3M Mobile SkyWalk Series Horizontal Lifeline Product Return Form THIS FULLY COMPLETED DOCUMENT MUST BE INCLUDED WITH EACH RETURN SHIPMENT IN ORDER FOR CREDIT TO BE ISSUED. ALL CREDITS WILL BE ISSUED TO THE DISTRIBUTOR INDICATED ON RETURN SHIPMENT FORM AT CURRENT PRODUCT COST. ALL RETURN SHIPMENTS MUST BE IDENTIFIED WITH RGA# SWSW914 ON EACH PACKAGE. SHIP ALL SWSW SYSTEMS OR COMPONENT RETURNS VIA UPS GROUND USING 3M UPS SHIPPING ACCOUNT NUMBER: 65W813 Distributor Name: Date of Return Shipment: Distributor 3M Account Number: Distributor Contact Person: Email: Location: Distributor Phone: Distributor Fax Quantity Returned: Please indicate quantities of each component returned on the attached form. Customer Name: Contact Person: Customer Phone #: Quantity Returned: Please indicate quantities of each component returned on the attached form. SHIP THIS FULLY COMPLETED FORM AND AFFECTED PRODUCTS TO: Montage Inc 912 Industrial Drive Milbank, SD 57252 RGA# SWSW914 Attn: Barb Bear Each returned package must clearly identify the RGA number on the outside of packaging. Product credit will be issued to the 3M Distributor indicated on this form at current 3M distributor pricing. 1 of 6
Products, September 2014 Product Recall List, September 2014 Connectors SWSW 06 10078371004191 70071528015 Connectors SWSW 06X 10078371007550 70071528031 Connectors SWSW 13 10078371004221 70071528106 Lifeline System Stud Bracket SWSW 06, 1 ea/case Lifeline System Flat Surface Weld Stud Bracket 1 ea/case Lifeline System PVC Sleeve SWSW 13, 1 ea/case The Stud Bracket has a receiver sleeve for the Aluminum Post Stanchions. The Stub Bracket may be attached to the base of a rebar cage, around the top of a concrete column, or through a concrete wall. The Flat Surface Weld Bracket is a weldable version of the Stud Bracket SWSW 06. It is constructed with 3/4 inch thick, 14 1/2 by 8 inch zinc plated steel, and Schedule 80 pipe as the receiver sleeve for the Aluminum Post Stanchion. The PVC Sleeve is 12 inches tall with a 4 inch inside diameter, and constructed of 4 inch Schedule 40 PVC. PVC Sleeve is cast into concrete and receives the Aluminum Posts Stanchions. Connectors SWSW 29 10078371004283 70071528171 Lifeline System Flat Base SWSW 29, 1 ea/case The Flat Base, constructed with 5/8 inch Steel and Schedule 40 Pipe, is designed to mount onto flat surfaces and to be used with the Aluminum Post Stanchion. Mounting holes are for 3/4 inch Grade 8 bolts or concrete anchor; mounting hardware is not included. Connectors SWSW 08A 10078371009523 70071528049 Lifeline System Aluminum Post Stanchion SWSW 08A, 1 ea/case The end/intermediate Aluminum Posts Stanchions are 7 1/2 feet long with a 3 1/2 inch outside diameter. Each post has 2 sets of 9/16 inch holes set 4 inches apart and at 90 for the SWSW 01 eyebolts (not included). Connectors SWSW 22 10078371004269 70071528155 Lifeline System Swivel Cap SWSW 22, 1 ea/case The Swivel Cap is placed over the top of the Aluminum Post Stanchion creating an elevated individual anchor point. A Self Retracting Lanyard may be attached to the Swivel Cap allowing the user to work 360. Connectors SWSW 24 10078371004276 70071528163 Lifeline System Skyhook Bracket SWSW 24, 1 ea/case The SkyHook Bracket clamps to # 9 or larger stirruped rebar, with two 2 inch inside diameter J bolts, at 6 1/2 feet above the working surface. A safety strap wraps around the rebar cage, creating an anchor point at the proper height for the Mobile Skywalk. The SkyBracket is constructed with aluminum and two 30 inch threaded bars that clamp to #9 or larger stirruped rebar. Installed at 6 1/2 feet above the working surface, it Connectors SWSW 30A 10078371013162 70071528189 Lifeline System Skyhook Bracket SWSW 30A, 1 ea/case creates an anchor point at the proper height for the Mobile Skywalk Horizontal Lifeline. Connectors SWPC 02 10078371004047 70071527918 SWPC 02, 1 ea/case 10 mm Lifeline Intermediate Support used with SWPC 15 and SWPC 08. Connectors SWPC 08 N/A N/A N/A Runner used with SWPC 15 and SWPC 02. Connectors SWPC 15 N/A N/A N/A Corner Pipe used with SWPC 08 and SWPC 02. Connectors SWSW 24XL 10078371007604 70071576162 Lifeline System Skyhook Bracket SWSW 24XL, 1 ea/case Same as the SWSW 24 except the J bolts are 3.5 inch versus 2 inch. Connectors SWSW 32 10078371010673 70071528197 Lifeline System Corner Post Bracket, 1 ea/case Corner bracket for SWSW 08A post, angled bracket 12 inches length. Connectors SWSW 31 10078371008601 70071575099 Connectors SWSW 06BP 10078371010147 70071528023 Lifeline System Sloped Wall Bracket SWSW 31, 1 ea/case Sloped wall bracket for Mobile Skywalk system for SWSW 08A post. SWSW 06, 1 ea/case Back plate for SWSW 06. 2 of 6
