15
196349 rev 1
EN
12.1 Regular safety inspection form
Device type
Serial No.
Inspection step
OK
Not OK Verification
Remark
Name plate
Plate with load capacity
Plate with supply pressure
Lifting/lowering tag
All supporting screws are tight
Secure scissor pins
State of pneumatic hoses
Safety valve set to 6.5 bar
operating pressure
Mains pressure manometer
Pmax = 8 bar
Control lever automatically re-
sets to the zero position when
released
Fall arrester function
Emergency release status
Air bellows status
Supporting structure status
Function test – Lifting/lowering
Function test – Lifting/lowering
with load
Inspection result
Start-up not permitted, verification recquired.
Start-up possible, faults to be rectified by...................................................................
No fault, start-up possible immediately
Safety inspection performed on: .................................................................................................................................................
Name and address of qualified assessor: ...................................................................................................................................
.................................................................................................
Signature of qualified assessor
Fault rectification required
.................................................................................................
Signature of qualified assessor
.................................................................................................
Signature of assessor
.................................................................................................
Signature of operator
.................................................................................................
Signature of operator
.................................................................................................
Signature of operator
Содержание IRT System Series
Страница 19: ...70 196349 rev 1...