IT IS RESPONSIBILITY OF THE USER ORGANISATION TO PROVIDE THE IDENTITY CARD AND TO FILL IN THE DETAILS REQUIRED. THE IDENTITY
CARD SHOULD BE FILLED IN ONLY BY COMPETENT PERSON RESPONSIBLE FOR PROTECTIVE EQUIPMENT. THE IDENTITY CARD SHOULD BE FILLED
IN BEFORE THE FIRST USE OF THE EQUIPMENT. ANY INFORMATION ABOUT THE EQUIPMENT LIKE: PERIODIC INSPECTIONS, REPAIRS, REASONS OF
EQUIPMENT'S WITHDRAWN FROM USE SHALL BE NOTED. THE IDENTITY CARD SHOULD BE STORAGED DURING A WHOLE PERIOD OF EQUIPMENT
UTILIZATION. DO NOT USE THE EQUIPMENT WITHOUT THE IDENTITY CARD.
MODEL AND TYPE OF EQUIPMENT
REF. NUMBER
SERIAL NUMBER
DATE OF MANUFACTURE
DATE OF PURCHASE
DATE OF FIRST USE
USER NAME
PERIODIC EXAMINATION AND REPAIR HISTORY
REASON FOR SERVICING /
DATE
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Louis Reyners BV, Symon Spiersweg 13A 1506 RZ, Zaandam, The Netherlands
IDENTITY CARD
REPAIR
Tel: +31 (0)756504750, fax +31 (0)756504760 www.lr.nl
REPAIRS CARRIED OUT
NAME AND
SIGNATURE OF
COMPETENT PERSON
EXAMINATION
DATE OF
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