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INSPECTION INFORMATION
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Inspector Name:

LANYARD INFORMATION

Model Name:

Date of manufacture:

Serial #:

D-RING

Signs of Deformity

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Body of D-Ring

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Corrosion

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Pitting

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Nicks

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

CABLE

Signs of Damage

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Kinks or Caging

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Broken Strands or Fibers

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

WEBBING

Termination to Connector

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Cuts

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Soiled

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Burned

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Melting

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Deterioration

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

BODY OF ANCHORAGE

Bars, Shafts, Housing

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Signs of Damage

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Corrosion or Pitting

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Impact Indicators

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

LABELS & MARKINGS

Legible Label

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Appropriate ANSI / CSA / OSHA Markings

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Remove from service immediately through destruction. Inform foreman in person or via phone. Inform tool room via email.

Date of First Use:
DEFINITION OF TERMS

DETERIORATION - Eaten or worn away by chemicals

PITTING - A small indentation in the surface

NICKS - A shallow notch, cut, or indentation on an edge or surface

KINKS - A tight curl, twist, or bend in a length of material.

CAGING - Intertwined in a confused mass.

SOILED - Dirty, stained, or tarnished surface.

NOTES

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.