Information

  • Fall Protection Inspection

  • Conducted on

  • Prepared by

  • Location

Harness Info:

  • Label Attached to Harness<br>

  • Label Fully Legible

  • HARNESS Date of Manufacture:

  • HARNESS Serial #

Hardware:

  • Buckles in Place?

  • D Rings in Place?

  • Back Pad in Place?

  • Loop Keepers in Place?

Hardware Condition:

  • Free of Damaged or Worn Parts?

  • Free of Broken or Bent Parts?

  • All Buckle Springs Loose?

  • Free of any Sharp Edges?

  • Free of Burrs?

  • Free of Cracks?

  • Parts free of distortion and elongation?

  • Free Corrosion?

Webbing:

  • Free of Cuts?

  • Webbing free of Frays?

  • Free of Broken Fibers?

  • Free of Broken Stitches?

  • Free of Tears?

  • Free of Abrasions?

  • Free of Mold?

  • Free of Burns?

Self Retracting Lanyard / Lifeline Info:

  • SRL Date of Manufacture:

  • SRL Serial #

SRL Condition:

  • Does impact indicator show no impacted or elongated?

  • Webbing free of frays?

  • Are all screws and fasteners tight and in place?

  • Housing free of any distortion, cracks, and other damage?

  • Lifeline free of cuts, burns, tears, abrasions, frays, excessive soiling, and discoloration?

  • Parts free of distortion and elongation?

  • Does lifeline lock quickly deployed?

  • Does lifeline retract fully with no slack after full deployment?

  • Are hooks & carabiners free of physical damage and corrosion and operate freely?

  • Are all labels present and fully legible?

Crossarm Strap

  • Date of Manufacture:

  • Serial #

Hardware Condition:

  • Free of Sharp Edges?

  • Free of Burrs?

  • Free of Cracks?

  • Free Corrosion?

  • Are all labels present and fully legible?

Webbing:

  • Free of Cuts?

  • Webbing free of Frays?

  • Free of Broken Fibers?

  • Free of Broken Stitches?

  • Free of Tears?

  • Free of Abrasions?

  • Free of Mold?

  • Free of Burns?

Overall inspection Info:

Overall inspection Info:

  • IF INSPECTION REVEALS ANY DEFECTIVE CONDITION, REMOVE FROM SERVICE AND DESTROY.

  • Signature of Inspector

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