FOG 442 9020 - Page 67

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67
E 219 GB - Issue 1
After sale responsible Mr. ______________________________ YEAR Maintenance Responsible Mr. ___________________________
1
st
QUARTER
Name _______________________ Date ________________________ Signature
YEARLY VERIFICATION
of safety parts made by the authorized institution
Mr. ___________________________ Ets ______________________________________ Adress ___________________________________________________________________ Potential comments _______________________________________________________
__________________________________________ Signature
Possible technical operations.
To be followed see the particular
report
VERIFICATION AND MAINTENANCE
in accordance with quaterly
operations listed page 68
2
nd
QUARTER
Name _______________________ Date ________________________ Signature
3
rd
QUARTER
Name _______________________ Date ________________________ Signature
4
th
QUARTER
Name _______________________ Date ________________________ Signature
After sale responsible Mr. ______________________________ YEAR Maintenance Responsible Mr. ___________________________
1
st
QUARTER
Name _______________________ Date ________________________ Signature
YEARLY VERIFICATION
of safety parts made by the authorized institution
Mr. ___________________________ Ets ______________________________________ Adress ___________________________________________________________________ Potential comments _______________________________________________________
__________________________________________ Signature
Possible technical operations.
To be followed see the particular
report
VERIFICATION AND MAINTENANCE
in accordance with quaterly
operations listed page 68
2
nd
QUARTER
Name _______________________ Date ________________________ Signature
3
rd
QUARTER
Name _______________________ Date ________________________ Signature
4
th
QUARTER
Name _______________________ Date ________________________ Signature