Title Page
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Tower Site / Name
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Tower Owner if not HEC.
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Prepared by
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Conducted on
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Tower Type
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Address or Lats N Longs
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Weather Conditions
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Job Descrption
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Potential " HAZARDS "
Full Body Harness
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Serial Number
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Run your hands over the hardware (D-ring, buckles).
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Check release tabs of the buckles.
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Look at and run your hands over the webbing and stitching.
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Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches?
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Are all labels present and legible?
Suspension Trauma Straps
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Check the cover for damage and the connection to the harness for wear.
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Free of any tears, abrasions, burns, discoloration, or knots?
Cable Grab-runner
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Serial Number
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Do all parts move freely and smoothly, Free of any wear on the inside where the cable passes through?
V or Y Lanyard
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TYPE
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Reference Lanyard Serial Number
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Serial Number-Last numbers.
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Look at and run your hands over the webbing and stitching. Is the webbing free of frayed, cut or broken fibers? Tears, abrasions, mold, discoloration and pulled or cut stitches? Does the keeper on the snap hook seat into the nose without binding and is not distorted or obstructed?
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Keeper Reference Picture
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Does the shock absorber show any signs of deployment?
Positioning Lanyard " Grillon "
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Serial Number
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Is the rope free of fuzzy, worn, broken, or cut fibers, as well as loose material such as dirt, sand, petroleum, or chemical contaminants?
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Is the hardware free of rough or sharp edges, corrosion, burrs, cracks, dents or distortion?
RF Monitor
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Knicker Bocker or other High RF Tower sites
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RF Levels every 15 min's
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Serial Number
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Make and Model
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Last time monitor was calibrated.
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Site Supervisor Name and Signature