LES Harness Inspection Form

• Client / Site

• Conducted on

  Date

• Name of Harness Manufacturer

• Name of Lanyard Manufacturer

• Name of Lifeline Manufacturer

• Name of Anchor Manufacturer

• Prepared by

Section 1.0 Harness

• Section 1.1 - Stitching, Three or more stitches pulled or broken? (If yes, remove from service.)

  Safe

  At Risk

  N/A

• Section 1.2 Webbing, Free of cuts, tears, stretching of fibers, fraying, raveling of edges, excessive wear or abrasion, spotting, chemical damage, burns, and weld splatter. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

• Section 1.3 - Connector(s), Free of cracks, heat damage, distortion, corrosion, and excessive wear. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

Section 2.0 - Lanyard(s)

• Section 2.1 - Double-Lock Connector / Snap-Hooks / Carabiners, Operates and is free of heat damage, distortion, corrosion, and excessive wear. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

• Section 2.2 - Webbing / Rope / Cable, Free of abrasion, chemical damage, burns, welding spatter, excessive heat exposure, frayed cables, bird-aging, or crushing. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

• Section 2.3 - Shock Absorber, Not torn and red webbing has not been deployed. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

Section 3.0 - Lifelines

• Section 3.1 - Rope(s), Free of cuts, tears, stretching of fibers, fraying, raveling of edges, excessive wear or abrasion, spotting, chemical damage, burns, and weld splatter. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

• Section 3.2 - Connector(s) / Snap-Hooks / Carabiners, Operates and is free of heat damage, distortion, corrosion, and excessive wear. (Otherwise, remove from service.)

  Safe

  At Risk

  N/A

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