3M DBI SALA 2100103 Manuel D'instructions page 11

Inspection Date:
Components: Inspection:
Toggle Anchor Inspect the Toggle Anchor for damage: Look for cracks, dents, or deformities. Look for bending,
kinks, or wear on the Swivel Ring (A), Main Cable (D), Red Warning Tube (C), Activator Cable
(Figure 2)
(E), Hole Plug (F), Toggle (G), Spring (H), and Retaining Ring (I).
Inspect the entire unit for corrosion.
Confirm the Swivel Ring (A) swivels freely and the Main Cable (D) and the Activator Cable (E)
operate freely.
Installation When installed, the top of the Activator Cable (1A) should be positioned below the Red Warning
Tube (1B).
(Figure 11)
Labels Figure 12
Verify that all labels are securely attached and are legible (see 'Labels')
PFAS and Other Additional Personal Fall Arrest System (PFAS) equipment (harness, SRL, etc) that are used with
the Anchorage 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:
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)
User
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
Person
1