146

[Subsidiary]

CAP.59] Construction Sites (Safety) Regulations [1983 Ed.

8. Defects noted and alterations or repairs required before crane is put into service. (If none enter "None").

註明所發現之毛病及該起重機於使用前所需作之修改或修理(如無不妥,則填「無」字。)

I hereby certify that the crane described in this certificate was tested and thoroughly examined by me on

茲證明本人會於 日試驗及詳細檢驗本證明書所指之起重機且上述各項均屬確實無訛。

Signature 簽署

Name and address of person, company, or association by whom the person conducting the test and examination is employed.

僱用執行此次試驗及檢驗之人士、公司或機構之姓名或名稱及地址

Date of certificate 簽發日期

Qualification 資格

FORM 4 [regs. 22 & 23.] 表格四 〔規例第二十二及二十三條〕

CONSTRUCTION SITES (SAFETY) Regulations CERTIFICATE OF TEST AND THOROUGH EXAMINATION OF CRABS AND WINCHES AND OF PULLEY BLOCKS, GIN WHEELS, AND SHEERLEGS USED FOR A LOAD OF 1 TONNE OR MORE

Form prescribed by the Commissioner for Labour for the purposes of regulations 22 and 23 of the Construction Sites (Safety) Regulations

建築地盤(安全)規例 起重滑車、絞車、及用以負重一公噸或以上之絞輔、吊重輪及脚架起重機之試驗及詳細檢驗結果證明書

本表格乃由勞工處長就建築地盤(安全)規例第二十二及二十三條之需要制訂

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