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~ Form - C

(See Rule 41)

SECOND CLASS BOILER ATTENDANT CERTIFICATE OF COMPETENCY

(Granted under rule 41 of the Boiler Attendants’ Rules, 2011)

Thiru epceeneseesecoes

at present residing at THOOTHUKUD; having satisfied the Board of

Examiners of his competency to fulfill the duties of Second Class Boiler Attendant, is granted

under the Boiler Attendants’ Rules, 2011, this Certificate of competency as a Second Class Boiler

Attendant authorizing him to have charge of a single boiler with steam pipes of any type, the

heating surface of which does not exceed 200 square meters. He may, however, attend to a

battery of boilers consisting of not more than three connected boilers (not exceeding 200 square

meters in aggregate of total heating surface) provided that such boilers shall be situated within

a radius of 30 meters in the same premises and belong to one owner and provided that he is

assisted by the number of firemen as are considered necessary by the Director of Boilers.

Dated at)..CHENNAT this 18 ¢P day of... MABCH. cose 20 MB. ooe

On rarer @

Secretary Chairman

Board of Examiners Board of Examiners

Description Roll

1. Date & Place of Birth:

2. Permanent Address :18/88 KATT!

STREET (WEST), THOOTHUKUDI, PIN ~ 628 008.

IKUD:

3. Nationality:

Height (without shoes) :

Marks of Identification ; .A..moe.

finger

A mole on the centre of the

fore head.

% Signature of Applicant

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: ansirdaih ax coin CERTIFICATE §.No SEC. 11 2RARN

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