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HALFEN PSA Assembly Instructions
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Sample template for documentation
HALFEN PSA Attachment system for (PPE) personal (fall) protection equipment
It is hereby confirmed that the HALFEN PSA Fixing system for (PPE Personal Protective Equipment) has been professionally
installed in compliance with all details and regulations as required in the installation instructions.
(A copy of this document must be given to the client in case of any forthcoming notification requirements by an approved
building authority).
City, date Stamp, signature
Site plan/drawings
Street, road: .........................................................................
Postcode, Zipcode/Town,City:..............................................
Client: ......................................................................
Street, road: .........................................................................
Postcode, Zipcode/Town,City: .............................................
Installation company: ..........................................................
Street, road: .........................................................................
Postcode, Zipcode/Town,City: .............................................
Details/Installation parameters
Component: ........................................................................
Component thickness: .........................................................
Axial spacing: .......................................................................
Building: .............................................................................
Floor: ..................................................................................
Contact: ...............................................................................
Phone/e–mail: .....................................................................
Installer: .............................................................................
Phone/e–mail: .....................................................................
Concrete strength: ...............................................................
Edge distance: .....................................................................
Reinforcement: ....................................................................
Project/location: .....................................................................................................................................................................
Installation documentation