Products, September 2014 PowerBrake SWSW 18 10078371004252 70071528148 Assemblies SWMS 200 10078371659278 70071650009 Lifeline System Power Brake SWSW 18, 1 ea/case 3M 200 ft Galvanized Skywalk SWMS 200, horizontal lifeline. The Power Brake is as the inline energy absorber designed to limit the maximum arrest load to less than 1,650 lb. on the end anchorages. 200 ft Galvanized Steel for Mobile Skywalk horizontal lifeline systems. assembly includes one finished swaged end, and one unfinished end with (2) Fist Grips Assemblies SWMS 30 SS 10078371659209 70071649936 Assemblies SWMS 60 SS 10078371659223 70071649951 Assemblies SWMS 100 SS 10078371659247 70071649977 3M 30 ft Stainless Steel Skywalk SWMS 30 SS, 3M 60 ft Stainless Steel Skywalk SWMS 60 SS, 3M 100 ft Stainless Steel Skywalk SWMS 100 SS, 30 ft Stainless Steel for Mobile Skywalk horizontal lifeline systems. assembly includes one finished 60 ft Stainless Steel for Mobile Skywalk horizontal lifeline systems. assembly includes one finished 100 ft Stainless Steel for Mobile Skywalk horizontal lifeline systems. assembly includes one finished Assemblies SWMS 200 SS 10078371659261 70071649993 Accessories SWSW 03 10078371004160 70071527983 Accessories SWSW 10 10078371013612 70071528056 Accessories SWSW 01 10078371004146 70071527967 3M 200 ft Stainless Steel Skywalk SWMS 200 SS, Lifeline System Shackle SWSW 03, 1 ea/case 200 ft Stainless Steel for Mobile Skywalk horizontal lifeline systems. assembly includes one finished horizontal lifeline. The Shackle is 1/2 in. and is a cable termination point. The Eye Nut attaches to the Eye Bolt to create an attachment point on the opposite side of the Aluminum Lifeline System Shoulder Eye Nut Posts Stanchion. They are zinc plated and have a one inch SWSW10, 1 ea/case inside diameter eye. Lifeline System Shoulder Nut Eyebolt SWSW 01, 1 ea/case horizontal lifeline. The zinc plated Eye Bolt for the aluminum post stanchions are 5 inches long with a one inch inside diameter eye and comes with a washer and nut. Accessories SWSW DD 10078371008236 70071529179 Lifeline System Dywidag Threadbar SWSW DD, 1 ea/case Replacement part: 30" dywidag threadbar used with the SWSW 06 Not available Accessories SWSW N 10078371008243 70071529187 Lifeline System Dywidag Nut SWSW N, 1 ea/case Replacement part: 5/8" dywidag nut used with the SWSW 06. Tensioners SWSW 02 10078371004153 70071527975 Tensioners SWSW 05 10078371004184 70071528007 Lifeline System Come Along SWSW 02, 1 ea/case Lifeline System Adjustable Safety Link SWSW 05, 1 ea/case The Come Along is constructed of zinc plated steel with 12 feet of 7/32 inch Aircraft cable to adjust tension in the Mobile Skywalk lifeline. It must always be used in conjunction with the SWSW 05 Adjustable Safety Link. The Adjustable Safety Link is constructed of 1 inch polyester webbing and is adjustable from 3 to 6 feet. The Adjustable Safety Link must be used with the Come along. A standard carabiner (not included) on each end is used to connect it to the system. 3 of 6
Products, September 2014 Tensioners SWPC 17 10078371004108 70071527926 Lifeline System Pre tensioner Component SWPC 17, 1 ea/case horizontal lifeline. The SWPC 17 Pre Tensioner is designed to easily identify if the Mobile Skywalk Horizontal Lifeline has been properly tensioned. Tensioners SWSW 20 10078371007581 70071578614 Lifeline System Shackle Block SWSW 20, 1 ea/case Shackle used with Mobile Skywalk to tie back the cable system. Along SWSWKIT1 10078371659872 70071650652 SWSWKIT1, 30 ft. Stainless Steel, 1 Kit Stainless Steel, Come Along, Power Brake, Pre in Along SWSWKIT2 10078371659889 70071650660 SWSWKIT2, 30 ft. Galvanized, 1 Kit Galvanized, Come Along, Power Brake, Pre in Along SWSWKIT5 