HSF6.5-0 Harness Inspection Checklist

• Branch / Location

• Inspected By:

• Engineers Name

• Engineers Payroll Number

• Date

  Date

Revision Information

• This form is equivalent to HSF6.5 issue 0 - This is electronic issue 1.0 - 15/08/2016

Harness Equipment Details

• Harness ID No:

• Cows Tail ID No:

• Restraint Lanyard ID No.

• Sling ID No.

• Suspension Kit ID No.

• Full Arrest Lanyard ID No:

• Ratchet ID No.

• Was all of the equipment issued on the same day?

  Yes

  No

• Kit issue date: Harness kit has a mandatory life of 5 years from issue.

  Date

• Harness Issue Date

  Date

• Cows Tail Issue Date

  Date

• Restraint Lanyard Issue Date

  Date

• Sling Issue Date

  Date

• Full Arrest Lanyard Issue Date

  Date

• Suspension Kit Issue Date

  Date

Harness Equipment Checks

• Is the harness sound, clean & dry, free of mud, paint, oil, etc?

  Yes

  No

  N/A

• Please provide details / reasons

• Is the harness free from tears, nicks or damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is all stitching in place and damage free?

  Yes

  No

  N/A

• Please provide details / reasons

• Are the buckles free of damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is the harness free from friction damage

  Yes

  No

  N/A

• Please provide details / reasons

• Is the harness free from mould / rot?

  Yes

  No

  N/A

• Please provide details / reasons

• Are the attachment D rings undamaged and in place?

  Yes

  No

  N/A

• Please provide details / reasons

• Are the leg straps free from excessive wear or damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is the harness tag and safety label fitted and intact?

  Yes

  No

  N/A

• Please provide details / reasons

• Is the rope free from wear?

  Yes

  No

  N/A

• Please provide details / reasons

• Is rope attachment to the karabiner in good order

  Yes

  No

  N/A

• Please provide details / reasons

• Is rocker free from damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is rocker lanyard free from obvious tears, nicks or damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is ratchet in good working order?

  Yes

  No

  N/A

• Please provide details / reasons

• Is strap free from nicks and wear?

  Yes

  No

  N/A

• Please provide details / reasons

• Are the karabiners undamaged?

  Yes

  No

  N/A

• Please provide details / reasons

• Do karabiners work freely?

  Yes

  No

  N/A

• Please provide details / reasons

• Does rocker have free movement?

  Yes

  No

  N/A

• Please provide details / reasons

• Is stitching free from damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is lanyard free from obvious tears, nicks or damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is cow’s tail free from tears, nicks or damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Is stitching free from damage?

  Yes

  No

  N/A

• Please provide details / reasons

• Are the manufactures instructions / inspection record available?

  Yes

  No

• Please provide details / reasons

• Are there any corrective actions required?

  YES

  NO

• Please provide details / reasons

Inspection Sign Off

• Harness Inspectors Signature:

  Sign