Innotech LOCK-11 Instructions For Installation And Use Manual page 11

SAFETY SOLUTIONS
I N S P E C T I O N L O G I
PROJECT:
PRODUCT:
ANNUAL SYSTEM INSPECTION EXECUTED ON:
INSPECTION POINTS:
DO C U M E NT AT IO N :
Instructions for installation and use
Acceptance log
Dowel log
Photo documentation
PPE (p e rs o n al p ro tec ti v e e qu i pm e nt ag a i n st f a l l i ng ) :
I ns p ect i on i n acc o rd a nc e w it h m a nu f ac tu r e r' s s pe ci f ic a ti on s
Expiration date
Annual inspection performed
Not checked (no authorization)
A N CH O R A G E PO I N T I NN O T E CH LO C K- 13
No deformation
The attachment eye can rotate
No corrosion
Threaded joints secured
Spring function
RE C E PT A CL E SL E E VE I N NO T E CH LO CK -1 1 :
No fouling
No corrosion
Firm seat
Acceptance result:
The safety system corresponds to the specifications in the manufacturer's instructions for
installation and use and the state of the art. Technical safety reliability is confirmed.
Comments:
Expert who is familiar with the safety system:
Edition 04/01/2007
checked and in order!
NAME:
SIGNATURE:
INNOTECH
Arbeitsschutz GmbH
MANUFACTURING NO.:
DEFECTS DETECTED:
(Description of defect / measures)
SERVICE FORM
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(COPY TEMPLATE - A4)