E
B D
A
C J
FS2019
123456
11/2021
EN361:2002
K
G
L
1 - PRODUCT
5 - PURCHASE DATE
7 - OTHER RELEVANT INFORMATION
9 - REASON FOR ENTRY
8 - DATE
(PERIODIC EXAMINATION OR REPAIR)
ADDITIONAL INFORMATION
+ 80° C
+ 176° F
AI1
- 40° C
- 40° F
AI2
12
AI3
AI4
MARKING/ LABELS
E
B D
H
FS2025-S/M
QRCODE
07/22
F
I
L
EQUIPMENT RECORD
EQUIPMENT RECORD
REGISTO DE EQUIPAMENTO | REGISTRO DE EQUIPO | ENREGISTREMENT DE L'ÉQUIPEMENT
REGISTO DE EQUIPAMENTO | REGISTRO DE EQUIPO | ENREGISTREMENT DE L'ÉQUIPEMENT
APPARATUUR RECORD | UTSTYR REKORD | REGISTRAZIONE DELL'APPARECCHIATURA
APPARATUUR RECORD | UTSTYR REKORD | REGISTRAZIONE DELL'APPARECCHIATURA
ALL PERIODIC EXAMINATIONS SHOULD BE RECORDED BY THE COMPETENT PERSON.
THIS RECORD SHOULD BE KEPT WITH THE EQUIPMENT DURING THE WHOLE LIFE TIME.
2 - REF. NUMBER
(SEE THE EQUIPMENT LABEL)
PERIODIC EXAMINATION AND REPAIR HISTORY
10 - DEFECTS, REPAIRS, ETC.
AI7
AI5
AI8
AI9
AI6
AI10
AI11
A
J
C
H
E
123445
QRCODE
EN361:2002
Zona Industrial da Varziela - Rua B
Lote 54, 4480-620 - Vila do Conde
Portugal
K
G
F
I
3 - SERIAL NUMBER
(SEE THE EQUIPMENT LABEL)
6 - DATE OF THE FIRST USE
11 - NAME & SIGNATURE
C
B
D J
A
K
H
F
FSXXX-S/M
0123456
11/2019
FALLSAFE-ONLINE.COM
EN 358:2018
G
4 - MANUFACTURING DATE
(SEE THE EQUIPMENT LABEL)
12 - NEXT PERIODIC EXAMINATION
(DUE DATE)
I
2