Proof of maintenance and repair work
Day of
inspection
Person
responsible
Verification
OK
Defects
Defects eliminated
(name, date, signature)
0,00 m
0,50 m
1,00 m
1,50 m
2,00 m
2,50 m
3,00 m
3,50 m
4,00 m
4,50 m
5,00 m
5,50 m
6,00 m
6,50 m
7,00 m
7,50 m
8,00 m
8,50 m
9,00 m
9,50 m
10,00 m
10,50 m
11,00 m
11,50 m
12,00 m
12,50 m
13,00 m
13,50 m
14,00 m
14,50 m
15,00 m
15,50 m
16,00 m
16,50 m
17,00 m
17,50 m
18,00 m
18,50 m
19,00 m
19,50 m
20,00 m
552024143..
10 / 10
