B
DEVICE PERIODIC CHECK SHEET.
No.
(O) Date.
(P) Reason for check.
O
Periodic check.
1
O
Additional check.
O
Periodic check.
2
O
Additional check.
O
Periodic check.
3
O
Additional check.
O
Periodic check.
4
O
Additional check.
O
Periodic check.
5
O
Additional check.
O
Periodic check.
6
O
Additional check.
O
Periodic check.
7
O
Additional check.
O
Periodic check.
8
O
Additional check.
O
Periodic check.
9
O
Additional check.
O
Periodic check.
10
O
Additional check.
Climbing Technology by Aludesign S.p.A. via Torchio 22
24034 Cisano B.sco BG ITALY
(Q) Name and signature of the person
responsible for checking.
www.climbingtechnology.com
(R) Notes (defects found, repairs perfor-
med or other relevant information)
IST23-2P656CT_rev.8 12-21
(S) Check results.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
O
O
Device fi t for use.
Device unfi t for use.
O
Device to be checked.
(T) Date of
next check.
6/24