SERIAL NUMBER:
MODEL NUMBER:
DATE PURCHASED:
INSPECTION DATE
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
Approved By:
INSPECTION AND MAINTENANCE LOG
INSPECTION ITEMS
NOTED
DATE OF FIRST USE:
CORRECTIVE ACTION
MAINTENANCE
PERFORMED