Product:
Model & type/identification:
Manufacturer:
Year of manufacture/life expiration date: Purchase date
Other relevant information (e.G. Document number)
Periodic examination and repair history
Date
30
EQUIPMENT RECORD
Reason for
entry (periodic
examination or
repair)
Trade name
Address
Defects noted,
repairs carried out
and other relevant
information
Identification
number
Tel, fax, email,
website
Date first put into
use
Name and
Periodic
signature of
examination next
competent
due date
person