Occupational Health and Safety Act, 1993 (Act No. 85 of 1993)RegulationsLift, Escalator and Passenger Conveyor Regulations, 2010Annexure 1 : Notification of installation of a lift/escalator/passenger conveyor |
| TO: | The Provincial Executive Manager |
Department of Labour
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I/We ................................................................................................................................
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Hereby give notice of my/our intention to install a lift/escalator/passenger conveyor (Insert the official, name and address of company or person (legal person) giving notice of the installation. Use a separate form for each installation)
| 1. | Name of building ................................................................................................ |
| 2. | Address of building (physical)... .. ....................................................................... |
| 3. | Lift type .............................................................................................................. |
| 4. | Name of manufacture ......................................................................................... |
| 5. | Country of origin ................................................................................................ |
| 6. | Design standard ................................................................................................. |
| 7. | Manufacture's serial number ............................................................................. |
| 8. | Year of manufacture........................................................................................... |
| 9. | Register person ................................................................................................. |
| 10. | Location of lift (machinery) ............................................................................... |
| 11. | Year of installation ............................................................................................ |
| 12. | Inclination angle (Esc) ....................................................................................... |
| 13. | Balustrades width (Esc) ..................................................................................... |
| 14. | Flight length (Esc) ............................................................................................. |
| 15. | Maximum number of persons ........................................................................... |
| 16. | Rated load in kg ................................................................................................ |
| 17. | Number of landings .......................................................................................... |
| 18. | Total travel distance ......................................................................................... |
| 19. | Rated speed ..................................................................................................... |
| ................................................... | ............................. |
| Signature of owner/user | Date |
(*Delete whichever is not applicable)
FOR OFFICIAL USE ONLY
Date received .............................................................................
Official number allocated................................ Date ...................
Inspector...................................... Office ...................................