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9
Periodic examination
Complete examination checklist
To access the Re-Certification Check Sheet scan the QR code
MSA
Workman Tripod
Re-Certification Check Sheet
Model:
Date of Manufacture
Examination Checks: Tripod
Item
Examine tripod carrying bag. Fasteners, carrying sling
1
Labels and markings, legible,
2
in service date.
Tripod Head complete, deformation, corrosion, impact damage.
3
Tripod Head x 4 Swivel Eye Bolts. Deformation, corrosion, level of wear.
4
Fixings x 2 flat washers Ny lock nut with thread protrusion. No modification.
2-piece tripod legs x 3. deformation, corrosion, impact damage. Tethered
leg adjustment bolt, Hog ring. Examine alignment and wear of adjustment
5
apertures.
Tripod feet x 3
6
wear and secure.
Tripod leg base strap wear and cam buckle serviceability.
7
Leg performance smooth leg adjustment, locking into place, adjustment bolt
8
engagement.
Complete recertification check sheet.
9
Comments
Item
Action
Competent Person Maintenance Recertification checklist Version 001-Oct19
29
or visit https://bit.ly/3MGwnj7
(Confined Space Entry Kit)
Equipment record
Customer
P/N 10153101
Ref No:
Contact
Details
Description
Pass
Fail
Advisory
P
F
P
F
P
F
P
F
P
F
deformation, corrosion, fixings, pivot freely. Foot pads level of
P
F
P
F
P
F
Y
N
MSAsafety.com
A
A
A
A
A
A
A
A
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