Aerial Platform Frequent Inspection/maintenance Page 4

Summary Page

Model / Serial# ______________________

Unit Number______________

Description

Number

R/C/I

Legend:

(R) Repair required.

(I) For Information only, no corrective action required at this time.

Note:

·Owner/User is responsible to have repairs performed before use.

·Manufacturer’s recommendations as to frequent and/or periodic inspection and maintenance schedules must be followed for safe

operation of this unit.

•Immediate Repairs Required (___________Yes__________No)

•Customer declined torque check of critical fasteners (___________Yes___________No). If checked, work order #_______________

•Do not consider this a pre-purchase inspection

Customer Signature

___________________________________ Print Name ___________________________

Inspector Signature ____________________________________Date____________________

TUFM 1069 Rev C, 9-2-14

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Parent category: Business