3M OSHA 1926.502 Mode D'emploi page 13

Inspection Date:
Components: Inspection:
Inspect the entire system for damage, deformation, corrosion, and rust. Look
Variable Davit System
for cracks, bends, dents, or wear that could affect strength and operation of the
(Figure 2)
system.
Inspect all fasteners for damage or corrosion. Tighten as necessary.
Inspect all moving parts for chips, cracks, breaks, or worn areas that can cause
malfunction during operation.
Verify that all adjustment points (pins, bolts, tri-screws, adjusting screws, etc.)
are in full functional condition and are adjusted properly.
Anchor Connection Ensure Anchor Connection Points are free of corrosion, cracks, or other
Points imperfections that my cause malfunction during operation.
Retrieval Devices Ensure Winches and Self-Retracting Devices are securely pinned in place and
that mounting brackets and adapter brackets are secure. Mounting brackets and
adapter brackets should be free of cracks, bends, corrosion, etc.
Labels
Verify that all labels are present and fully legible.
(Figures 10 and 11)
PFAS and Other Additional Personal Fall Arrest System (PFAS) equipment, winches, Self-
Equipment Retracting Devices (SRDs), etc. that are used with the system should be
inspected per the manufacturer's instructions.
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:
1 Competent Person:
One who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary,
hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them.
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:
Competent
User Person
1
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: