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AMF-BRUNS K90 ACTIVE - Inspection Results - Yearly; Re-inspection

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Inspection Log
Back-in-Box-Lift K70 / K90 / K90 ACTIVE Page 77 of 100
Inspection result of a yearly inspection / a re-inspection
Serial No. /Type
*
………………………………………………………………………………………………….
Number plate ………………………………………………………………………………………………….
Sheet No. ………………………………………………………………………………………………….
On ……………..………… the Back-in-Box-Lift was subject to a yearly inspection in accord-
ance with the inspection list / a re-inspection.
No / the following defects were found:
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
There are no issues to preclude continued operation / Re-inspection is required.
Place, date ………………………………………………………………………………………………….
……………………………………………………………………..….
Company / Company stamp
……………………………………………………………………..….
Signature (technical expert)
Note has been taken of the result of the inspection.
All deficiencies have been rectified.
Confirmation by the owner or his representative with date and signature
……………………………………………………………………..….
Place / date
……………………………………………………………………..….
Signature (owner)
* see rating plate

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