Title Page

  • Prepared by

  • Conducted on

  • Client / Site

Full Body Harness

  • Reference Harness Serial Number

    Harness Serial Number.png
  • Serial Number

  • Run your hands over the hardware (D-ring, buckles).

  • Is the hardware free of sharp edges, burrs, cracks, worn parts, or corrosion and not damaged, broken, or distorted?

  • Check release tabs of the buckles.

  • Do they work freely and a click is heard when the buckle engages?

  • Look at and run your hands over the webbing and stitching.

  • Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?

  • Are all labels present and legible?

Suspension Trauma Straps

  • Check the cover for damage and the connection to the harness for wear.

  • Free of any tears, abrasions, burns, discoloration, or knots?

  • Verify that one strap is marked “hook” and the other “loop,” and that they contain one of each type.

Lad-Safe/Tuf-Tug

  • Serial Number

  • Surface is free of any bends, cracks, and deformations?

  • Do all parts move freely and smoothly?

  • Free of any wear on the inside where the cable passes through?

  • Are all labels in place and clearly legible?

Lanyard and Self Locking Snap Hooks

  • Reference Lanyard Serial Number

    Lanyard Serial Number.png
  • Serial Number

  • Look at and run your hands over the webbing and stitching.

  • Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?

  • Keeper Reference Picture

    Self Locking Snap hook.png
  • Does the keeper on the snap hook seat into the nose without binding and is not distorted or obstructed?

  • Does the keeper spring exert enough force to firmly close the keeper?

  • Does the keeper lock prevent the keeper from opening when closed?

  • Is the hardware free of rough or sharp edges, corrosion, burrs, cracks, dents or distortion?

  • Does the shock absorber show any signs of deployment?

Positioning Lanyard

  • Do you have a positioning lanyard? If yes complete the following. If no, sign and complete report.

  • Serial Number

  • Is the rope free of fuzzy, worn, broken, or cut fibers, as well as loose material such as dirt, sand, petroleum, or chemical contaminants?

  • Look at and run your hands over the webbing and stitching.

  • Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?

  • Does the keeper on the snap hook seat into the nose without binding and is not distorted or obstructed?

  • Does the keeper spring exert enough force to firmly close the keeper?

  • Does the keeper lock prevent the keeper from opening when closed?

  • Is the hardware free of rough or sharp edges, corrosion, burrs, cracks, dents or distortion?

  • Inspector Name and Signature

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.