74 - EN
No.
Equipment
Present?
Features to be tested
Note
5.0
Other equipment
5.1
Latching / lock
Function / state
5.2
Wicket door
Function / state
5.2.1 Wicket door contact
Function / state
5.2.2 Door closer
Function / state
5.3
Traffic light control
Function / state
5.4
Photoelectric sensors
Function / state
5.5
Closing edge safety device
Function / state
6.0
Documentation of the operator / owner
6.1
Rating plate / CE marking
complete / readable
6.2
Door system’s Declaration of
Conformity
complete / readable
6.3
Installation, Operation and
Maintenance Instructions
complete / readable
9.2
Proof of inspection and maintenance of the door system
Date
Work performed /
necessary measures
Test carried out
Defects rectified
Signature /
company
address
Signature /
company
address
