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The test card must be completed in full by
the expert during the annual inspection.
This test card does not claim to cover
all test criteria and does not relieve the
expert from his decision about the overall
condition.
Manufacturer:
BORNACK GmbH & Co.KG
info@bornack.de
www.bornack.de
Date
_______________________________________________________________________
1. year
_______________________________________________________________________
2. year
_______________________________________________________________________
3. year
_______________________________________________________________________
4. year
_______________________________________________________________________
5. year
_______________________________________________________________________
6. year
_______________________________________________________________________
7. year
_______________________________________________________________________
8. year
_______________________________________________________________________
9. year
_______________________________________________________________________
10. year
_______________________________________________________________________
T E S T C A R D
FOR ANNUAL MONITORING
Next
Signature
Inspection
Type Product name:
Production date:
_____________________
Serial no.:
_________________________
Purchase date:
______________________
Date of first use:
_____________________
Life span end at the latest:
Application scope :___________________
Reason for inspection
__________________
_____________
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