Malta Dynamics X Series User manual

INSTRUCTION
MANUAL

XSERIES Instruction Manual
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THE MALTA DYNAMICS MOBILE GRABBER
INSTRUCTION MANUAL
These instructions apply to the following model(s): X1240, X1250 & X1260
Manual Revision Date: 16 August 2021
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revision available for this product offering as well as supporting documentation
X1240
Tow Weight:
6100 lbs. (approx.)
Tow Length: 15’-6”
Tow Width: 6’-0”
Tow Height: 8’-5”
Receiver: 2-5/16”
Plug: 7 Blade RV
Brakes: Electric
8'-5"
6'-0"
11'-4" 34'-0"
30'-2"
15'-6"
8'-5"
30'-2"
15'-6"
6'-0"
11'-4"
Tow Weight:
5900 lbs. (approx.)
Tow Length: 15’-6”
Tow Width: 6’-0”
Tow Height: 8’-5”
Receiver: 2-5/16”
Plug: 7 Blade RV
Brakes: Electric
Meets ANSI Z359.6 Standard and OSHA Compliant

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X1250
Tow Weight:
6100 lbs. (approx.)
Tow Length: 15’-6”
Tow Width: 6’-0”
Tow Height: 8’-5”
Receiver: 2-5/16”
Plug: 7 Blade RV
Brakes: Electric
8'-5"
6'-0"
11'-4" 34'-0"
30'-2"
15'-6"
8'-5"
30'-2"
15'-6"
6'-0"
11'-4"
Tow Weight:
5900 lbs. (approx.)
Tow Length: 15’-6”
Tow Width: 6’-0”
Tow Height: 8’-5”
Receiver: 2-5/16”
Plug: 7 Blade RV
Brakes: Electric
X1260
Tow Weight:
6100 lbs. (approx.)
Tow Length: 15’-6”
Tow Width: 6’-0”
Tow Height: 8’-5”
Receiver: 2-5/16”
Plug: 7 Blade RV
Brakes: Electric
8'-5"
6'-0"
11'-4" 34'-0"
30'-2"
15'-6"
8'-5"
30'-2"
15'-6"
6'-0"
11'-4"
Tow Weight:
5900 lbs. (approx.)
Tow Length: 15’-6”
Tow Width: 6’-0”
Tow Height: 8’-5”
Receiver: 2-5/16”
Plug: 7 Blade RV
Brakes: Electric
Meets ANSI Z359.6 & EN 795 Standard and OSHA Compliant
OSHA Compliant

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TABLE OF CONTENTS
General ---------------------------------------------------------------------------------------5
Training ---------------------------------------------------------------------------------------5
TrainingTopics-----------------------------------------------------------------------------5-6
Under Penalty of Law ---------------------------------------------------------------------6
Warnings & Limitations ---------------------------------------------------------------7-9
Towing and Moving ------------------------------------------------------------------------9
Lifting the Unit ------------------------------------------------------------------------10-12
Initial Setup & Operation -----------------------------------------------------------12-14
Wireless XSERIES Remote -------------------------------------------------------------14
Maintenance Schedule -----------------------------------------------------------------15
Fluids Used Within the System---------------------------------------------------------16
Deep Cycle Battery Maintenance -----------------------------------------------16-17
Mast Syncing -------------------------------------------------------------------------17-18
Burnishing Breaks --------------------------------------------------------------------18-19
Safety Instructions ----------------------------------------------------------------------19
Inspection -----------------------------------------------------------------------------20-21
Initial Quality Inspection ---------------------------------------------------------------21
Limited Warranty ------------------------------------------------------------------------22
Warranty Registration Card -----------------------------------------------------------23

