Page 11 of 12
Edition 09/26/2014
INNOTECH
EAP QUAD-11
INNO
TECH
SAFETY SOLUTIONS
Arbeitsschutz GmbH
I N S P E C T I O N L O G I
PROJECT:
PRODUCT:
units
MANUFACTURING NO.:
ANNUAL SYSTEM INSPECTION EXECUTED ON:
INSPECTION POINTS:
checked and in order!
DEFECTS DETECTED:
(Description of defect / measures)
DOC U ME NT AT IO N :
Instructions for installation and use
Acceptance log
Dowel log
Photo documentation
PPE (p e rs o n al p ro tec ti v e e qu i pm e nt ag a i n st f a l l i ng ) :
I ns p ect i on i n acc o rd a nc e w it h m a nu f ac tu r e r's s pe ci f ic a ti on s
Expiration date
Annual inspection performed
Not checked (no authorization)
V IS I BL E P AR TS O F THE A N CHO R A GE DE V ICE
No deformation
The attachment eye can rotate
No corrosion
Threaded joints secured
Firm seat
ROOF SE A LI N G :
No damage
No corrosion
HOR I ZO NT AL LI FE LI NE S YSTE M :
Attention:
Strictly ensure that the supplemental TEST LOG II (copy template in the installation instructions / user copy)!
Acceptance result:
The safety system corresponds to the specifications in the manufacturer's instructions for
installation and use and the state of the art. Technical safety reliability is confirmed.
Comments:
Expert who is familiar with the safety system:
NAME:
SIGNATURE:
