Aerial Work Platform Certification Form.doc
DOC document 45 KB Posted
- Attached to
- USNS PATUXENT HYSTER Forklift Recertification
- Solicitation number
- N3220522Q2241
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Text version
SAFETY INSPECTION AND WEIGHT TEST CERTIFICATION
OF AERIAL MAINTENANCE PLATFORM
USN NO.
COMMAND:
MANUFACTURER:
EQUIPMENT TYPE:
AERIAL MAINTENANCE PLATFORM
SERIAL NUMBER:
BASKET #
MODEL:
MODEL YEAR:
HOUR METER:
CAPACITY:
500 Lbs. Unrestricted
CERTIFICATION:
This is to certify that inspections and tests have been conducted in accordance with procedures set forth in the current NAVFAC P-300 and applicable manufactures technical manual. It is further certified that the above Aerial Maintenance Platform is satisfactory to lift its rated capacity and is fully operational.
· Certified for 500 Lbs., (500 lb. un-restricted). Percent testing 100% .
· Not certified for electrical or hot work
X Annual Certification Special Certification
Certification Date:
Expiration Date:
Inspector (printed name)
| Inspector (signature) |
| Date |
MHE-11-2010
REVISED 07/19/10
File details come from the government source that posted it. Updated .