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GENERAL
Malta Dynamics fall protection systems are designed for use where fall hazards
exist.
This equipment is to be used with an ANSI rated self-retracting device (SRD) with
an average arresting force of 900lbs or less. This fall arrest system meets the
needs of a construction and industrial worker’s safety requirements.
The Malta Dynamics Mobile Grabber is comprised primarily of A36 steel but also
includes but not limited to rubber, plastics, copper, concrete, hydraulic fluid, and
battery components.
TRAINING
All training shall be conducted by trainers deemed competent. A “competent
person is dene by OSHA as one who is capable of identifying existing and
predictable hazards in the surroundings or working conditions which are
unsanitary, hazardous, or dangerous to employees, and who has
authorization to take prompt corrective measures to eliminate them.
Manufacturer’s based training is essential to help understand the capabilities
and limitations of their personal protective equipment. Training also helps
promote condence and should be conducted as an initial introduction as well as
periodically for review and additional practice.
Please note, it is the expectation of the manufacturer that users are all deemed
competent for working at heights and conned space under the relevant industry
codes.
TRAINING TOPICS
Following is a suggested list of training objectives. Training should be site and
project specic and may need to cover more topics than those listed.
1. Recognizing fall hazards, and eliminating hazards where possible.
2. Knowing the four parts of a fall arrest system:
Anchorage, Body Support, Connectors and Devices.
•Select the proper PPE for the job.
•Consider environmental and other work place factors.
•Determine and reduce free fall distance, always work in limited free-fall.
•Wear a properly tted harness.

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•Implement a pre-determined rescue plan.
•Inspect and maintain all PPE.
•Understand the limitations and requirements of the PPE being used.
•Understand the consequences of not following or understanding these
instructions.
Malta Dynamics systems shall be a part of a complete fall
protection system.
If the user chooses to disregard this warning, he or she is solely
responsible for the safety of the entire system and all users.
Prior to replacing or modifying any components to a fall
protection system, consult Malta Dynamics.
Any changes to this system must be authorized by Malta
Dynamics in writing.
Operators must read and understand all instructions fully; failure
to do so could result in a serious or fatal injury.
To achieve the maximum level of safety that this system is
capable of providing, all instructions must be followed diligently.
This means careful planning of your application and work method.
WARNING
WARNING
WARNING
UNDER PENALTY OF LAW
The instructions are not to be removed except by the user of this system.
Current instructions must always be available to any potential user. If you have
any difculty or experience any problems with Malta Dynamics systems or need
assistance with the instruction: contact Malta Dynamics for assistance.
This equipment is designed to be used as a part of a complete fall protection
system. It is to be inspected and maintained on a regular basis.
It is the responsibility of the user and their management to review these
instructions periodically, and to ensure their continued compliance.
You assume complete liability if you fail to follow these
instructions and become injured. Use this system only as
instructed.
WARNING
WARNING
WARNING

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WARNINGS & LIMITATIONS
Failure to follow these instructions could result in a serious or fatal electrical
incident.
Do not raise the mast when wind speeds may exceed 28 mph (12.5 m/s). If
wind speeds exceed 28 mph (12.5 m/s) when the mast is raised, lower the mast
and do not continue to operate the machine.
Equipment shall only be used by a person trained and competent in its safe use.
Do not use if the system or any part of the system appears to be damaged.
Do not use the system if any components do not operate properly.
Use in highly corrosive or caustic environments dictates a more frequent
inspection and servicing program to ensure the integrity of the system is
maintained.
Do not attempt to repair this system without consent from the manufacturer.
Any repair shall only be conducted by a competent person for repair, who has
been authorized by the manufacturer, and that the repair procedure shall be
strictly in accordance with the manufacturer’s instructions.
Do not make alterations or additions to the equipment without the
manufacturer’s prior written consent, and any repair shall be carried out in
accordance with the manufacturer’s procedures.
Personal fall arrest systems and components subjected to impact loading shall
be immediately removed from service and shall not be used again for employee
protection until inspected and determined by a competent person to be
undamaged and suitable for reuse.
A rescue plan shall be in place to deal with any emergencies that could arise
during work. Each plan should be job and site specic.
All equipment must be inspected before each use. Any component exhibiting
deformities, unusual wear, or deterioration must be immediately removed from
service.
The X1240 is designed for up to 2 workers and the X1250 is designed for
up to 3 workers in any combination of Fall Arrest. The X1260 is designed for
up to 5 workers. Each anchor point provided is rated for a single user up to
310lbs (including clothing, tools, etc.). The Malta Dynamics Mobile Grabber
Fall Protection System is a mobile engineered anchorage solution designed to
protect workers from fall hazards.

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Never use fall protection equipment for towing or hoisting.
Do not increase the surface area of the platform or load. Increasing the area
exposed to the wind will decrease machine stability.
Inspect for dangers that may arise by the use of combinations of items and
equipment in which the safe function of any one item is affected by or interferes
with the safe function or another.
User must carry out a pre-use check of the equipment, to ensure that it is in a
serviceable condition and operates correctly before it is used.
It is essential for safety that equipment is withdrawn from use immediately
should any doubt arise about its condition for safe use or if it has been used
to arrest a fall. Unit must not be used again until conrmed in writing by a
competent person that it is acceptable to do so.
It is essential for safety that the anchor device or anchor point should always be
positioned, and work carried out in such way, as to minimize both the potential
for falls, potential fall distance, and swing fall hazards.
A full body harness is the only acceptable body holding device that can be used
in a fall arrest system.
Verify the free space required beneath the user at the workplace before each
occasion of use, so that, in the case of a fall, there will be no collision with the
ground or any other obstacle in the fall path.
Consider hazards that may affect the performance of the equipment and
corresponding safety precautions that have to be observed (e.g.: extremes
of temperature, trailing or looping of lanyards or lifelines over sharp edges,
chemical reagents, electrical conductivity, cutting, abrasion, climatic exposure,
pendulum falls).
It is essential for the safety of the user that if the product is re-sold outside the
original country of destination the reseller shall provide instructions for use, for
maintenance, for periodic examination and for repair in the language of the
country in which the product is to be used.
Perform regular annual, or more frequent examinations, as the safety of
users depends upon the continued efciency and durability of the equipment.
Periodic examination frequency shall be at least every 12 months. Periodic
examinations are only to be conducted by a competent person and strictly in
accordance with the manufacturer’s periodic examination procedures.

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Check the legibility of the product markings.
This product contains a chemical known to the state of California
to cause cancer, birth defects, or other reproductive harm.
WARNING
WARNING
WARNING
Always check for obstructions below the work area to make certain the potential
fall path is clear.
Use only approved Malta Dynamics hardware and fasteners with this product.
Do not attempt to move the system while workers are attached.
The Malta Dynamics Mobile Grabber should always be placed on level surfaces.
Main axle wheels must always be chocked unless unit is raised on outrigger
jacks or if the unit is being moved. The unit should only be moved with the GO!
System Friction Drive Mobility Package, tow vehicle, or other suitable moving
device. Unexpected movement or rolling of the unit could occur resulting in
bodily injury or death.
Do not remove product labels.
TOWING AND MOVING
LOCATION: The area where the system is used must be no less capable
of supporting twice the weight of the system and the loads applied by the
system in event of a fall.
APPROVED TOWING AND MOVING OPTIONS
• Vehicle with 2 5/16th ball hitch
• Forklift
• Grabber Go Function
• Crane
MOVING THE SYSTEM: Always disconnect workers before attempting
to move the system. Never expose a worker(s) to a fall hazard by pulling
the system while connected to the system.

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LIFTING THE UNIT
CRANE TRANSFER: This unit comes with lifting lugs which should only
be used for lifting purposes. It is the responsibility of the owner to have a
lifting plan in place before attempting to lift the unit. Extreme caution must
be taken at all times and the plan shall include the use of a spreader bar.
Use only appropriately sized equipment to lift unit. Weight listed on unit is
dry weight for base model only. Additional accessories, options, and
equipment can increase this weight. It is the responsibility of the owner to
verify lifting weight of unit before attempting to do so. Use extreme
caution – failure to do so can lead to bodily harm or death.
FORKLIFT TRANSFER: To properly lift the unit with a forklift, use the
built-in forklift pockets.
COMPONENT COMPATIBILITY: The XSERIES Mobile Grabber is
designed for use with ANSI Z359.14-2014 Class B Self retracting lifelines
and approved components only. Substitution or replacement with non-
approved components will endanger the compatibility within the system
and may affect the reliability and safety of the total system.

