Skyrise Fall Protection Equipment Inspection

• Fall Protection Equipment Inspection

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Harness Info:

• Label Attached to Harness<br>

  Yes

  No

  N/A

• Label Fully Legible

  Yes

  No

  N/A

• HARNESS Date of Manufacture:

Hardware:

• Buckles in Place?

  Yes

  No

  N/A

• D Rings in Place?

  Yes

  No

  N/A

• Back Pad in Place?

  Yes

  No

  N/A

• Loop Keepers in Place?

  Yes

  No

  N/A

Hardware Condition:

• Free of Damaged or Worn Parts?

  Yes

  No

  N/A

• Free of Broken or Bent Parts?

  Yes

  No

  N/A

• All Buckle Springs Loose?

  Yes

  No

  N/A

• Free of any Sharp Edges?

  Yes

  No

  N/A

• Free of Burrs?

  Yes

  No

  N/A

• Free of Cracks?

  Yes

  No

  N/A

• Parts free of distortion and elongation?

  Yes

  No

  N/A

• Free Corrosion?

  Yes

  No

  N/A

Webbing:

• Free of Cuts?

  Yes

  No

  N/A

• Webbing free of Frays?

  Yes

  No

  N/A

• Free of Broken Fibers?

  Yes

  No

  N/A

• Free of Broken Stitches?

  Yes

  No

  N/A

• Free of Tears?

  Yes

  No

  N/A

• Free of Abrasions?

  Yes

  No

  N/A

• Free of Mold?

  Yes

  No

  N/A

• Free of Burns?

  Yes

  No

  N/A

Lanyard Info:

• LANYARD Date of Manufacture:

Hardware Condition:

• Free of Damaged or Worn Parts?

  Yes

  No

  N/A

• Free of Broken or Bent Parts?

  Yes

  No

  N/A

• Free of any Sharp Edges?

  Yes

  No

  N/A

• Free of Burrs?

  Yes

  No

  N/A

• Free of Cracks?

  Yes

  No

  N/A

• Parts free of distortion and elongation?

  Yes

  No

  N/A

• Free Corrosion?

  Yes

  No

  N/A

Webbing:

• Free of Cuts?

  Yes

  No

  N/A

• Webbing free of Frays?

  Yes

  No

  N/A

• Free of Broken Fibers?

  Yes

  No

  N/A

• Free of Broken Stitches?

  Yes

  No

  N/A

• Free of Tears?

  Yes

  No

  N/A

• Free of Abrasions?

  Yes

  No

  N/A

• Free of Mold?

  Yes

  No

  N/A

• Free of Burns?

  Yes

  No

  N/A

Dual Lanyard Info:

• LANYARD Date of Manufacture:

• LANYARD Serial #

• LANYARD Model #

• LANYARD Lot #

Hardware Condition:

• Free of Damaged or Worn Parts?

  Yes

  No

  N/A

• Free of Broken or Bent Parts?

  Yes

  No

  N/A

• Free of any Sharp Edges?

  Yes

  No

  N/A

• Free of Burrs?

  Yes

  No

  N/A

• Free of Cracks?

  Yes

  No

  N/A

• Free Corrosion?

  Yes

  No

  N/A

• Parts free of distortion and elongation?

  Yes

  No

  N/A

Hooks / Carabiners

• Free of corrosion & physical damage?<br>

  Yes

  No

  N/A

• Small carabiners free of corrosion & physical damage?

  0

  1

  2

  3

  4

• Large carabiners free of corrosion & physical damage?

  0

  1

  2

  3

  4

Overall inspection Info:

• IF INSPECTION REVEALS ANY DEFECTIVE CONDITION, REMOVE FROM SERVICE AND DESTROY.

• Signature of Inspector

  Sign