OMNI IPS Harness & Lanyard Inspection Report V3

• Conducted on

  Date

• Prepared by

• Location of Job

• Other equipment being used

Equipment

• Equipment Being Inspected

  Select Harness Lanyard Harness and lanyard

  • Harness
  • Lanyard
  • Harness and lanyard

• type of inspection

  Detailed pre use inspections

  Interim inspection

Details

• Colour

• Serial number

• Manufacturer

• Expiry date or date of last inspection

  Date

• Photo of equipment being inspected

• Equipment checked for

  Select Fraying Weld Burns Cuts Excessive Wear Stitching Rivets Eyelets D-Rings Buckles Body Pad Data Tag (Certification data present & legible

  • Fraying
  • Weld Burns
  • Cuts
  • Excessive Wear
  • Stitching
  • Rivets
  • Eyelets
  • D-Rings
  • Buckles
  • Body Pad
  • Data Tag (Certification data present & legible

• Reference numbers or last 4 numbers of the serial numbers on the equipment

• details of the pre use inspection

  Pass

  Fail

• details of actions taken

• Item must be withdrawn form service if failed inspection report to IPShealthandsafety@omnifm.com

• Please confirm the equipment is safe to use

  Yes

  No

• Inspectors Signature:

  Sign