Inspection guide: U-Stair with two flat landing

Inspection guide:

U - Stair with two flat landing

Inspection date:

Date

Choose company doing the inspection*

Name of inspection person:

E-mail inspection person*

example@example.com

Name user / customer

Address

Phone number

E-Mail

example@example.com

Have you already received any financial support?

Where did you hear about AssiStep?

Please specify other/magazin/tv:

Who made the order (or will)

Order number NAV HMS

Is the contact information to the therapist relevant?

YesNo

Name therapist

Phone number therapist

What material is the wall made of? (you can choose multiple materials)

What is the difference in depth between different wall surfaces (cm)? (If there are)

cm

On which side of the stairs, viewed from below, should AssiStep be installed?

RightLeft

Type of backboard?

WhiteUntreated

Bag hook?

YesNo

Extended warranty?

YesNo

What is the height from the floor/ground and up to the users elbow (cm)?

cm

Overview of staircase and measurements:

Start with measurements for the top and bottom area

! Note that decimal is given with a point (.) and not with comma (,) !

Position 1:

TopBottom

1.1: Distance to obstacle or end of the wall (cm)

1.2: Maximum rail extension from last step (cm)

1.3: Width (cm)

Position 2:

TopBottom

2.1: Distance to obstacle or end of the wall (cm)

2.2: Maximum rail extension from last step (cm)

2.3: Width (cm)

Add the cm measurements for the staircase:

Length measurements should be taken along the staircase, in the same angle as the staircase. Note that decimal is given with a point (.) and not with comma (,) !

1: Length along staircase, from 1. step, at the stair nosing, to last step and top of the 1. flat landing (cm)

2: Length from the last step to the corner on the 1. flat landing (cm)

3: Length from corner on the 1. flat landing to the first step (cm)

4: Length along staircase, from 1. step, at the stair nosing, to last step and top of the 2. flat landing (cm)

5: Length from the last step to the corner on the 2. flat landing (cm)

6: Length from corner on the 2. flat landing to the first step (cm)

7: Length along staircase, from 1. step, at the stair nosing by the 2. flat landing, to last step on the top of the staircase (cm)

8: Width in center of the staircase (cm)

9: Measure the height of one step in the middle of the staircase (cm)

Add the angles in the staircase:

When you measure the angle (in degrees) in the staircase, put the digital leveling tool on the edge of each step. In the corners you determine the degree by measuring along where the railing for the AssiStep would be. Note that decimal is given with a point (.) and not with comma (,) !

1: Angle in the center of the staircase on the steps towards position 1 (degrees)

2: Angle in the center of the staircase, on the the steps between the two flat landings (degrees)

3: Angle in the center of the staircase on the steps towards position 2 (degrees)

Describe the solution for the staircase

Describe in detail what solution has been agreed with the customer regarding extension at the top of the stairs, extension at the bottom of the stairs, solution if obstacles in the staircase and other relevant information required to compile the correct item list:

Draw the solution for this staircase and add a picture of the drawing here:

Are there other information that is relevant for the order, delivery, installation etc, add the necessary description here:

Take the following pictures of the stair:

1. Overview picture(s) showing the whole stair, ex:

2. Pictures showing potential obstructions and where the wall ends, for the top and bottom area of the staircase, ex:

3. Detail pictures showing obstructions and potentially difficult sections in the staircase, ex:

! If the internet connection is slow or the total file size is more than 40 MB (or each picture is more than 4 MB), do not upload the pictures here. Just send the form and attach the pictures to the email you will receive (before sending it to receive a price offer). When uploading the pictures here you will see the file size for each picture.

Only file type: pdf, jpg, jpeg, png

Is the inspection form finished? If YES, tick of if the form should also be sent to ordre@assistep.no, or just to the inspection persons mail for control*

ordre@assistep.noOnly to inspection person

Send: The form and photos is sent to the e-mail {emailTo}