Title Page
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Client
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Date of Manufacture
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Serial Number
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Date and Time of Inspection
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Inspected by
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Location
Harness Equipment Inspection
General Information
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Description of work on which a safety harness will be used
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Take a photo of the equipment
Full Body Harnesses
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Does the legible tag identify the harness, model, date of manufacture, name of manufacturer, limitations and warnings
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Take a photo of it
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Nylon webbing is free of cuts, burn marks, and chemical damage
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Webbing is free of tears, broken fibers, frayed edges, and pulled stitches
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Harness webbing has no additional holes
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D-rings are free of excessive wear, pits, deterioration, cracks, and sharp edges
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D-rings pivot freely
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Buckles are not deformed or cracked, and will operate correctly
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All grommets are secure and not deformed
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All rivets are tight and not deformed
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Tongue/straps show no excessive wear from repeated buckling
Snaphooks
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Snaphooks have no hook and eye distortions
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Snaphooks have no cracks and pitted surfaces
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Keeper latches are not be bent, distorted, or obstructed
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Keeper latches seat into the nose without binding
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Keeper springs securely close the keeper latches
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Locking mechanism was tested to verify that keeper latches lock properly
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All rivets are tight and not deformed
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Tongue/straps show no excessive wear from repeated buckling
Lanyard
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Type of Lanyard
- Shock-Absorbing Lanyard
- Self-Retracting Lanyards
- Positioning Lanyards
Shock-Absorbing Lanyard
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Nylon webbing is free of cuts, abrasions, burn marks, and chemical damage
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Webbing is free of tears, broken fibers, frayed edges, and pulled stitches
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Wire rope lanyard is free of cuts, frayed areas, and unusual wearing patterns
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Shock absorber pack is free of burn holes and tears
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Shock absorber pack stitching is free of loose strands, rips, and deterioration
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Flag on shock-absorbing lanyard has not been activated
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D-rings are free of excessive wear, pits, deterioration, cracks, and sharp edges
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D-rings pivot freely
Self-Retracting Lanyards
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Body has no visible physical damage
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All back nuts or rivets are tight
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Nylon strap is free of any burns, kinks, knots, and excessive wear
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Nylon strap is free of tears, broken fibers, frayed edges, and pulled stitches
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Nylon strap retracts freely
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Unit was tested to verify that the locking mechanism is operating correctly
Positioning Lanyards
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Impact indicator free from rupture of colored stitching, elongated indicator
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Webbing free from cuts, burns, tears, abrasions, frays, excessive soiling and discoloration, corrosion which effects the operation and/or strength
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Stitching free from pulled or cut stitches
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All labels are legible and securely held in place
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All wire rope are free from broken wires, corrosion, kinks, and separation of strands
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All synthetic rope are free from pulled or cut yarns, barns, abrasions, knots, excessive soiling and discoloration
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Energy absorbing component free from elongation, tears, and excessive soiling
Tie-Off Adaptors/Anchorages
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Tie-off adaptor is free of cuts, abrasions, burn marks, and chemical damage
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Tie-off adaptor is free of tears, broken fibers, frayed edges, and pulled stitches
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Tie-off adaptor is free of signs of deterioration, heat damage, and stretching
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Unit was tested to verify that the locking mechanism is operating correctly
Horizontal Lifelines
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All labels are present, legible, and securely attached
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Lifeline rope has no visible physical damage
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All metallic parts for evidence of defects, damage, alteration, and missing parts
Recommendation
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Overall Rating
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Write down your recommendation
Completion
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Inspected by (Name and Signature)