ROTHOBLAAS LOOP, Manual For Installation And Use

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STATEMENT OF CORRECT INSTALLATION OF FALL PROTECTION DEVICES
The owner shall keep the equipment installed in good working condition in order to maintain the necessary solidity and resistance in time.
Maintenance shall be performed by qualified personnel and carried out according to the procedures and time schedules indicated by the manufacturer.
With regard to the installation of the anchor devices for protection against falls installed on the building located in:
Address: No.:
City : Postal Code: Prov.:
The undersigned:
First name: Last name:
Legal representative of the company:
Address of head office: No.:
City: Postal Code: Prov.:
Declares that the devices
EN 795 Quantity Model Manufacturer Serial No./Year
Type A
*
Type C
*
Type D
*
Type E
*
Fastening element Sub-base size/quality Installation depth
[mm]
Ø Hole
[mm]
Tightening torque
[Nm]
have been correctly installed as per the indications of the manufacturer and
as per the provisions of standard EN 795
The anchor devices have been positioned on the roof as per the attached plan prepared by:
Architect/Engineer/Surveyor
according to the instructions provided in the calculation report prepared by:
Architect/Engineer/Surveyor
The characteristics of the anchor device(s), the instructions regarding
their correct use, the inspection sheets have been filed with:
*
the owner of the building
*
the building manager
The notice-plate for fall protection systems is posted:
*
Near every roof access point
*
Date of first system start-up: Date of first inspection:
Date: The Installer (stamp and signature):