3M DBI SALA 8000000 Manuel D'utilisation page 16

Inspection Date:
Components: Inspection:
Tripod All bolts and nuts must be securely attached. Check for missing, altered, or substituted bolts,
nuts, locking detent pins or other parts.
(Figure 2)
Inspect the entire unit for corrosion.
Check each leg to see that it can be telescoped in and out freely. Inspect legs for straightness.
Ensure the legs lock into place when the Tripod is erect.
Check the feet on each leg and ensure that they pivot and that the rubber pad is in place.
Check the Safety Chain and connections. Ensure that the chain is free of defects and that the
hook is in place and works properly.
Check the Head and ensure the Eye-Bolt Anchorage Points are in place and are free from
damage. Ensure the Cable Pulleys are clean and rotate freely.
Locking Pins Inspect for smooth operation of the leg locking pins.
(Figure 2)
Inspect each of the leg locking pins for corrosion.
Labels
Verify that all labels are securely attached and are legible (see 'Labels').
(Figure 14)
PFAS and Other Additional Personal Fall Arrest System (PFAS) equipment (harness, SRD, etc.) that are used
with the Tripod should be installed and inspected per the manufacturer's instructions.
Equipment
Serial Number(s):
Model Number:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Table 2 – Inspection and Maintenance Log
Inspected By:
(See Section 1 for Inspection Frequency)
Date Purchased:
Date of First Use:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Competent
User Person
1
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due: