Electric Results Safety Harness Inspection

• Audit Title

• Conducted on

  Date
• Location
  Address

• Personnel

HARNESS IDENTIFICATION

• Harness Manufacturer<br>

  Yes

  No

  N/A

• Manufacturer Name

• Harness Model

  Yes

  No

  N/A

• Model Name

• Harness Lot Number

  Yes

  No

  N/A

• Lot Number

• Harness Serial Number

  Yes

  No

  N/A

• Serial Number

• Date of Manufacture

  Yes

  No

  N/A

• Select date

  Date

• In-Service Date

  Yes

  No

  N/A

• Harness CSA Class: A - Fall Arrest

  Yes

  No

  N/A

• Harness CSA Class: D - Suspension and Controlled Descent

  Yes

  No

  N/A

• Harness CSA Class: E - Limited Access

  Yes

  No

  N/A

• Harness CSA Class: L - Ladder Climbing

  Yes

  No

  N/A

• Harness CSA Class: P - Work Positioning

  Yes

  No

  N/A

HARDWARE

• D-rings<br>Check D-rings for rust or corrosion, distortion, cracks, breaks, and rough or sharp edges. D-rings should pivot freely.

  Safe

  At Risk

  N/A

• Buckles<br>note any unusual wear, damage or distortion. On tongue buckles check that the roller and tongue move freely and that the tongue overlaps the buckle frame. Check the outer and center bars on friction and mating buckles for distortion. On quick release types check for broken plastic and that they will not release when one release is opened. Mating buckles should nest together.

  Safe

  At Risk

  N/A

WEBBING

• Webbing<br>Inspect the entire length of all the webbing looking for frayed edges, broken fibers, pulled stitches, cuts, burns and chemical damage. Also look for mildew, discoloration, hard shiny spots, any webbing that has been marked with a felt pen, excessive hardness or brittleness or the Harness Fall Indicator deployment.

  Safe

  At Risk

  N/A

• Stitching <br>Check all stitching for ripped or pulled stitches and to make sure the webbing joints are not loose. Also look for missing stitching, hard or shiny spots, or discoloration of stitching.

  Safe

  At Risk

  N/A

LABELS

• Inspect to be certain that all harnesses have a label that is legible and securely held in place.

  Yes

  No

  N/A

OVERALL DISPOSITION

• Harness is approved for use at time of inspection.

  Yes

  No

  N/A

• Harness is NOT approved for further use and must be removed from service.

  Yes

  No

  N/A

Signature

• Add signature

  Sign