3M 8530433 Instructions D'utilisation page 13

Inspection Date:
Components: Inspection:
Jib Boom Assembly Check the Jib Boom (C) for structural defects or damage including bends,
(Figure 2) cracks, dents, corrosion, and deformation.
Glide Rail Assembly Visually inspect fasteners on the Glide Rail (D) to ensure they are tight.
(Figure 2)
Inspect the Rail Track for structural defects. Rail Track must be straight without
any bends or dents.
Visually inspect the Glide Four-Wheel Trolley (F) for damage to the trolley
and excessive wheel wear. Ensure the Trolley rolls freely in Glide Rail and the
wheels are securely attached.
Labels (Figure 13) Verify that all labels are present and fully legible.
Fall Protection Additional Fall Protection equipment that is used with the product should be
Equipment installed and inspected per the manufacturer instructions.
Serial Number(s):
Model Number:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
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Corrective Action/Maintenance:
Corrective Action/Maintenance:
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Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Table 2 – Inspection and Maintenance Log
Inspected By:
(See Section 1 for Inspection Frequency)
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:
Approved By:
Date:
Competent
User Person
Next inspection due:
Next inspection due:
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Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due:
Next inspection due: