fallprotec Securope 2012 - Page 18

User Manual
Securope 2012 horizontal
DOC039-UK-19.07.15
18
Schematic plan of installation
Building / Structure
Adress :
Notes :
Order N°:
Type of order :
Shape of the roof :
Anchoring device: Class C- Lifeline
Client
Name :
Adress :
Contact :
Telephone N°:
Installer
Name :
Adress :
Installer chief:
Telephone N°:
Anchoring device
Manufacturer : FALLPROTEC
Model identification /type : Securope 2012
Building components
Attachments / Studs
 Data of fixations
Ø drilled hole
Depth
Torque
mm
mm
N.m
Type :
Material :
Minimum distance from the edge (c):
Minimal axial distance (s):
Minimum thickness of the component:
Permissible tensile strength :
Breaking force :
Distance from the edge
Axial spacing
Cx:
Sx:
Cy:
Sy:
Notes:
Drilling method:
Test device:
 Hammer
 Rotative
Wrench
 Cleaning of the drilled hole
 Testing devise of fixations
System
impact
 yes
 Humid
 yes
 No
 dry
 No
Control list
Ground plan of the roof:
 Substrate except exceptions
(no doubt on the capacity)
 Installation in accordance
with manufacturer’s instructions
 Recommended attachments
used
 All attachements
photographed with
identification
 Visibles attachments
 Installation plan attached on
site
 Screw immobilisation by
traversing fixing technique
Additional information
Breakout force (kN), required torque (Nm)
Anchoring point 1
Anchoring point 2
Anchoring point 3
Anchoring point 4
Anchoring point 5
Anchoring point 6
Anchoring point 7
Anchoring point 8
Anchoring point 9
Anchoring point 10
Anchoring point 11
Anchoring point 12
Anchoring point 13
Anchoring point 14
Anchoring point 15
Anchoring point 16
Adittional fixations:
Note of installation chief:
Date : Signature