Table 2 – Inspection and Maintenance Log
Inspection Date:
Inspected By:
Components:
Inspection:
(See Section 4 for
Inspection Frequency
)
User
Competent
Person
Floor Mount Base
(Figure 1)
Inspect the Floor Mount Base for structural defects or damage including bends,
corrosion, etc.
Inspect the mounting fasteners to ensure they are tightened to the proper
torque value, as specified by the fastener manufacturer.
Inspect the ground around the Base to ensure there are no defects.
The Floor Mount Base should be periodically greased using the grease fitting
(A) located on all M100 Jib Booms. See Figure 3.2 for reference.
Labels (Figure 7)
Verify that all labels are present and fully legible.
Fall Protection
System and Other
Equipment
Additional Fall Protection system equipment that are used with the system
should be installed and inspected per the manufacturer’s instructions.
Serial Number(s):
Date Purchased:
Model Number:
Date of First Use:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance:
Approved By:
Next inspection due:
Date:
Summary of Contents for 8530873
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