Certificate of Inspection
Lifting Appliances
Name of Vessel:
IMO Number:
Owner/Manager:
Flag:
Classification Society:
Type of Vessel:
Place of Service:
Date of Service:
Next Service:
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Rows
Description of loose gear
Serial Number
SWL
Condition
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Condition 1 = Satisfactory
Condition 2 = Unsatisfactory
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Notes/remarks
Woell Marine Stamp & Signature
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Cusomer Name
First Name
Last Name
Customer E-Mail
example@example.com
Technician Name
First Name
Last Name
Technician Email
example@example.com
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