All information about the personal protective equipment ( name, serial number, date of purchase and
date of putting into operation, user name, periodic examination and repair history, and next periodic
examination date ) shall be noted into de check card.
All records in the check card can only be filled in by a competent person.
Do not use the personal protective equipment without a duly filled check card.
REFERENCE
SERIAL NUMBER
YEAR OF MANUFACTURE
IT CAN BE USED WITH
DATE OF PURCHASE
DATE OF FIRST PUT INTO USE
USER NAME
COMMENTS
DATE
REASON FOR
ENTRY ( Periodic
examination/Repair)
UE type examination carried out by the notified body : AITEX, Instituto Tecnológico Textil Plaza Emilio Sala
1, 03801 (notified body number 0161) and ongoing assessment carried out by the notified body : AITEX,
Instituto Tecnológico Textil Plaza Emilio Sala 1, 03801 (notified body number 0161).
EQUIPMENT RECORD
PERIODIC EXAMINATIONS AND REPAIR HISTORY
COMPETENT
PERSON Name
+ Signature
INSTRUKCJA UŻYTKOWANIA
LINKA KOTWICZĄCA IRUDEK
COMMENTS
NEXT DUE
DATE FOR
Periodic
Examination
PL