SAFETY WORLD Equipment Inspection Report - Harness - Lanyard - Connectors - duplicate

• Document No.

• Equipment Inspection Report - Harness / Lanyard / Connectors

• Client

• Conducted on

  Date

• Prepared by Barry Barton, Safety World

• DOM
  Address
• Withdrawal Date
  Address
• Location
  Address
• Manufacturer
  Address
• Serial:
  Address
• Company ID:
  Address

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

• Any welds

  yes

  no

• Any visible signs of distortion / bent

  yes

  no

• Any visible signs of corrosion

  Pass

  Fail

• Any sharp edges / burrs

  yes

  no

• Any visible wear indications and correct orientation

  yes

  no

• Missing Parts

  yes

  no

• Poor Function (Buckles)

  Yes

  No

  N/A

Stitching

• Cuts / Tears

  yes

  no

• Broken

  yes

  no

• Pulled

  yes

  no

• Missing stitch pattern

  yes

  no

• Burned

  yes

  no

Shock Absorber

• Cuts / Tears / Abrasions

  Yes

  No

  N/A

• Deployed / Stretched

  Yes

  No

  N/A

• Plastic cover missing

  Yes

  No

  N/A

• Holes / Burns

  Yes

  No

  N/A

• UV Damage / Fading

  Yes

  No

  N/A

• 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

• Deterioration due to rotting / mildew / mould

  yes

  no

• Any missing / damaged stitch pattern

  yes

  no

• Any visible hardening of the webbing

  Pass

  Fail

• Any visible excessive stretching

  Pass

  Fail

Check all Connectors

• Any visible damage / cracks

  yes

  no

• Any sharp edges / burrs

  yes

  no

• Missing Parts

  yes

  no

• Any visible signs of corrosion

  Pass

  Fail

• Any visible signs of distortion / bent

  yes

  no

• Labelled / Marked

  yes

  no

• Any sticky gates

  yes

  no

• Stays Open / Won't Lock

  yes

  no

• Closes but does not lock

  yes

  no

• Excess Dirt / Grease

  yes

  no

Stitching

• Cuts / Tears

  yes

  no

• Broken

  yes

  no

• Pulled

  yes

  no

• Missing stitch pattern

  yes

  no

• Burned

  yes

  no