Business/place of installation :
owner :
street :
city :
telephone :
fax :
Manual received by :
(worker or representative of business)
head engineer of installation company
In :
Defects, differences and deviations from the inspection forms must be listed
here :
Defects, identified deficiencies
26
installation company :
street :
city :
telephone :
fax :
Name
Name
Date :
Responsible
party
Signature
Signature
Signature
Date