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SURFACE GRADE: The Malta Dynamics Mobile Grabber is designed for
use on surfaces that allow the unit to be leveled within 2° horizontal and
vertical to grade.
Warning: Do not use on surfaces that do not allow the unit to be leveled
within 2° horizontal and vertical to grade.
WORKING DISTANCE: WARNING: DO NOT EXCEED WORKING
DISTANCE REQUIREMENTS.
DO NOT preform work outside of the 30 degrees radius to tie off point.
WORKING AREA/USE: When using the unit, the walking/working
surface being accessed by the user must be of a sufcient height as not
to allow any part of a worker’s body to strike an object, or, the next lower
level, in the event of a fall arrest situation, as required by OSHA. The Malta
Dynamics Mobile Grabber may be used up to 30 degrees off plumb in the
East, West and South directions depending upon model and anchor points
being used so long as the user cannot strike an object or the next lower
level in a fall arrest. Please see diagrams below.
X1240 - 30°
2 User Capacity
X1250 - 30°
3 User Capacity
X1260 - 30°
5 User Capacity
CONNECTORS: Anchorage connectors are components that couple the
personal fall arrest system to the anchorage. In accordance with ANSI
Z359.1-2007 the anchorage connector must be capable of withstanding
(without breaking) a 5,000 lb. (22.2kN) load, and able to withstand a 3,600
lb. (16kN) load without cracking, or permanent deformation visible to the
unaided eye. Non-approved, non-compatible components may cause
accidental disengagement (roll-out). Only self-locking, self-closing
connectors are recommended.

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Each anchor point provided is rated for a single user up to 310lbs.
Caution must be taken when using self-retracting devices near moving
machinery, electrical hazards, sharp edges, or abrasive surfaces. Contact
with these elements may cause equipment failure, personal injury, or
death.
INITIAL SETUP & OPERATION
Don a full body harness according to the manufacturer’s instructions.
Install only ANSI compliant self-retracting devices (SRD’s) and personal fall
protection according to the manufacturer’s instructions supplied with that
product.
Before using the unit, be sure to read, understand, and follow the instructions
that come with your system. Knowing how to use the system properly will
greatly reduce the possibility of injury.
Before the first use of the XSERIES, it must be fully charged. The
power switch must be in the “off” position before charging.
1. Using vehicle, position the unit as close as possible to working
location. When possible, place the system on a solid, level surface.
The surface must be suitable for supporting the machine in the case
of a fall. The unit may remain connected to the vehicle as long as all
fall forces are absorbed by the unit. When positioning the unit, be
sure to allow enough clearance for the mast to raise without
interference.
2. Unpin the foot of the jack and drop the foot as close to the surface,
ground, as possible. Re-pin the foot of the jack in the closest hole and
rotate the jack clockwise.
3. Starting at the anchor-side of the machine, adjust the 2 outrigger
jacks until the level indicator shows that the unit is level.
•NOTE: The outrigger jacks, NOT the tires, must support the
system’s weight. The tires may be in contact with the ground,
but load must be on outriggers.
4. Moving to the tow-side of the machine, repeat the process in step 4
until the system shows level.
• NOTE: Double check to ensure the system is level in both
directions. The unit must be within 2 degrees of level before
use.

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WARNING: Be sure to lower each jack correctly. Not doing so
could hinder the performance of the machine and may cause
serious or fatal injury.
WARNING
WARNING
WARNING
5. Connect the controller to the connection point on control box located
at the anchor-side of the unit. Turn the power switch to “ON”.
6. Raise the anchor point of the mast to chest height by pressing the
Mast Raise button.
7. Attach SRD(s) to anchor point(s) and attach tagline to the snap hook
of the SRD(s).
WARNING: Use only ANSI rated SRLs. Adhere to all safety
precautions and warnings that come with your SRL. Attach
SRLs only to designated anchor points on the system. Failure
to do so could lead to serious injury or death.
WARNING
WARNING
WARNING
8. Raise Mast to the desired height by pressing Raise Mast button. Take
note of overhead obstacles as well as required working distances.
Once desired height is met, turn off main power and disconnect
control pendant from the unit. Follow any lock out/tag out procedures
required by your organization. Steps need to be taken to ensure that
the unit will not be lowered while workers are attached which could
lead to serious injury or death.
•NOTE: Be sure to allow for adequate swing fall distances when
raising the mast.
•NOTE: The mast must be raised to a minimum of 2ft before
use. NEVER use the system without raising the mast to the
minimum height.
9. Use the attached tagline to lower SRD connector for use. Once
attached, the system is ready to use. Follow any and all directions
while attached to the Malta Dynamics Mobile Grabber.

