#500964-001 -
Product Manual: Model #SB-SM1 Fall Arrest Tower Base
- Revision 01 - Date: 03-04-2010
Page 18
6.3 - Inspection Log
Da
te
La
be
ls
B
as
e
lu
gs
Pi
vo
tin
g
A
rm
s
M
ou
nt
in
g
B
lo
ck
s
Not
es
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
In
sp
ec
to
r (
pr
in
t &
s
ig
n)
:
Pl
ac
e
a
chec
k
(
√)
in
the
box
if
item
is
ac
cept
abl
e,
pl
ac
e
an
x
(X)
in
the
box
if
item
requi
res
m
ai
nt
enanc
e
or
repai
r
M
ode
l N
um
be
r :
Se
ria
l N
um
be
r :
D
at
e
Pu
rch
ased
:
#SB
-SM
1