Table 2 – Inspection and Maintenance Log
Inspection Date:
Inspected By:
Components:
Inspection:
(See Section 3 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.
Mounting Surface
Inspect the mounting surface for cracks in the cement.
Labels (Figure 7)
Verify all labels are securely attached and are 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:
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 3M Flexiguard M200
Page 2: ...2 2 F M D E C A K K H I G H K H D E D C K G A J B F N L N N N N 3 4 A ...
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