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XSERIES WIRELESS REMOTE
WIRELESS REMOTE PAIRING INSTRUCTIONS:
1. Make sure unit power is in the off
position.
2. Hold power button on the remote for
10-15 seconds. The green light on the
remote will then begin to flash.
3. Turn the machine power to the on postion
4. The remote is paired

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MAINTENANCE SCHEDULE
Malta Dynamics Mobile Grabber Maintenance & Inspection Schedule
Every Use
(By Authorized
User)
Monthly
(By Authorized
User)
Annual
(Competent
Person Other
than End User)
Item to Inspect
x Tire Pressure
x Brake System Bettery Check
x Grease Coupler
x x x Labels
x x x Main Power Disconnect
x x Battery
x Battery Charger
x x x Remote Control
x x Hydraulic Fluid
x x Hydraulic Pump/Motor/Manifold
x x Hydraulic Hoses/Lines
x x x Upper Cylinder
x x x Lower Cylinder
x x x All Hydraulic Connections
x x x Manual
x x Grease Fittings
x x x Anchor Points (Bolts & Swivel)
x Torque Bolts
Use the QR code below to access the in depth Maintenance Manual for
the XSERIES.

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FLUIDS USED WITHIN THE SYSTEM
HYDRAULIC FLUID
Standard-Mobile DTIO Excell22
Cold Weather- Schaffer #288 ISO 32 Synthetic
Fill the hydraulic fluid to the full mark on the side glass located on the front of the
hydraulic tank. The hydrualic fluid should be checked with the mast stowed.
BATTERY
Use only distilled or treated water that does not exceed 200 T.D.S (total dissolved
solids... parts per million)
Check the water level after charging. The water level should be kept 1/4” below
the bottom of the ll well in the cell cover.
DEEP CYCLE BATTERY MAINTENANCE
When charging the unit’s battery, always do so with the battery box
lid open as this allows for venting of both gases and heat.
WARNING
WARNING
WARNING
This product contains a chemical known to the state of California
to cause cancer, birth defects, or other reproductive harm.
WARNING
WARNING
WARNING
1. New batteries should be given a full charge before use.
2. Battery cables should be intact, and the connectors kept tight at
all times. Always use insulated tools to avoid shorting battery
terminals. Regular inspection is recommended.
3. Vent caps should be correctly installed and tight during
operation.
4. Batteries should be kept clean and free of dirt and corrosion at
all times.
5. Batteries should always be watered after charging unless plates
are exposed before charging. If exposed, plates should be
covered by approximately 1/8” of electrolyte (add distilled
water only). The electrolyte level should be kept 1/4” below the
bottom of the ll well in the cell cover.
6. Water used to replenish batteries should be distilled or treated
not to exceed 200 T.D.S. (Total Dissolved Solids... parts per

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million). Particular care should be taken to avoid metallic
contamination (iron).
7. For best battery life, batteries should not be discharged below
80%of their rated capacity.
8. Avoid charging at temperatures above 120 degrees F or ambient,
whichever is higher.
9. Always use the provided matched charger and battery pack
system. Unmatched chargers will cause potential problems.
10. As batteries age, their maintenance requirements change. This
means longer charging time and/or higher nish rate (higher
amperage at the end of the charge). Usually older batteries
need to be watered more often… and their capacity decreases.
11. Lead acid batteries like the ones used in the unit should be
brought up to full charge at the earliest opportunity. Avoid
continuously operating batteries in a partially charged
condition.This will shorten their life and reduce their capacity.
12. Extreme temperatures can substantially affect battery
performance and charging. Cold reduces battery capacity and
retards charging. Heat increases water usage and can result in
overcharging. Very high temperatures can cause “thermal run-
away” which may lead to an explosion or re. If extreme
temperature is an unavoidable part of an application, consult a
battery/charger specialist about ways to deal with the problem.
13. Inactivity can be extremely harmful to all lead acid batteries. If
season use is anticipated, we recommend the following:
i. Completely charge the battery before storing.
ii. Remove all electrical connections from the battery,
including series/parallel connectors.
iii. Store the battery in as cool a place as possible.
However, do not store in a location which will consistently
be below 32 degrees F. Batteries will discharge when
stored, the lower the temperature the lower the
self-discharge.
iv. When not in use, boost every two months.
MAST SYNCING
The mast beams may become un-synced during use. Re-syncing the unit can be
done while either in the fully deployed position or the fully collapsed position.
Re-sync while deployed:
1. Raise mast to full deployed height.
2. Press the same button to raise the unit and hold for 5 second bursts.

