3M DBI-sala FlEXIguarD M100 Instructions De Montage page 10

Inspection Date:
Components: Inspection:
Floor Mount Base Inspect the Floor Mount Base for structural defects or damage including bends,
(Figure 1) corrosion, etc.
Inspect the mounting fasteners to ensure they are tightened to the proper
torque value, as specified by the fastener manufacturer.
Inspect the ground around the Base to ensure there are no defects.
The Floor Mount Base should be periodically greased using the grease fitting
(A) located on all M100 Jib Booms. See Figure 3.2 for reference.
The Floor Mount Base should be periodically greased using the grease fitting
(A) located on all M100 Jib Booms. See Figure 7 for reference.
Labels (Figure 8) 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:
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
Inspected By:
(See Section 4 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:
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:
Next inspection due:
Next inspection due: