulations 1998 STATUTORY INSTRUMENTS 1992 NO. 3073 The Supply of Machinery (Safety) Regulations 1992 STATUTORY INSTRUMENTS 1998 NO. 2306 The Provision and use of Work Equipment Regulations 1998

Client: Inspection Location: Inspector: Forklift Type: Forklift Manufacturer: Model Number: Serial Number: SWL Tested to Certificate Number: Inspection Date: Next Date of Examination:

Niger Dock Nig PLC RIGGING LOFT. KELECHI EMERIBE.


VERTICAL MAST FORKLIFT. LINDE H 70D -01 H2X396C00688

7T 7700kg 6282 13/11/13 12/11/14

This is to certify that I did Thorough Examination on the forklift in accordance with ASME B 56.6 and all statutory requirements as stated above. The records of examination are true without prejudice for the purpose it was designed for. Fit for use.
Inspectors Name/Qualification Signature/Date

KELECHI EMERIBE LEEA Qualified Lifting Equipment Tester and Examiner. FID, SNT Level 11 MT, PT, VT, ET, UT, in compliance 13
TH

November, 2013

JC International Limited

RC. 413243

Port Harcourt Office: Plot 5 JC Street, Off Peter Odili Road, P.O. Box 6427 Trans Amadi Port Harcourt, Rivers State. Tel: +234-84-489909 Lagos Office: 56A Bourdillon Road, P.O. Box 52224 Ikoyi. Tel: +234-1-842-5813 E-mail: service@jcinternationalng.com Website: www.jcinternationalng.com

VERTICAL MAST FORKLIFT INSPECTION REPORT


ID. No: JCB5AHTGA01524961 Manufacturer:
EXCAVATORS LTD JC BAMFORD

Report no- 6271


Legends: S Satisfactory Unsatisfactory Not Applicable

Serial No: 55096 Model: 533-105 Location:.


MECHANIC WORKSHOP

SWL: 3300kg Date Manufactured: 2011 Place of Test: MECHANIC WORKSHOP


NIGERDOCK.

Owner:

U N/A

TR08
Date of Inspection: 07/11/2013 Inspector: KELECHI EMERIBE Contract No: Description: VERTICAL MAST FORKLIFT Specification: ASME B56.6

Date of last test: NOT SEEN Date of Next Inspection: STATUS: Not Fit for use

CHASIS Steering Axle Hydraulic System Wheels Tyres Brakes Light Indicator Gauges Suspension ok ok ok ok ok ok ok ok ok

FORKS

NDE Crack found on the fork

Forks Blade

Crack

Tilt Cylinder S Hydraulic System S Fork Heels U


Signature/Date 07/11/2013

Inspectors Name/Qualification Kelechi Emeribe LEEA Qualified Lifting Equipment Tester and Examiner.

SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 1 of 4

JC International Limited
RC. 413243

CHECKLIST FOR FORKLIFT INSPECTION


Name & Address of the Owner Niger Dock Nig PLC Name & Address of the Manufacturer: JC BAMFORD EXCAVATORS LTD Type 533-105 Location: MECHANICAL WORKSHOP Serial No: 55096 Test Load Applied N/A Date of last Proof load Test Not seen
Tilt Cylinder Creep in 5 minutes Comments:

Date of thorough examination 07/11/13 Date of last thorough Inspection Not seen
Relevant Standard

Survey Requested By OPERATION


Date of last load test and Insp.

ASME B56.5 Capacity: 3300kg Model No: Not seen


Relief Valve Adjustment

Owner ID: TR 08

N/A License No. Not seen


Date of next Thorough Insp.

N/A Validity of this certificate 06/11/2014

06/11/14.

Comments noted and alterations or repairs required before Forklift are put into service (if none enter NONE)

Crack found on the fork; it should be replaced or rewelded. NOT FIT FOR USE

Page 2 of 4

JC International Limited
RC. 413243

SECTION

NEEDED CORRECTIONS (if any) DEFECTS NOTED

General: Wheels Tyres Mast and Fork-carrier Load Chain Side Rollers Roll-over cage Forks Horn and Safety Devices Hydraulic System Electrical System Engine Compartment Exhaust System Cooling System Steering Operational Controls Gauges in Cab Fire Extinguisher Maintenance

ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok

Inspectors Name/Qualification

Signature/Date

KELECHI EMERIBE
7/11/2013 LEEA QUALIFIED LIFTING EQUIPMENT TESTER AND EXAMINER, SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

