Title Page
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Site conducted
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Conducted on
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Prepared by
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Operative Name
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Location
Harness Inspection
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Pre-Use Checks- Checks should be carried out before a harness and lanyard are used
- Yes- Cheks should be carried out before a harness and lanyard are used.
- No
- N/A
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Detailed Inspection - Detailed inspections must always be recorded
- Yes-More in depth inspection should be carried out periodically
- No
- N/A
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3 monthly
- Yes
- No
- N/A
- Aresta
- Big Ben
- Muller
- Other
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Interim Inspections-
- Yes- Interim Inspections may be required between Detailed Inspections because a risk assessment has identified risks that may result in significant deterioration that affects the safety of the harness and lanyard, before the next inspection is due
- No
- N/A
- Yes
Harness Details
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Harness Make and Model
- Yes
- No
- N/A
- Aresta
- Big Ben
- Muller
- Other
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Date of Manufacture
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Serial Number
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Harness webbing
- Safe
- At Risk -Cats at the edge of the webbing
- At Risk -Abrasion on the surface and edges
- At Risk - Damage stitching
- At Risk - Heat or friction damage (glazed appearance,hardening)
- At Risk -Contamination (dirt, grit, chemicals) which may result in internal or external abrasion
- At Risk - Uv- degradation(loss of colour or powdery surface)
- Unable to read the Identification Tag details
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Harness Stitching
- Safe
- At Risk - Stitching breaking down
- At Risk - Frayed
- At Risk -Irregular stitching patterns
- At Risk -Not stitched through the material
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Rivets and Eyelets
- Safe
- At Risk -Deformation
- At Risk -Cuts
- At Risk - Heavy marking or scoring
- At Risk - Burring
- At Risk - Corrosion
- At Risk - Contamination
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Identification Tag is attached and Legible
- Safe
- At Risk -Cats at the edge of the webbing
- At Risk -Abrasion on the surface and edges
- At Risk - Damage stitching
- At Risk - Heat or friction damage (glazed appearance,hardening)
- At Risk -Contamination (dirt, grit, chemicals) which may result in internal or external abrasion
- At Risk - Uv- degradation(loss of colour or powdery surface)
- Unable to read the Identification Tag details
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Date and Time of Inspection
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Harness fit for purpose
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Decommissioning date- Harness withdrawn from use and considered damaged or defective should be permanently broken up before they are disposed of to ensure that they cannot be retrieved and used again.
Lanyard Details
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Lanyard Make and Model
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Date of Manufacture
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Serial Number
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Lanyard Webbing
- Safe
- At Risk -Cats at the edge of the webbing
- At Risk -Abrasion on the surface and edges
- At Risk - Damage stitching
- At Risk - Heat or friction damage (glazed appearance,hardening)
- At Risk -Contamination (dirt, grit, chemicals) which may result in internal or external abrasion
- At Risk - Uv- degradation(loss of colour or powdery surface)
- Unable to read the Identification Tag details
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Lanyard Stitching
- Safe
- At Risk - Stitching breaking down
- At Risk - Frayed
- At Risk -Irregular stitching patterns
- At Risk -Not stitched through the material
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Rivets and Eye Lets
- Safe
- At Risk -Deformation
- At Risk -Cuts
- At Risk - Heavy marking or scoring
- At Risk - Burring
- At Risk - Corrosion
- At Risk - Contamination
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Hook Safety Latch
- Safe
- At Risk -Cats at the edge of the webbing
- At Risk -Abrasion on the surface and edges
- At Risk - Damage stitching
- At Risk - Heat or friction damage (glazed appearance,hardening)
- At Risk -Contamination (dirt, grit, chemicals) which may result in internal or external abrasion
- At Risk - Uv- degradation(loss of colour or powdery surface)
- Unable to read the Identification Tag details
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Identification Tag is attached and Legible
- Safe
- At Risk -Cats at the edge of the webbing
- At Risk -Abrasion on the surface and edges
- At Risk - Damage stitching
- At Risk - Heat or friction damage (glazed appearance,hardening)
- At Risk -Contamination (dirt, grit, chemicals) which may result in internal or external abrasion
- At Risk - Uv- degradation(loss of colour or powdery surface)
- Unable to read the Identification Tag details
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Date and Time of Inspection
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Lanyards fit for purpose- Lanyards withdrawn from use and considered damaged or defective should be permanently broken up before they are disposed of to ensure that they cannot be retrieved and used again.
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Decommissioning date
Sign Off
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I have today been issued with the above equipment and understand that I must wear and use it during the course of my work and store it in a proper manner as per training received and I will report any defects to my line manager
- Yes- Interim Inspections may be required between Detailed Inspections because a risk assessment has identified risks that may result in significant deterioration that affects the safety of the harness and lanyard, before the next inspection is due
- No
- N/A
- Yes
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I am familiar with and have been trained in the use of fall personal safety equipment
- Yes- Interim Inspections may be required between Detailed Inspections because a risk assessment has identified risks that may result in significant deterioration that affects the safety of the harness and lanyard, before the next inspection is due
- No
- N/A
- Yes
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I understand fully the safety rules and requirements for correct usage and the necessary pre-use checks which are required to be carried out
- Yes- Interim Inspections may be required between Detailed Inspections because a risk assessment has identified risks that may result in significant deterioration that affects the safety of the harness and lanyard, before the next inspection is due
- No
- N/A
- Yes
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I understand that failure to wear or correctly use the equipment will be considered to be serious breach of safety regulations and that I will be subject to disciplinary action
- Yes- Interim Inspections may be required between Detailed Inspections because a risk assessment has identified risks that may result in significant deterioration that affects the safety of the harness and lanyard, before the next inspection is due
- No
- N/A
- Yes
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Operative Full Name
