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INSPECTION REPORT
MANUFACTURER: Rotho Blaas srl - Via dell'Adige 2/1 - 39040 Cortaccia (BZ) - www.rothoblaas.com
Tel: +39 0471 81 84 00 - Fax: +39 0471 81 84 84 - e-mail: info@rothoblaas.com
DATE OF PURCHASE
POINTS TO BE CHECKED
INSTRUCTIONS FOR ASSEMBLY AND USE
STATEMENT OF CORRECT INSTALLATION
REPORTS ON FASTENING ELEMENTS
PHOTO GALLERY
NO WARPING
NO CORROSION
SCREW CONNECTIONS TIGHT
STABILITY
MARKING READABLE
NO DAMAGE
NO CORROSION
Inspection result:
The safety installation is compliant with the manufacturer's instructions for assembly and use and with the state of the art. It is hereby confirmed that the
installation is reliable in terms of safety.
Remarks:
Expected date of next inspection:
Name and signature of the expert who is familiar with the safety system:
Name:
Rotho Blaas Srl
Via dell'Adige N.2/1 | I-39040, Cortaccia (BZ) | Italia | Tel: +39 0471 81 84 00 | Fax: +39 0471 81 84 84 | info@rothoblaas.com | www.rothoblaas.com
PRODUCT
PERIODIC SYSTEM INSPECTION PERFORMED ON
VISIBLE PARTS OF THE ANCHOR DEVICE
ROOF WATERPROOFING
PROJECT
(Defect description/ Measures taken)
DOCUMENTATION
Signature:
SERIAL No./YEAR
DATE OF FIRST USE
DEFECT FOUND
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