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Visual inspection
(authorized expert)
Inspection report
on a regular/extraordinary inspection/re-inspection*.
The device was subjected to an inspection for operational readiness. No/the following* defects were found:
Scope of inspection: Functional and visual inspection according to specifications
Partial inspection still outstanding:
There are no *) objections to commissioning, subsequent testing is not *) required.
(Signature of expert)
(Name of expert)
(Job title)
(Address)
(place, date)
Confirmation of acceptance:
(Employed by)
Operator (Company stamp, date, signature)
Defects noted **)
Deficiencies corrected **)
*) Please delete where not applicable
**) Confirmation of the operator or an authorized representative with date and signature
® Copyright ATH-Heinl GmbH & CO.KG, All rights reserved / Misprints and technical changes reserved
Release date: 10-2022 / Product manufacturer ATH-Heinl GmbH & CO. KG