Harness & Lanyard Inspection Report

• Site conducted

  Select

• Client / Site

• Conducted on

  Date

• Prepared by

Harness:

• Manufacturer

• Serial Number

• Manufacture Date

  Date

• Photo of harness labelling

  Media

• Can Harness remain in service

  Yes

  No

  N/A

Lanyards

• Manufacturer

• Serial Number

• Manufacture Date

  Date

• Photo of Lanyard labelling

  Yes

  No

  N/A

Lanyard Type:

• Check Type Lanyards Inspecting

  Select Single Double Adjustable Self Retracting

  • Single
  • Double
  • Adjustable
  • Self Retracting

• 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