SAFETY WORLD Equipment Inspection Report - Harness - Lanyard - Connectors

• Equipment Inspection Report - Harness / Lanyard / Connectors

• Prepared by Barry Barton, Safety World

• Document No.

• Company

• Company ID

• Purchase Order No.

• Location
  Address

• Item Description

• Manufacturer

• Conducted on

  Date

• DOM

  Date

• Withdrawal Date

  Date

• Safety World
  Address: Unit 1/39 Innovation Circuit, Wangara, WA 6065
  Phone: (08) 9302 6711
  Fax: (08) 9302 6542
  Email: sales@safetyworld.com.au
  Website:
  http://www.safetyworld.com.au

Check Labels

• Present and Attached ?

  Yes

  No

  N/A

• Legible ?

  Yes

  No

  N/A

Check all Buckles and D rings

• Any visible damage / cracks ?

  Yes

  No

  N/A

• Any welds ?

  Yes

  No

  N/A

• Any visible signs of distortion / bent ?

  Yes

  No

  N/A

• Any visible signs of corrosion ?

  Yes

  No

  N/A

• Any sharp edges / burrs ?

  Yes

  No

  N/A

• Any visible wear indications and / or incorrect orientation ?

  Yes

  No

  N/A

• Any Missing Parts ?

  Yes

  No

  N/A

• Any Poor Function (Buckles) ?

  Yes

  No

  N/A

Check Stitching

• Any visible Cuts / Tears?

  Yes

  No

• Any stitching Broken?

  Yes

  No

• Any Pulled stitching?

  Yes

  No

• Any Stitching Burned?

  Yes

  No

Check Shock Absorber

• Any Cuts / Tears / Abrasions ?

  Yes

  No

  N/A

• Has Shock Absorber been Deployed / Stretched ?

  Yes

  No

  N/A

• Is the Plastic cover missing ?

  Yes

  No

  N/A

• Any Holes / Burns ?

  Yes

  No

  N/A

• Any UV Damage / Fading ?

  Yes

  No

  N/A

• Any Excessive Soiling ?

  Yes

  No

  N/A

Check Webbing / Rope

• Any visible Cuts / Tears / Holes ?

  Yes

  No

• Any visible heat damage / glazing ?

  Yes

  No

• Any visible abrasions ?

  Yes

  No

• Any visible fraying ?

  Yes

  No

• Any Knots (Rope) ?

  Yes

  No

  N/A

• Any visible discolouration due to chemical contaminates or prolonged ultraviolet exposure ?

  Yes

  No

• Any visible contamination from corrosives, solvents, grease, grime or paint ?

  Yes

  No

• Is there Deterioration due to rotting / mildew / mould ?

  Yes

  No

• Any missing / damaged stitch pattern ?

  Yes

  No

• Any visible hardening of the webbing ?

  Yes

  No

  N/A

• Any visible excessive stretching ?

  Yes

  No

Check all Connectors

• Any visible damage / cracks ?

  Yes

  No

  N/A

• Any sharp edges / burrs ?

  Yes

  No

  N/A

• Any Missing Parts ?

  Yes

  No

  N/A

• Any visible signs of corrosion ?

  Yes

  No

  N/A

• Any visible signs of distortion / bent ?

  Yes

  No

  N/A

• Is it Labelled / Marked ?

  Yes

  No

  N/A

• Any sticky gates ?

  Yes

  No

  N/A

• Connector Stays Open / Won't Lock.

  Yes

  No

  N/A

• Connector Closes but does not lock.

  Yes

  No

  N/A

• Any Excess Dirt / Grease ?

  Yes

  No

  N/A

• Final Appraisal - Pass or Fail

  Pass

  Fail

• Inspected by Mr Barry Barton, Safety World