22
PERIODIC CHECKS AND INSPECTIONS
Device Periodic Check Sheet
No.
Date
Reason for
Check
1
Periodic check
Additional check
2
Periodic check
Additional check
3
Periodic check
Additional check
4
Periodic check
Additional check
5
Periodic check
Additional check
6
Periodic check
Additional check
7
Periodic check
Additional check
IMPORTANT:
A periodic inspection shall be performed at least once every 12 months and again after any exceptional
event(s)s that may occur during use of the product to ensure product safety for users. The inspection shall
be performed by a competent person. Additional information on the inspection process and an inspection
checklist can be found at cmcpro.com/ppe-inspection.
Check Results
Notes
(damage, defects,
excessive wear or
other relevant data)
Name & Signature of
Competent Person
Performing Check
CLUTCH USER MANUAL
Date of
Next
Check
23
