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With reference to the installation of the fall arrest system installed on
System serial number:
Description of the building:
Address:
City:
The INSTALLER
First name:
Legal representative of the company:
With headquarters at:
VAT number:
Manufacturer
•
In compliance with the manufacturer's installation instructions, they have been installed in compliance with
the project drafted by the Arch./Eng./Surv.:
•
They have been fastened to the specified structure, in compliance with the instructions supplied in the
calculation report drafted by the Arch./Eng./Surv.:
•
They have been fixed as specified (e.g. numbers of bolts, correct materials, correct position/location).
•
They have been commisioned in accordance with the manufacurer's information.
•
They have been supplied with photographic information/documentation, especially where fixing (e.g. bolts)
and the under lying substrate are no longer visible after completing the installation.
•
The fastening/anchoring element structural characteristics, their use instructions, the manuals of the different
products used, the installation layout and the documents/pictures taken and drafted during the installation
have been submitted to Mr./Mrs.
First name:
Role:
has been affixed near every access and/or onto the fall arrest system
System installation date
20/03/19
CORRECT INSTALLATION FORM
Project:
that the following systems and fastening devices used
Product
HAVE BEEN INSTALLED CORRECTLY
The compulsory SIGN
Country:
Last name:
DECLARES
Model
Last name:
ENGLISH
Post code:
City:
Type
Tensile forces allowed
The installer
(Stamp and Signature)
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