10078371659919 70071650694 SWSWKIT5, 60 ft. Stainless Steel, 1 Kit Stainless Steel, Come A Long, Power Brake, Pre in Along SWSWKIT6 10078371659926 70071650702 SWSWKIT6, 60 ft. Galvanized, 1 Kit Galvanized, Come A Long, Power Brake, Pre in Stainless Steel, Come A Long, Power Brake, Pre SWSWKIT9, Along SWSWKIT9 10078371659950 70071650736 100 ft. Stainless Steel, 1 Kit in Storage Bag Along SWSWKIT10 10078371659964 70071650744 SWSWKIT10, 100 ft. Galvanized, 1 Kit Galvanized, Come A Long, Power Brake, Pre in Along SWSWKIT13 10078371659995 70071650777 SWSWKIT13, 200 ft. Stainless Steel, 1 Kit Stainless Steel, Come A Long, Power Brake, Pre Tensioner, Link, (4) Carabiners, (2) Fist Grip, and Thimble in Along SWSWKIT14 10078371660007 70071650785 SWSWKIT14, 200 ft. Galvanized, 1 Kit Galvanized, Come A Long, Power Brake, Pre in 4 of 6
Products, September 2014 Kits Turnbuckle SWSWKIT3 10078371659896 70071650678 SWSWKIT3, 30 ft. Stainless Steel, 1 Kit Stainless Steel, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT4 10078371659902 70071650686 SWSWKIT4, 30 ft. Galvanized, 1 Kit Galvanized, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT7 10078371659933 70071650710 SWSWKIT7, 60 ft. Stainless Steel, 1 Kit Stainless Steel, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT8 10078371659940 70071650728 SWSWKIT8, 60 ft. Galvanized, 1 Kit Galvanized, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT11 10078371659971 70071650751 SWSWKIT11, 100 ft. Stainless Steel, 1 Kit Stainless Steel, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT12 10078371659988 70071650769 SWSWKIT12, 100 ft. Galvanized, 1 Kit Galvanized, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT15 10078371660014 70071650793 SWSWKIT15, 200 ft. Stainless Steel, 1 Kit Stainless Steel, Turnbuckle, Power Brake, Pre Kits Turnbuckle SWSWKIT16 10078371660021 70071650801 SWSWKIT16, 200 ft. Galvanized, 1 Kit Galvanized, Turnbuckle, Power Brake, Pre 5 of 6
Products, September 2014 Kit PVC Sleeve SWSWKIT17 10078371660038 70071650819 SWSWKIT17, 1 Kit This horizontal lifeline system kit contains (2) PVC Sleeves and (2) Shoulder Eye Bolts. Accessories SWSW 00 10078371013605 70071527934 3M Variant Length Variant length cable product. Accessories 0216 R 10078371001145 70071535168 Accessories SWSW 04 10078371004177 70071527991 Accessories SWSW 11 10078371004214 70071528072 Accessories 0210 07 10078371013070 70071535119 Accessories SWSW 12 10078371009530 70071528080 3M Lifeline Traveler 0216 R, 1 ea/case Lifeline traveler is for cable or rope lifelines up to 1/2 inch. Lifeline System Turnbuckle SWSW 04, 1 ea/case Lifeline System Fist Grip SWSW 11, 1 ea/case 3M Fall Protection Autolock Carabiner 0210 07, 1ea/case horizontal lifeline. The Jaw and Jaw 5/8 inch Turnbuckle is constructed of forged galvanized steel and adjusts from 18 to 28 inches. The unfinished end of the Mobile Skywalk is used for system length adjustment. The Fist Grips are used to secure the unfinished end of the Mobile Skywalk once adjustment is complete. Fall protection safety equipment steel autolock carabiner with 0.78" gate opening. Swedge Clamp SWSW12, 5/16in, Lifeline Systems 1/case Swedge clamp. N/A Accessories SWSW 12T 10078371009547 70071528098 Accessories SWMS 30 10078371659216 70071649944 Accessories SWMS 60 10078371659230 70071649969 3M(TM) Thimble SS SWSW12T, 5/16in, Lifeline Systems 1/case 3M 30 ft Galvanized Skywalk SWMS 30, 3M 60 ft Galvanized Skywalk SWMS 60, Thimble (replacement part) included in cable assembly. 30 ft Galvanized Steel for Mobile Skywalk temporary horizontal lifeline systems. assembly includes on finished swaged end, and one unfinished end with two fist grips and thimble for manual termination. 60 ft Galvanized Steel for Mobile Skywalk temporary horizontal lifeline systems. assembly includes on finished swaged end, and one unfinished end with two fist grips and thimble for manual termination. Accessories SWMS 100 10078371659254 70071649985 3M 100 ft Galvanized Skywalk SWMS 100, 100 ft Galvanized Steel for Mobile Skywalk temporary horizontal lifeline systems. assembly includes on finished swaged end, and one unfinished end with two fist grips and thimble for manual termination. 6 of 6