Table 3 – Inspection and Maintenance Log
Inspection Date:
Inspected By:
Components:
Inspection:
(See Section 1 for
Inspection Frequency
)
User
Competent
Person
1
Mounting Bracket
(Figure 2)
Inspect the Mounting Bracket for cracks, dents, or deformities.
Inspect the entire unit for corrosion.
PFAS and Other
Equipment
Additional Personal Fall Arrest System (PFAS) equipment (harness, SRL, etc) that are
used with the Tripod Mounting Base and Bracket 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:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Corrective Action/Maintenance:
Approved By:
Date:
Summary of Contents for PROTECTA 8008005
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