ROTHOBLAAS COPPO Normas De Seguridad, Instrucciones De Uso E Instalación página 21

STATEMENT OF CORRECT INSTALLATION
OF FALL PROTECTION DEVICES
With regard to the installation of the anchor devices for protection against falls installed on the building located in:
Address:
City:
The undersigned:
First name:
Legal representative of the company:
Address of head office:
City:
EN 795 QUANTITY
TYPE A
TYPE C
TYPE D
TYPE E
FASTENING ELEMENT
have been correctly installed as per the indications of the manufacturer and as per the provisions of standard EN 795
The anchor devices have been positioned on the roof as per the attached plan prepared by:
Architect/Engineer/Surveyor
according to the instructions provided in the calculation report prepared by:
Architect/Engineer/Surveyor
The characteristics of the anchor device (s), the instructions regarding their correct use,
the inspection sheets have been filed with:
the owner of the building
the building manager
The notice-plate for fall protection systems is posted:
Near every roof access point
Date of first system start-up:
Date:
The owner shall keep the equipment installed in good working condition in order to maintain the necessary solidity and resistance in time.
Maintenance shall be performed by qualified personnel and carried out according to the procedures and time schedules indicated by the manufacturer.
Rotho Blaas Srl
Via dell'Adige N.2/1 | I-39040, Cortaccia (BZ) | Italia | Tel: +39 0471 81 84 00 | Fax: +39 0471 81 84 84 | info@rothoblaas.com | www.rothoblaas.com
Declares that the devices
MODEL
SUB-BASE SIZE/QUALITY
The Installer (stamp and signature):
Postal Code:
Last name:
Postal Code:
MANUFACTURER
INSTALLATION DEPTH
[mm]
Date of first inspection:
No.:
Prov.:
No:
Prov.:
SERIAL NO./YEAR
Ø HOLE TIGHTENING TORQUE
[mm] [Nm]
• ATTENZIONE! L'uso del dispositivo di sicurezza è ammesso
soltanto dopo che l'utente ha letto le istruzioni per l'uso e il
fascicolo tecnico del sistema anticaduta nella rispettiva
lingua nazionale. Non utilizzare il sistema di ancoraggio se
l'ispezione non è stata e ettuata.
• ATTENTION! The use of the safety device is allowed only
after the user read the original application instruction and
the technical file of the fall protection system in his national
language. Do not use the anchoring system if the inspection
has not been carried out.
• ACHTUNG! Die Verwendung der Sicherungseinrichtung
ist erst erlaubt, nachdem der Anwender die originale
Gebrauchsanleitung und die technischen Unterlagen des
Absturzsicherungssystem in der jeweiligen Landessprache
gelesen hat. Das System nicht Verwenden wenn die
Überprüfung nicht durchgeführt wurde.
• Data di messa in esercizio del sistema
• Date of first system start-up • ¡ATENCIÓN! No está permitido utilizar el dispositivo de
• Datum der Inbetriebnahme des Systems
protección antes de que el usuario hayan leído las
• Fecha de puesta en ejercicio del sistema
instrucciones de uso originales y el expediente técnico del
• Date de mise en service du système
sistema anticaídas en el idioma del respectivo país. No
utilizar el sistema de anclaje si la inspección no ha sido
realizada.
• Data prevista per la prossima ispezione
• ATTENTION! L'utilisation du dispositif de sécurité n'est
• Expected date of next inspection
autorisée qu'après lecture par l'utilisateur des instructions
• Für die nächste Überprüfung vorgesehenes Datum
d'utilisation et du dossier technique de système antichute
• Fecha prevista para la próxima inspección
dans la langue du pays de mise en œuvre. N'utiliser pas le
• Date prévue pour la prochaine inspection
système d'ancrage si l'inspection n'a pas été realisié.