1971-HKRS30-16-30_Part06 — Page 21

Address of installation

裝置之地址

Description of pressure receiver

壓力容器說明

Date of construction

始日期

Particulars of test:

-

Pressure receiver examined internally

and externally and found to be

placed in a satisfactory condition.

Signature adderazionEE1000 簌哭人

Date Added 日期

Note

Wales an earlier examination de regaired in consequence of aur condues endorsed d

this corudesse or by othat requircarestis of the Ordance, Ibà certificate in valid In

而必須拋甲予以糠麟,否用,根據網爐及壓力容器管制燦睏

Accordance with section 290X8) of the Rollers and Pressure Receivers Ordiotace wat

...........

19.

.....

‧日假止。

(b) by deleting Form 4 and substituting the following-

"FORM4.

[3.6]

(Front of cover)

*Pressura receiver examined under

hydraulic test of

叶

版

Signature

簽署人

Dale 日期

Fittings examined and found satis- 配件聯爲褡

aLay.

Signature 簽署人

Daic 日期

I certify that I have this day examined the above pressure receiver under

►

將上谴之 壓力容躁

pressure and I am satisfied that it is in safe working order and may be 在受壓力下子以機號

鄂

used at a maximum permissible working pressure of

垒可用" 並且可以许可使用之壓力甑 and that the safety valve has been set and sealed or 德朋

otherwise adjusted in accordauter with section 45 of the Ordinance *subject 慊例第四十五款之说定面菜翻苄以核蘸點鋼對戚薇惟溯趱 to (here insert any conditions required under section 33(5) of the Ordinance) (開特憬例第三十三款第(五)段所規定之任何懒忭城於本欄]

Certificate No.

Issued to

滿號干

Date

日期

• Delete if or applicabla.

將不適用者去。

BOILERS AND Pressore Receivers OrdHNANCE.

(Chapter 56).

(香港法例第五十六章,

CERTIFICATE OF COMPETENCY.

合格

(Inalde Front Cover)

Boilers and Pressure Receivers OrdinanCE,

(Chapter 36).

(香港法例或十六章,

*Boiler Inspector.

嗣健耀宾

•Air Receiver inspector,

您軀容器赀蠬

Bdentity Card No, 身份证麴龋

13" x 14"

时时

Photograph

相片

(Page 1)

第一期)