Information
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Date of Inspection?
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Lead Name?
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Who are the equipment users?
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Who will be useing the equipment or is it assigned to?
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Has this equipment assigned to a specific vehicle? If so, what is the vehicle number?
Harness Information
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What is the harness serial number?
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What is the harness size?
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Is the harness free of any tears or rips?
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What is the condition of the straps?
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What is the condition of the buckles?
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What is the condition of the D ring?
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What is the condition of the label(s)?
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What is the overall condition of the harness?
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Lanyard Information
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What is the lanyard serial number?
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What type of lanyard?
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What is the length of lanyard?
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What is the condition of the hook?
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Is the lanyard free of tears or rips?
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What is the condition of the carabiner?
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Self Retracting Lifeline
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What is the serial number of the self retracting lifeline?
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What is the length of the self retracting lanyard?
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What is the condition of the hook?
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What is the condition of the cable?
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What is the condition of the carabiner?
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If you are working from a lift are you using a retractable or a self adjustable lanyard
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Are you using a horizontal life line?
Roof anchors
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How menny anchors are being used
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Are anchors installed propperly
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Have you calculated fall distance
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Are employees working in restraint?
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Are employees working in arrest?
Documentation
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Have you filled out your fall protection plan?
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Have all employees read and signed the fall protection plan?
Verification Signature
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