3M DBI SALA 2101000C Mode D'emploi page 13

Inspection Date:
Components: Inspection:
Concrete Detent Anchor
Inspect the Concrete Detent Anchor for damage. Remove the Detent Pin and inspect
for cracks or wear that may affect the strength.
(Figure 2)
Verify that the Detent Button (D) operates smoothly and that it rotates freely within the
Anchor Socket. The Detent Ring (A) should rotate 180 degrees on the Detent Pin.
Inspect the four Detent Balls (C) for signs of damage. All four balls should fully extend and
lock when the Detent Button is released.
Inspect the Detent Ring (A) for deformation, cracks, or other signs of damage.
Inspect the Concrete Detent Anchor for signs of corrosion.
Labels (Figure 13)
Verify that all labels are securely attached and present.
Verify that the concrete structure and mounting hole meet the requirements of Table 1.
Structure
Verify that the concrete is free of any cracks or damage.
PFAS and Other
Additional Personal Fall Arrest System (PFAS) equipment (harness, SRD, etc.) that are used
with the system should be installed and inspected per the manufacturer's instructions.
Equipment
Serial Number(s):
Model Number:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Table 2 – Inspection and Maintenance Log
(See Section 1 for Inspection Frequency)
Inspected By:
Date Purchased:
Date of First Use:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Competent
User Person
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due: