Title Page
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Site conducted
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Prepared by
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Conducted on
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Client / Site
Full Body Harness
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Reference Harness Serial Number
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Serial Number
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Run your hands over the hardware (D-ring, buckles).
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Is the hardware free of sharp edges, burrs, cracks, worn parts, or corrosion and not damaged, broken, or distorted?
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Check release tabs of the buckles.
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Do they work freely and a click is heard when the buckle engages?
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Look at and run your hands over the webbing and stitching.
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Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?
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Are all labels present and legible?
Suspension Trauma Straps
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Check the cover for damage and the connection to the harness for wear.
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Free of any tears, abrasions, burns, discoloration, or knots?
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Verify that one strap is marked “hook” and the other “loop,” and that they contain one of each type.
Lad-Safe/Tuf-Tug
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Serial Number
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Surface is free of any bends, cracks, and deformations?
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Do all parts move freely and smoothly?
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Free of any wear on the inside where the cable passes through?
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Are all labels in place and clearly legible?
Lanyard and Self Locking Snap Hooks
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Reference Lanyard Serial Number
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Serial Number
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Look at and run your hands over the webbing and stitching.
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Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?
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Keeper Reference Picture
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Does the keeper on the snap hook seat into the nose without binding and is not distorted or obstructed?
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Does the keeper spring exert enough force to firmly close the keeper?
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Does the keeper lock prevent the keeper from opening when closed?
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Is the hardware free of rough or sharp edges, corrosion, burrs, cracks, dents or distortion?
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Does the shock absorber show any signs of deployment?
Positioning Lanyard
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Do you have a positioning lanyard? If yes complete the following. If no, sign and complete report.
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Serial Number
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Is the rope free of fuzzy, worn, broken, or cut fibers, as well as loose material such as dirt, sand, petroleum, or chemical contaminants?
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Look at and run your hands over the webbing and stitching.
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Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?
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Does the keeper on the snap hook seat into the nose without binding and is not distorted or obstructed?
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Does the keeper spring exert enough force to firmly close the keeper?
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Does the keeper lock prevent the keeper from opening when closed?
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Is the hardware free of rough or sharp edges, corrosion, burrs, cracks, dents or distortion?
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Inspector Name and Signature
