Holler Tore BALU Mode D'installation Et D'emploi page 78

4. Supplementary declaration of the assembly
(Supplement to the declaration of conformity of the manufacturer / distributor)
The company ______________________________________________________
Name ______________________________________________________
Adress ______________________________________________________
______________________________________________________
______________________________________________________
herewith declares that it complies with all assembly specifications in accordance with
the installation manual or the operation manual of the gate manufacturer, as well as
proper and professional installation using installation material that is appropriate to
the place of installation or the subsoil present there.
The person signing this declaration is ___________________ (*) of the company.
(*) e.g. proprietor, shareholder or Managing Director (CEO)
_________________ _________________
Place Date
5. Handing over and instructions on use
(Data about the system in accordance wirth clauses 2,3 and 4 of the declaration)
Persons present who have been trained and instructed on the gate system:
________________________________________
________________________________________
________________________________________
________________________________________
Pulse encoder demonstraded:
Hand-held transmitter handed over:
Keys handed over:
Safety equipment and devices demonstrated:  Yes  No
Emergency locking system demonstrated and attention drawn to the fact that locking and unlocking
shouldbe done only when the system is at standstill:
Outputs on the display explained:
Briefing given on the maintenance intervals:
___________________________________________________________
Place / date when system handed over
Technical documentation handed over:
___________________________________
______________________
seal and signature
Name
Name
Name
Name
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 Yes  No
Signature fitter
ENGLISH
________________________________________
Unterschrift
________________________________________
Unterschrift
________________________________________
Unterschrift
________________________________________
Unterschrift
 Yes  No
___________________________________
signature system operator
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