Send this record, filled out and signed to Nußbaum after
the installation !
Otto Nußbaum GmbH & Co.KG
Korker Straße 24
77694 Kehl-Bodersweier
Germany
The automotive lift 4.40 H with the
serial number.: ...................................
at the firm...........................................
the saftey mechanism and operation were checked.
The installation was done by the operater / competent person (please delete as applicable)
The safety of the automotive lift was checked by the person before the initial operation
The operater attests, the correct installation of the automotive lift. The competent person attests the
correct initial operation.
..............................
date
..............................
date
Record of installation
................................................
name of the operater
................................................
name of the competent person
Instruction and Documentation
was installed on .........................................................
a t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
signature of the operater
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
signature of the competent person
5
4.40 H