
#500995-001 -
Product Manual: #LG5 Series Manhole Guard Retrieval System
- Revision 06 - Date: 01-09-2018
Page 19
6.3 - Inspection Log
Date
labels
Pins & Fasteners
Overhead Anchor
Points
Overall Structure
Notes
Inspector (print & sign) :
Inspector (print & sign) :
Inspector (print & sign) :
Inspector (print & sign) :
Inspector (print & sign) :
Inspector (print & sign) :
Inspector (print & sign) :
Inspector (print & sign) :
Place a check
(
¥
)
in the box if item is acceptable, place an x
(X)
in the box if item requires maintenance or repair
model Number
:
Serial Number
:
Date Purchased
:
#LG5