Harness & Lanyard Inspection Report

• Client / Site

• Conducted on

  Date

• Prepared by

Harness:

• Manufacturer

• Serial Number

• Manufacture Date

  Date

• Photo of harness labelling and tags

  Media

Harness Type:

• Check Type Harnesses Inspecting

  Select Full-Body Adjustable Harness Full-Body Specialty Harness Flame Retardant Kevlar/Nomax Welders Harness Padded Full-Body Adjustable Harness Flotation Full-Body Adjustable Harness

  • Full-Body Adjustable Harness
  • Full-Body Specialty Harness
  • Flame Retardant Kevlar/Nomax Welders Harness
  • Padded Full-Body Adjustable Harness
  • Flotation Full-Body Adjustable Harness

• Check any items found Bad

  Select Fraying Weld Burns Cuts Excessive Wear Stitching Rivets Eyelets D-Rings Buckles Body Pad Data Tag (Certification data present & legible

  • Fraying
  • Weld Burns
  • Cuts
  • Excessive Wear
  • Stitching
  • Rivets
  • Eyelets
  • D-Rings
  • Buckles
  • Body Pad
  • Data Tag (Certification data present & legible

• Take photos of any defects found

  Media

• Can the Harnesses remain in service?

  Yes

  No

  N/A

Lanyards

• Manufacturer

• Serial Number

• Manufacture Date

  Date

Lanyard Type:

• Check Type Lanyards Inspecting

  Select Single Double Loop On/D-Ring Lanyard Hook On Adjustable Self Retracting Yo-Yo

  • Single
  • Double
  • Loop On/D-Ring Lanyard
  • Hook On
  • Adjustable
  • Self Retracting Yo-Yo

• Check any items found Bad

  Select Excessive Wear Fraying Cuts Weld Burns Deteriorate Safety Latch Hook D-Rings Data Tag (Certification data present & legible)

  • Excessive Wear
  • Fraying
  • Cuts
  • Weld Burns
  • Deteriorate
  • Safety Latch Hook
  • D-Rings
  • Data Tag (Certification data present & legible)

• Take photos of any defects found

  Media

• Can the Lanyards remain in service?

  Yes

  No

  N/A

• Comments

• Inspectors Signature:

  Sign