Page 3 of 4

JC International Limited
RC. 413243

Section 1
1.1 a) b) c) d) e) f) g) h) i) j) k) l) m) n) o) p) q) r) s) t) u) v) w)

Operators Cab

NA

Operators Cab Condition: Access / Handholds/Steps Non-slip surfaces House keeping Door(s) Glass Window Wiper Heater/Air Conditioner Wiring Mirrors Seat/Seats Belts Instruments and gauges Roof access Load Capacity Chart Operators Manual

Warning Decals Power Line Warning Decal Hand Signal Chart Lights Control Linkage Beams float & pad Cylinder Outriggers Operators Seat

Page 4 of 4

JC International Limited
RC. 413243
Port Harcourt Office: Plot 5 JC Street, Off Peter Odili Road, P.O. Box 6427 Trans Amadi Port Harcourt, Rivers State. Tel: +234-84-489909 Lagos Office: 56A Bourdillon Road, P.O. Box 52224 Ikoyi. Tel: +234-1-842-5813 E-mail: service@jcinternationalng.com Website: www.jcinternationalng.com

VERTICAL MAST FORKLIFT INSPECTION REPORT


ID. No: JCB5AHTGK01524405 Manufacturer: JC BAMFORD EXCAVATORS LTD Owner: Model: 533-105 Location: Mechanic Workshop Inspector: Kelechi Emeribe Date Manufactured: 2011 Place of Test: Mechanic Workshop Nigerdock Date of last test: not seen Serial No: 54751 WLL: 3300kg

Report no- 6272


Legends: S U N/A Satisfactory Unsatisfactory Not Applicable

TR09.

Date of Inspection: 08/11/12 Contract No: Description: Vertical mast forklift Specification: ASME B 56.6

STATUS:

Fit for use

CHASIS Steering Axle Hydraulic System Wheels Tyres Brakes Light Indicator Gauges Suspension ok ok ok ok ok ok ok ok ok FORK

NDE GOOD Forks Blade S

Tilt cylinder S Hydraulic System S Fork Heels S


Signature/Date: 08/11/2013

Inspectors Name/Qualification Kelechi Emeribe LEEA Qualified Lifting Equipment Tester and Examiner. SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A. Page 1 of 4 LOAD TEST

3600kg

JC International Limited
RC. 413243

CHECKLIST FOR FORKLIFT INSPECTION


Name & Address of the Owner Niger Dock Nig PLC Name & Address of the Manufacturer: JC BAMFORD EXCAVATORS LTD Type 533-105 Location: MECHANICAL WORKSHOP Serial No: 54751 Owner ID: TR 09 Date of thorough examination 08/11/13 Date of last thorough Inspection Not seen
Relevant Standard

Survey requested by: Operation


Date of last load test and insp.:

ASME B56.6 Capacity: 3300kg Model No: Not seen


Relief Valve Adjustment

Not seen License no:

Test Load Applied 3600kg Date of last Proof load Test Not seen
Tilt Cylinder Creep in 5 minutes

Test Load Applied

07/11/2013 N/A Validity of this certificate 07/11/2014


Comments:

FIT FOR USE Comments noted and alterations or repairs required before Forklift are put into service (if none enter NONE) None.

Page 2 of 4

JC International Limited
RC. 413243

SECTION

NEEDED CORRECTIONS (if any) DEFECTS NOTED

General: Wheels Tyres Mast and Fork-carrier Load Chain Side Rollers Roll-over cage Forks Horn and Safety Devices Hydraulic System Electrical System Engine Compartment Exhaust System Cooling System Steering Operational Controls Gauges in Cab Fire Extinguisher Maintenance

ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok ok Ok ok

Inspectors Name/Qualification

Signature/Date 08/11/2013

Kelechi Emeribe LEEA Qualified Lifting Equipment Tester and Examiner. SNT LEVEL 11 MT, PT & UT IN COMPLIANCE WITH SNT-TC-1A.

JC International Limited
RC. 413243

Page 3 of 4

Section 1
1.1 a) b) c) d) e) f) g) h) i) j) k) l) m) n) o) p) q) r) s) t) u) v) w) x)

Operators Cab

NA

Operators Cab Condition: Access / Handholds/Steps Non-slip surfaces House keeping Door(s) Glass Window Wiper Heater/Air Conditioner Wiring Emergency Stop Mirrors Seat/Seats Belts Instruments and gauges Roof access Load Capacity Chart Operators Manual

Warning Decals Power Line Warning Decal Hand Signal Chart Lights Trafigator Reverse Light Revolving Light Brake Light Fire Extinguisher

Page 4 of 4

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