FORM No.

34 [See Rule 69 (8) (ii)]

REGISTER OF WATER SEALED GAS HOLDERS
Sl. No. of the Gas holde rs 1 Pressure shown by holder when full of gas 6 Date of inspection as required under sub-rules, 4 & 5 of Rule 69 and by whom carried out 7 The method of inspectio n used 8 Natures of repairs and name of persons carrying out repairs 10

Maker s Name 2

Date of manufactu re 3

Capacit y

No. of lifts 5

Date of painting etc., 9

Remark s

11

Signature of Occupier/Manager Date . . . . . . . . . . . . . . . . . . . . . . . .