Product:
Purchase date:
Other relevant information:
Date
Reason for entry
(periodic examination
or repair)
Defects, Repairs Etc.
Name & signature
(competent person)
Periodic examination
next due date
PERIODIC EXAMINATION AND REPAIR HISTORY
REF:
SN:
Serial No.
(see equipment label)
Reference No.
(see equipment label)
Manufacturing date
(see equipment label)
10 RECORDS
10.1 All periodic examinations should be recorded below by the competent person. This record should be kept with
the equipment during the whole life time.
EQUIPMENT RECORD
Listed
Ê
organisation
Ê
for
Ê
CE
Ê
type
Ê
approval
89/686/EEC
Ê
11B,
Ê
ISO9001:2000:
Made by:
VVUÚ. a.s., Pikartská 1337/7 - 716 07 Ostrava - Radvanice, Czech Republic; Notify Body No.: CE1019
F a lls a fe - O n lin e L da
R ua
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C o nde
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,
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B
o te 2 2
4 4 8 0 - 6 2 0 V i la d
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I n te r n e t: www. fa lls a fe - o n lin e . c o m
E - m a il: s u ppo r t@ fa lls a fe - o n lin e . c o m
7 - LEGEND
Anchor Point
Composite Outer Shell
Label
A
B
C
Line (Webbing/Cable/Rope)
D
Energy Absorber
Fall Arrest indicator
E
F
Connector
G
4 - INSTALATION
5 - CONNECTORS ADJUSTMENT
6 - MARKINGS
Product type Standard
A
B
Please read user Instructions before use
C
D
Serial Number
Manufacture Date
E
Reference Nº
RFID
QR CODE
.APK
SN
FS920 REV 2
S/N: 00000
MFG Date: 02/2015
A
B
C
D
E
4A
4B
4C
Use a connector to
install the fall arrest
blocks on a anchor
point
Connect the hook of
the fall arrest block to
your Dorsal D-ring
Make sure the fall
arrest block is above
your shoulder
A
B
E
C
D
F
G
