INNO
TECH
SAFETY SOLUTIONS
Arbeitsschutz GmbH
Edition 04/01/2007
SERVICE FORM
(COPY TEMPLATE - A4)
A C C E P T A N C E L O G
PROJECT:
PRODUCT:
MANUFACTURING NO.:
CLIENT:
CONTRACTOR:
INSTALLATION
COMPANY:
SPECIALIST:
COMPANY
ADDRESS:
•
Client accepts the performances of the contractor.
•
The instructions for installation and use, dowel log and photo documentation have been
transferred to the client (building owner) and have been made available to the user. When
accessing the roof securing system, you must document the positions of the attachment
devices by means of diagrams.
•
The expert fitter familiar with the safety system confirms that the installation work
has been executed properly, in accordance with the state of the art, and in
accordance with the manufacturer's instructions for installation and use. The safety
specifications for reliability are confirmed by the installation company.
Comments:
D O W E L L O G / P H O T O
D O C U M E N T A T I O N
Date:
Location:
Setting
depth:
Drill bit Ø:
Pull-out test:
Photos:
(File name)
Test
force:
(KN)
Duration:
(sec.)
The undersigned installation company warrants that the dowels have been properly processed in accordance with the dowel manufacturer's
guidelines. (Proper cleaning of bores, compliance with curing times and processing temperature, edge spacing of the dowels, inspection of
the substrate, etc.)
Substrate (concrete quality (e.g. C16/20), etc.):
Client:
Fitter:
NAME
NAME
DATE, SIGNATURE
DATE, SIGNATURE
