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USER INSTRUCTIONS ■ BEAMGLIDE
12.5
FORMAL INSPECTION LOG FOR MSA BEAMGLIDE™ TROLLEY
506266
Model No.:
T01001T
Serial No.:
5/27/2012
Date Made:
INSP.
DESCRIPTION
POINT
1
Cross bar
2
Housing
3
Wheels
4
Wheel jam nut and spring pin
5
Hangar bracket
6
Bolts, nuts, cotter pins
7
Ball lock with lanyard
8
Bolts, nuts
9
Labels
10
Bushing
N/A
Lubrication
N/A
Wheel Movement
N/A
Pivotable
506252
Model No.:
T01001T
Serial No.:
5/27/2012
Date Made:
INSP.
DESCRIPTION
POINT
1
Cross bar
2
Housing
3
Wheels
4
Wheel jam nut and spring pin
5
Hangar bracket
6
Bolts, nuts, cotter pins
7
Bolts, nuts
8
Labels
9
Bushing
N/A
Lubrication
N/A
Wheel Movement
N/A
Pivotable
(a) Optional simplified PASS/FAIL inspection format: Whenever an acceptable condition is found, the entry in the COND. and OVERALL ASSESS. columns may be left blank. Whenever
an unacceptable condition is found, enter "FAIL." The inspection may end upon detection of a single unacceptable condition.
(b) Blank copies of this LOG, with associated CHECKLIST and DIAGRAM, are available from MSA Call Toll Free (800) 845-1127.
Copyright © 2014, MSA
TROLLEY
™
SAMPLE - MODEL 506266 BALL LOCK PIN
J.W. Doe
Inspector:
09/05/2012
Inspection Date:
See item 6, return to MSA
Disposition:
QTY/
COND (a)
BGT
METALLIC PARTS
1
2
4
4
1
1
1
3
PLASTIC PARTS
1
1
FUNCTIONAL CHECKS
N/A
N/A
N/A
SAMPLE - MODEL 506252 RED HEAD BOLT
J.W. Doe
Inspector:
09/05/2012
Inspection Date:
See item 6, return to MSA
Disposition:
QTY/
COND (a)
BGT
METALLIC PARTS
1
2
4
4
1
1
3
PLASTIC PARTS
1
1
FUNCTIONAL CHECKS
N/A
N/A
N/A
OVERALL ASSESS. (a)
M0
MA
M0
MA
M0
MA
M0
MA
M0
MA
M3
MN
M0
MA
M0
MA
P0
PA
P0
PA
L0
LA
W0
WA
V0
VA
OVERALL ASSESS. (a)
M0
MA
M0
MA
M0
MA
M0
MA
M0
MA
M3
MN
M0
MA
P0
PA
P0
PA
L0
LA
W0
WA
V0
VA
COMMENTS
Some wear - Minor
Bolt & nut missing
COMMENTS
Some wear - Minor
Bolt & nut missing
P/N R621595
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