NEW Lanyard Inspection

• Audit Title

• Conducted on

  Date

• Prepared by

• Location
  Address

Lanyard Information

• Lanyard Model

• Serial Number

• Lot Number

• Manufacture Date

Lanyard Inspection

• Hardware

  Safe

  At Risk

  N/A

• Webbing

  Safe

  At Risk

  N/A

• Stitching

  Safe

  At Risk

  N/A

• Synthetic Rope

  Safe

  At Risk

  N/A

• Wire Rope

  Safe

  At Risk

  N/A

• Energy Absorbing Component

  Safe

  At Risk

  N/A

• Labels

  Safe

  At Risk

  N/A

Lanyard Approval

• Overall Disposition

  Safe

  At Risk

  N/A

• Inspected By

  Sign