*Auxiliary equipment (including the fuel burning installation) examined and found satisfactory.
Signature
Date
"Boiler examined under hydraulic test of
Signature ...............+44
p.s.i.
Date
*Pressure receiver cxamined under hydraulic test of ---, ------------་ ་ ་-----་ p.s.i.
Fittings examined and found satisfactory.
3
Signature
Date
Signature
Date
"Miscellaneous inspections:-
*In accordance with section 28, the steam container connected to the boiler has been examined and the outlet therefrom found to be open and free from obstruction.
Signature
Darc
Signature
Dare
I certify that I have this day examined the above boiler under pressure and I am satisfied that it is in safe working order and may be used and operated at a maximum permissible working pressure of
*subject to there insert any conditions imposed under section 33(5) of the Ordinance)
I certify that I have this day examined the above pressure receiver under pressure and I am satisfied that it is in safe working order and may be used at a maximum permissible working pressure of
"subject to there insert any conditions required under section 33(5) of the Ordinance)
Dare
• Exelene if moa. Applicable.
More
* Bofler Inspector.
• Ab Receiver Inspector,
Daless an exler examinación la requined to collequence of why condition endorsed on thin certificate or by poker requirements of the Ordinance. tala ceruzate je wadd in accordance whh section 37080 at the Bollers and Pressure Receiver Ordmarice. 1961 wall
19......
Date
* Delete if not applicable.
Boiler Inspector.
Nere: Unless an sieliet exhomioptipa ln required in consequence of any condition adored the th
ceniticum ex by other requlicmendeb the Ordinance. this canincate be valid in accordance with section 27a) of the Boiler and Pressure Receivers Ordinance. 1962. kl
ly.
FORM 2
BOILERS AND Pressure Receivers Ordinance, 1962. CERTIFICATE OF FITNESS FOR A PRESSURE RECEIVER (OTHER THAN A PRESSURE VESSEL).
KAJAKKER konta
Registration number of pressure receiver
Name of owner
Address of owner
Address of installation
Description of pressure receiver
Particulars of test:
Pressure receiver examined internally and
Signature
externally and found to be or placed in a satisfactory condition.
Date
Date of construction
FORM 3.
BOOLERS AND PRESSURE REceivers OrdiNANCE, 1962.
APPLICATION FOR REGISTRATION.
TO THE REDISTRAR
Sir,
Part 1
I. the undersigned, residing at
hereby apply for registration of the following items in accordance with the provisions of the above Ordinance—
*Boiler
Туре
Date of manufacture
This boiler is/is not one of a range of boilers.
This boiler /is not designed to be transportable from one place
to another.
This boiler is "new/existing within the meaning of the Ordinance. *Steam container
This steam container *is/is not connected to the boiler described
Above.
This steam container to *new/existing within the meaning of the
Ordinance.
́steam receiver
*Pressure receiver Type air receiver
portable gas
generator
Date of manufacture ........................
This pressure receiver isfis not designed to be transportable from
one place to another.
This pressure vessel is "new/existing within the meaning of the
Ordinance.