Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Harness

    Harness
  • Manufacturer

  • Date of Manufacture

  • Serial Number

  • Is the webbing free of:<br>- Cuts or tears<br>- Abrasion damage<br>- Excessive stretching<br>- Damage due to contact to heat, corrosives or solvents<br>- Deterioration due to rotting, mildew or ultraviolet rays<br><br>Are all D-rings, buckles and adjusters:<br>- In good condition<br>- Clean<br>- Locking / connecting correctly<br>- Free of rust and / or chemical damage

  • Has a tag been fitted with the current certification date?

  • Pass / Fail

  • Photos

Lanyard

    Lanyard
  • Manufacturer

  • Date of Manufacture

  • Serial Number

  • Is the webbing free of:<br>- Cuts or tears<br>- Abrasion damage<br>- Excessive stretching<br>- Damage due to contact to heat, corrosives or solvents<br>- Deterioration due to rotting, mildew or ultraviolet rays<br><br>Are all D-rings, buckles and adjusters:<br>- In good condition<br>- Clean<br>- Locking / connecting correctly<br>- Free of rust and / or chemical damage<br><br>Are the snap hooks / karabiners:<br>- Showing no signs of distortion<br>- Showing no signs of cracks<br>- Showing no signs of excessive wear<br>Please ensure all snap hooks / karabiners open, close and lock properly

  • Has a tag been fitted with the current certification date?

  • Pass / Fail

  • Photos

Shock Absorber

    Shock Absorber
  • Manufacturer

  • Date of Manufacture

  • Serial Number

  • Is the webbing free of:<br>- Cuts or tears<br>- Abrasion damage<br>- Excessive stretching<br>- Damage due to contact to heat, corrosives or solvents<br>- Deterioration due to rotting, mildew or ultraviolet rays<br><br>Are all D-rings, buckles and adjusters:<br>- In good condition<br>- Clean<br>- Locking / connecting correctly<br>- Free of rust and / or chemical damage<br><br>Are the snap hooks / karabiners:<br>- Showing no signs of distortion<br>- Showing no signs of cracks<br>- Showing no signs of excessive wear<br>Please ensure all snap hooks / karabiners open, close and lock properly

  • Has a tag been fitted with the current certification date?

  • Pass / Fail

  • Photos

Rope

    Rope
  • Manufacturer

  • Date of Manufacture

  • Serial Number

  • Is the webbing free of:<br>- Cuts or tears<br>- Abrasion damage<br>- Excessive stretching<br>- Damage due to contact to heat, corrosives or solvents<br>- Deterioration due to rotting, mildew or ultraviolet rays<br><br>Are all D-rings, buckles and adjusters:<br>- In good condition<br>- Clean<br>- Locking / connecting correctly<br>- Free of rust and / or chemical damage<br><br>

  • Has a tag been fitted with the current certification date?

  • Pass / Fail

  • Photos

Slings / Tie off Adaptors

    Slings / Tie off Adaptors
  • Manufacturer

  • Date of Manufacture

  • Serial Number

  • Is the webbing free of:<br>- Cuts or tears<br>- Abrasion damage<br>- Excessive stretching<br>- Damage due to contact to heat, corrosives or solvents<br>- Deterioration due to rotting, mildew or ultraviolet rays<br><br>Are all D-rings, buckles and adjusters:<br>- In good condition<br>- Clean<br>- Locking / connecting correctly<br>- Free of rust and / or chemical damage<br><br>Are the snap hooks / karabiners:<br>- Showing no signs of distortion<br>- Showing no signs of cracks<br>- Showing no signs of excessive wear<br>Please ensure all snap hooks / karabiners open, close and lock properly

  • Has a tag been fitted with the current certification date?

  • Pass / Fail

  • Photos

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.