Evolution Height Safety Full Body Harness INSPECTION

• Serial no

• Client / Site

• Document No.

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Full Body Harness

• Serial number

• Model

• MFG Date

• Type of harness e.g full body or rope access

• Brand of harness

Label

• Label

  Safe

  At Risk

  N/A

• Serial number

  Yes

  No

  N/A

• MFG date older than 5 or 10 years

  Safe

  At Risk

  N/A

• Unit Standard

  Safe

  At Risk

  N/A

• Company details

  Safe

  At Risk

  N/A

• Add media

  Media

Stiching

• Stitching safe?

  Safe

  At Risk

  N/A

• Stitching coming loose

  Safe

  At Risk

  N/A

• Missing

  Safe

  At Risk

  N/A

• Apart

  Safe

  At Risk

  N/A

• Add media

  Media

Webbing

• Is the Webbing safe?

  Safe

  At Risk

  N/A

• Cuts

  Safe

  At Risk

  N/A

• Abrasions

  Safe

  At Risk

  N/A

• Discoloration ( paint, tipex, marker)

  Safe

  At Risk

  N/A

• Burns

  Safe

  At Risk

  N/A

• Add media

  Media

Metals parts

• Is the metal components safe?

  Safe

  At Risk

  N/A

• Corrosion (rust)

  Safe

  At Risk

  N/A

• Missing

  Safe

  At Risk

  N/A

• Bend

  Safe

  At Risk

  N/A

• Functionality of the buckles

  Safe

  At Risk

  N/A

• Cracks

  Safe

  At Risk

  N/A

• Add media

  Media

Safe for use

• Is the product safe for use

  Safe

  At Risk

  N/A

• Last 3 months inspection history provided?

Sign off

• Select date

  Date

• Add signature

  Sign

Disclaimer

• Evolution Height Safety does not take any liability or responsibility for any product that is being miss used in any format.
  Only use the product is intended and designed for.
  Please read the user manual.
  Only competent person allowed to use this product.
  Personal inspection must be done by the user before and after use!
  Results of the equipment is based on the last 3 months inspection information given of the product's history.