Harness Inspection (Parachute)

• Conducted on:

  Date

• Building Name:

• Building Address:
  Address

• Harness User:

  Select

• Harness Identification:

  Select Paneless H01 Paneless H02 Paneless H03 Paneless H04 Paneless H05 Paneless H06 Paneless H07 Paneless H08 Paneless H09 Paneless H10

  • Paneless H01
  • Paneless H02
  • Paneless H03
  • Paneless H04
  • Paneless H05
  • Paneless H06
  • Paneless H07
  • Paneless H08
  • Paneless H09
  • Paneless H10

• Lanyard Identification:

  Select Paneless L01 Paneless L02 Paneless L03 Paneless L04 Paneless L05 Paneless L06 Paneless L07 Paneless L08 Paneless L09 Paneless L10 Paneless DL02 Paneless DL01

  • Paneless L01
  • Paneless L02
  • Paneless L03
  • Paneless L04
  • Paneless L05
  • Paneless L06
  • Paneless L07
  • Paneless L08
  • Paneless L09
  • Paneless L10
  • Paneless DL02
  • Paneless DL01

Job Description

• Task:

  Select Aerial Lift Window Cleaning Aerial Lift Pressure Cleaning Aerial Lift Eavestrough Cleaning Anchored Eavestrough Cleaning Other

  • Aerial Lift Window Cleaning
  • Aerial Lift Pressure Cleaning
  • Aerial Lift Eavestrough Cleaning
  • Anchored Eavestrough Cleaning
  • Other

• Task:

Visual Inspection

• Tags / Labels

  Safe

  At Risk

  N/A

• CSA Approval

  Safe

  At Risk

  N/A

• Nylon Webbing

  Safe

  At Risk

  N/A

• Buckles (Chest and Legs)

  Safe

  At Risk

  N/A

• Strap Keepers

  Safe

  At Risk

  N/A

• D-Ring

  Safe

  At Risk

  N/A

• D-Ring Pad

  Safe

  At Risk

  N/A

• Lanyard

  Safe

  At Risk

  N/A

• Shock Absorber

  Safe

  At Risk

  N/A

• Snap Hooks

  Safe

  At Risk

  N/A

• Additional comments or observatons

  No

  Yes

  N/A

• Additional comments/observation

Observation

• Add observations/comments here.

Results

• Pass or Failure

  Pass - Return to Service

  Failure - Remove From Service

• I hereby certify that all information is accurate and that an actual inspection was conducted as per company policy.

• Inspector's Printed Name & Signature

  Sign