11
(13)
inDOMO HP
- Platform lift
FINAL TESTS
IM.TEC.028.EN_rev.10.2
- November 2015
All rights reserved
List of installed components:
Safety components
Component type
Landing door lock
Block valve
Safety brake
Electronic safety device
(floor levelling)
LIFT N° ____________________________________________
YEAR OF MANUFACTURE: ______________________________
LOAD: __________________________________________ kg
TRAVEL: _________________________________________ m
N° STOPS: ________________________
N° SERVICES: ______________________ N° CAR ACCESSES: __________________
Manufacturer: LIFTINGITALIA S.r.l.
Address: V. Caduti del Lavoro, 16 - 43058
Bogolese di Sorbolo (PR) - ITALY
ph. +39 0521.695311 - fax. +39 0521.695313
Supplier: LIFTINGITALIA S.r.l.
Address: V. Caduti del Lavoro, 16 - 43058
Bogolese di Sorbolo (PR) - ITALY
ph. +39 0521.695311 - fax. +39 0521.695313
Owner: ____________________________________________
Address: ___________________________________________
___________________________________________
Ph. ______________________ - Fax. ____________________
Installation site: _____________________________________
Address: ___________________________________________
___________________________________________
Ph. ______________________ - Fax. ____________________
Installer: ___________________________________________
Address: ___________________________________________
___________________________________________
Ph. _________________ - Fax. ________________
Tests effected (date) : __________________________________
by ________________________________________________
as installer’s representative
Special notes : ____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
