SAFETY SOLUTIONS
A C C E P T A N C E L O G
PROJECT:
PRODUCT:
SPECIALIST:
COMPANY
ADDRESS:
• Client accepts the performances of the contractor.
• The instructions for installation and use, dowel log and photo documentation have been
transferred to the client (building owner) and have been made available to the user. When
accessing the roof securing system, you must document the positions of the attachment
devices by means of diagrams.
• The expert fitter familiar with the safety system confirms that the installation work
has been executed properly, in accordance with the state of the art, and in
accordance with the manufacturer's instructions for installation and use. The safety
specifications for reliability are confirmed by the installation company.
Comments:
D O W E L L O G / P H O T O
Date:
Location:
The undersigned installation company warrants that the dowels have been properly processed in accordance with the dowel manufacturer's
guidelines. (Proper cleaning of bores, compliance with curing times and processing temperature, edge spacing of the dowels, inspection of
the substrate, etc.)
Substrate (concrete quality (e.g. C16/20), etc.):
Client:
Edition 04/01/2007
CLIENT:
D O C U M E N T A T I O N
Setting
Drill bit Ø:
depth:
NAME
DATE, SIGNATURE
Arbeitsschutz GmbH
MANUFACTURING NO.:
CONTRACTOR:
Pull-out test:
Test
Duration:
force:
(KN)
Fitter:
INNOTECH
INSTALLATION
COMPANY:
Photos:
(File name)
(sec.)
NAME
DATE, SIGNATURE
SERVICE FORM
(COPY TEMPLATE - A4)
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