Inspection Checklist
Model Number:
Date:
Date of Manufacture:
Date of First Use:
#
Description
1
Housing
2
Labels
3
Lifeline
4
Energy absorber
5
Connectors
Lock on (ensure device
locks)
US
Good—Safe
Good—Safe
for Use
for Use
V-TEC Web PFL
7 Pre-Use Checks and Periodic Examinations
Serial Number:
Inspector (Name / Signature):
Date of Purchase:
Date Due for Next Periodic Inspection:
Damaged, Worn, Altered,
Good—Safe
Missing—Remove from
for Use
Service
V-TEC® PFL
Comments
V-TEC Cable PFL
16