TEST LOG I
SINGLE ANCHORAGE POINT (EAP)
PROJECT:
ORDER NUMBER:
PRODUCT:
units
Year of manufacture / serial number:
(Type designation EAP)
ANNUAL SYSTEM INSPECTION EXECUTED ON:
CLIENT:
Specialist:
H
Company address:
CONTRACTOR:
Specialist:
H
Company address:
INSPECTION POINTS:
checked and in order!
DEFECTS DETECTED:
(Description of defects/ measures)
DOCUMENTATION:
Instructions for installation and use
Inspection log / fastener
/ photo documentation
PPE (personal protection equipment against falling):
I n s p e c t i o n i n a c c o r d a n c e w i t h m a n u f a c t u r e r ' s s p e c i f i c a t i o n s
Expiration date
Annual inspection performed
Not checked (no authorisation)
ROOF SEALING:
No damage
No corrosion
VISIBLE PARTS OF THE ANCHORAGE DEVICE
No deformation
The attachment eye can rotate
No corrosion
Threaded joints secured
Tightening torque of the fastening bolts
Firm seat
Attention: Strictly ensure that test log II is filled out for horizontal lifeline systems in accordance with
EN 795:2012 TYP C!
Acceptance result:
The lifeline system corresponds to the specifications in the manufacturer's instructions for installation
and use and the state of the art. Technical safety reliability is confirmed.
Comments:
Name:
Client
Inspection:
Contractor:
(Expert who is familiar with the safety system)
Date,
Signature