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The motor will sound different; this is perfectly ne.
3. Continue these bursts until unit is fully deployed.
4. The mast is now synced.
Re-sync while compact:
1. Lower mast to full compact height.
2. Press the same button to lower unit and hold for 5 second bursts. The
motor will sound different; this is perfectly ne.
3. Continue these bursts until unit is fully compact.
4. The mast is now synced.
BURNISHING BREAKS:
Electric Drum brakes require a break in period to achieve full performance. Prior
to any adjustments, your trailer brakes should be burnished in. There are two
methods to burnishing breaks. Standard vs. Aggressive.
Standard method includes:
Initial speed of 40mph
20 to 50 brake applications
Applying approximately 8-10 volts to the trailer brakes
Allowing the truck/trailer combination to slow down to 20-25mph.
Turn the gain on the trailer brake controller to the maximum level. Proceed at driving
to a speed of 40 Mph. Move the sliding mechanism on the trailer brake controller
to apply 8-10 volts to the trailer brakes, allowing the truck/trailer to slow down
to 20-25mph. DO NOT use the tow vehicles brakes during this period, the trailer
brakes will seat in faster by only using the trailer brakes to slow down. Release
the slide mechanism on the break controller and repeat this process at one-mile
intervals. You should feel a noticeable difference in the brake performance during
this period, in as few as 10 applications. Repeat this braking process 20-50 times.
This may result in the brake or axle area starting to smoke, which is a normal
result in the burnishing procedure. An ideal temperature for the brakes during this
process is between 350 and 400degrees Fahrenheit. If the brakes are not heating
up, please repeat this process.
Advanced:
Turn the gain on the trailer brake controller to the maximum level. Proceed to a
driving highway speed of 60-70 mph, not exceeding posted speed limits. Move
the sliding mechanism on the trailer brake controller to apply the trailer brakes
while maintaining the posted highway speed, without locking up the trailer brakes.
Continue with the trailer brakes applied while maintaining the posted speed limit
for one half mile. Release the sliding mechanism on the break controller. This may

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result in the brake or axle area starting to smoke, which is a normal result in the
burnishing procedure. An ideal temperature for the brakes during this process is
between 350 and 400degrees Fahrenheit. If the brakes are not heating up, please
repeat this process.
SAFETY INSTRUCTIONS
Safety Warning Labels
You shall read and follow all instructions and safety labels for your own
protection.
You must read and fully understand or have the following instructions explained
to you before using this equipment. You must be properly trained prior to using
this equipment.
All inquiries should be made to Malta Dynamics either by means of phone, fax,
or e-mail. Malta Dynamics shall not be held responsible for injuries the user may
receive from a fall if the system or any PPE is used outside of the prescribed
scope or any Industrial Code of Practice.
The user is responsible for all maintenance, training and
inspection records. The system must be recertied on a bi-
annual basis by an authorized Malta Dynamics representative
or competent person.
WARNING
WARNING
WARNING
At no time shall this unit be altered or repaired unless authorized by the
manufacturer. Failure to follow the preceding instructions can result in a serious
or fatal injury.
At no time shall the equipment not be used in a way or for a purpose other than
as instructed by the manufacturer.
Use of components within the system must adhere to the instructions provided.
Using combinations of components including but not limited to lanyards,
harnesses, SRDs, and anchors in combinations is strictly prohibited.
Exposing the system to any chemical that could in any way effect its
performance must be avoided. Users must contact the manufacturer for further
guidance if such a situation presents itself.
Extreme caution must be used when using the system around moving
machinery.
Workers must be aware and use appropriate caution when using the system
around sharp edges.

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INSPECTION
Inspection frequency: All systems shall be inspected visually by the user
prior to each use. The unit shall be inspected by a competent person other than
the end user at a minimum of once a year.
Detailed inspection records shall be kept. An inspection chart is provided in the
owner’s manual attached to the system for your convenience. In the event this
system has been involved in a fall, the unit and all components must be removed
from service immediately and checked by a trained and competent person
before possibly being put back in service.
Systems used in harsh environments may require more frequent formal
inspections. (Example: caustic or corrosive environments.)
Corrective actions: If damage is found or questionable conditions are apparent,
remove the equipment from service immediately and tag DO NOT USE. Failure
to remove systems that have been damaged or where their condition is
questionable could lead to a serious or fatal injury.
Use this form to maintain records for inspection of this equipment.
Inspection Date User Pass Fail