Harness Inspection (Petzl Rappel)

• Conducted on:

  Date

• Building Name:

• Building Address:
  Address

• Harness User:

  Select

• Harness Identification:

  Select Harness Petzl AVAO BOD Size 2 (Red) Harness Petzl AVAO BOD Size 2 (Green) Harness Petzl AVAO BOD Size 1 (Orange) Harness AVAO BOD CROLL Size 1 (Blue) Harness AVOA BOD CROLL Size 2 (Victor's)

  • Harness Petzl AVAO BOD Size 2 (Red)
  • Harness Petzl AVAO BOD Size 2 (Green)
  • Harness Petzl AVAO BOD Size 1 (Orange)
  • Harness AVAO BOD CROLL Size 1 (Blue)
  • Harness AVOA BOD CROLL Size 2 (Victor's)

• Lanyard Identification:

  Select Lanyard Petzl 40cm ASAP'SORBER (Red) Lanyard Petzl 40cm ASAP'SORBER (Green) Lanyard Petzl 40cm ASAP'SORBER (Orange) Lanyard Petzl 40cm ASAP'SORBER (Blue) Lanyard Safe Tec Duck-R (Victor's)

  • Lanyard Petzl 40cm ASAP'SORBER (Red)
  • Lanyard Petzl 40cm ASAP'SORBER (Green)
  • Lanyard Petzl 40cm ASAP'SORBER (Orange)
  • Lanyard Petzl 40cm ASAP'SORBER (Blue)
  • Lanyard Safe Tec Duck-R (Victor's)

Job Description

• Task:

  Select Rappel Window Cleaning Rappel Pressure Cleaning Other

  • Rappel Window Cleaning
  • Rappel Pressure 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

• Attachment Points

  Safe

  At Risk

  N/A

• Attachment Buckles

  Safe

  At Risk

  N/A

• D-Rings

  Safe

  At Risk

  N/A

• D-Ring Pad

  Safe

  At Risk

  N/A

• Comfort Parts

  Safe

  At Risk

  N/A

• CROLL Rope Clamp

  Safe

  At Risk

  N/A

• Lanyard

  Safe

  At Risk

  N/A

• Shock Absorber

  Safe

  At Risk

  N/A

• ASAP Rope Grab

  Safe

  At Risk

  N/A

• Secondary Rope Grab

  Safe

  At Risk

  N/A

• Ascender

  Safe

  At Risk

  N/A

• I'D Descender

  Safe

  At Risk

  N/A

• Additional comments or observations

  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