Information
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Completed by
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Inspection Date
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Location
Harness and Lanyard Details:
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Harness Model #
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Harness Serial #
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Is the label attached to Harness and fully legible
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Is the Harness within the 10yr Date of Manufacture?
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Lanyard Model #
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Lanyard Serial #
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Is the Lanyard within the 10yr Date of Manufacture?
Hardware:
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Buckles in Place?
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D Rings in Place?
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Back Pad in Place?
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Loop Keepers in Place?
Hardware Condition:
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Any Damaged or Worn Parts?
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Any Broken or Bent Parts?
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All Buckle Springs Loose?
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Any Sharp Edges?
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Any Burrs?
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Any Cracks?
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Any Parts Distorted or Out of Shape?
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Any Corrosion?
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Check the plastic sleeve is not yellow or perished
Webbing:
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Any Cuts?
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Any Webbing Frayed?
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Any Broken Fibers?
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Any Broken Stiches?
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Amy Tears?
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Any Abrasions?
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Any Mold?
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Any Burns?
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IF INSPECTION REVEALS ANY DEFECTIVE CONDITION, REMOVE FROM SERVICE AND DESTROY.
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Signature of Inspector