Publicidad
Model Number (Serial Number):
Date Purchased:
;
This product must be inspected by the user before each use. Additionally, a Competent Person other than the user must
inspect this equipment at least once each year.
Component
Door Jamb Anchor
(Figure 2)
Anchorage Structure
Labels (Figure 9)
Fall Protection Equipment
;
If the product fails an inspection procedure, then the product fails overall inspection. If the product fails inspection, remove
it from service immediately. Clearly tag the product "DO NOT USE". See Section 5 for more information.
Inspection Type:
Inspected By:
Signature:
Additional Notes:
Table 2 – Inspection and Maintenance Log
Inspection Procedure
Inspect for cracks, dents, and deformities.
Inspect for loose bolts and bent, damaged, or missing parts.
Look for signs of corrosion on the entire unit.
Verify that the anchorage structure meets the requirements of this
instruction. Verify that the install location has no signs of damage.
All labels are present and fully legible.
Additional Fall Protection equipment that is used with the product is
installed and inspected per the manufacturer instructions.
User
Competent Person
Date of First Use:
···
···
···
···
Overall Inspection Result:
Date of Inspection:
Next Inspection Due:
···
Inspection Result
Pass
Fail
Pass
Fail
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