Information

  • Conducted on:

  • Building Name:

  • Building Address:
  • Harness User:

  • Harness Identification:

  • Lanyard Identification:

Job Description

  • Task:

  • Task:

Visual Inspection

  • Tags / Labels

  • CSA Approval

  • Nylon Webbing

  • Attachment Points

  • Attachment Buckles

  • D-Rings

  • D-Ring Pad

  • Comfort Parts

  • CROLL Rope Clamp

  • Lanyard

  • Shock Absorber

  • ASAP Rope Grab

  • Secondary Rope Grab

  • Ascender

  • I'D Descender

  • Additional comments or observations

  • Additional comments/observation

  • Observation
  • Add observations/comments here.

Results

  • Pass or Failure

Signatures

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

  • Inspector's Printed Name & Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.