Visual inspection (authorised expert)
relating to a regular / extraordinary inspection / audit *)
The device has undergone a readiness test.
No / the following *) defects were found:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Inspection contents: functional and visual inspection according to specifications
Pending partial inspection:
_________________________________________________________________________________
_________________________________________________________________________________
There were no *) concerns arising from commissioning, an audit is not *) required.
(Place, date)
Confirmation of acceptance:
Operator (company stamp, date, signature)
Faults noted **) ________________________________________________________
Faults remedied **) ____________________________________________________________________
*)
Delete if not applicable
**)
Confirmation of operator or a representative with date and signature
® Copyright ATH-Heinl GmbH & Co. KG, All rights reserved / Misprints and technical changes reserved / As of: 2021-10
Inspection Certificate
(Technical expert signature)
(Name of technical expert)
(Title)
(Address)
(Employed at)
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