IPS Harness / Lanyard Inspection

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Labels:

• Label Attached to Harness<br>

  Yes

  No

  N/A

• Label Fully Legible

  Yes

  No

  N/A

• HARNESS Date of Manufacture:

• HARNESS Serial #

• HARNESS Model #

• LANYARD Date of Manufacture:

• LANYARD Serial #

• LANYARD Model #

Hardware:

• Buckles in Place?

  Yes

  No

  N/A

• D Rings in Place?

  Yes

  No

  N/A

• Back Pad in Place?

  Yes

  No

  N/A

• Loop Keepers in Place?

  Yes

  No

  N/A

Hardware Condition:

• Any Damaged or Worn Parts?

  Yes

  No

  N/A

• Any Broken or Bent Parts?

  Yes

  No

  N/A

• All Buckle Springs Loose?

  Yes

  No

  N/A

• Any Sharp Edges?

  Yes

  No

  N/A

• Any Burrs?

  Yes

  No

  N/A

• Any Cracks?

  Yes

  No

  N/A

• Any Parts Distorted or Out of Shape?

  Yes

  No

  N/A

• Any Corrosion?

  Yes

  No

  N/A

Webbing:

• Any Cuts?

  Yes

  No

  N/A

• Any Webbing Frayed?

  Yes

  No

  N/A

• Any Broken Fibers?

  Yes

  No

  N/A

• Any Broken Stiches?

  Yes

  No

  N/A

• Amy Tears?

  Yes

  No

  N/A

• Any Abrasions?

  Yes

  No

  N/A

• Any Mold?

  Yes

  No

  N/A

• Any Burns?

  Yes

  No

  N/A

• IF INSPECTION REVEALS ANY DEFECTIVE CONDITION, REMOVE FROM SERVICE AND DESTROY.

• Signature of Inspector

  Sign