Title Page
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Document No.
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6011 EAST HWY 80 MIDLAND, TEXAS PHONE: 432-687-1883 FAX: 432-687-1887
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Conducted on
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Prepared by
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Location
HARNESS INFORMATION AND INSPECTION (GENERAL FACTORS)
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HARNESS MODEL #
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SERIAL #
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LOT #
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MANUFACTURE DATE
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1. IMPACT INDICATORS: Inspect indicator for activation (rupture of red stitching, elongated indicator, etc.)
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2. SCREWS/FASTENERS: Inspect for damage and make certain all screws and fasteners are tight.
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3. HOUSING: Inspect for distortion, cracks and other damage. Inspect anchoring loop for distortion and damage.
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4. LIFELINE: Inspect for cuts, burns, tears, abarsions, frays, excessive soiling and discoloration, broken wires.
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5. LOCKING ACTION: Inspect for proper lock-up of brake mechanism.
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6. RETRACTING/EXTENSION: Inspect spring tension by pulling lifeline out fully and allowing it to retract fully (no slack).
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7. HOOKS/CARABINERS: Inspect for physical damage, corrosion, proper operation and markings.
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8. LABELS: Inspect all labels are securely held in place and legible.
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OVERALL CONDITION
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Comments:
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Inspected by:
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Assigned User
