System Certificate of Inspection

Certificate No.
Client Details Location
Contact: Address:
Address: Site Details:
Installation Details Manufacturers Details
Installed By: Manufactured By:
Date Installed: Next Inspection Date: / /
Asset Type Rating Comments
Conditions [see below]
This audit has been prepared and compiled in accordance with AS/NZS 1657.2013, 1891.4.2009 & 4488.1.1997. Any variations or additions to the installed system are clearly marked in the comments field and have attached photographic evidence as proof of variation to the original installation.
In the event of a fall or damage of the systems, all components must be certified before further use.
This inspection and proof load testing has been completed in accordance with AS/NZS 4488.1 & 1891.4 and NSW WorkCover requirements. Hydraulic tester used in load testing: HydraJaws tester 2. Serial no.: 75292. Calibration due: 01/09/2018