Information
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Job Name
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Job Number
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Serial Number
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Manufacturers Date
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Conducted on
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Prepared by
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Location
Webbing:
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Shoulder Staps:
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Waist Straps:
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Leg Straps:
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Cuts, burns, holes, mildew, paint, deterioration?
Stitching:
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Shoulder Straps:
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Waist Straps:
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Leg Straps:
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Cuts, burns, holes, mildew, paint, deterioration?
D-Rings:
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Back D-Ring
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Waist D-Ring
Buckles:
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Shoulder Adjustment:
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Chest and Back:
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Chest Carabiner:
Labels and Markings:
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ANSI/CSA/OSHA markings:
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Legible Label
Lanyards/SRL’s
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Lanyard or SRL?
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Serial Number
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Housing/Anchor Points: distortion, cracks or other Damage?
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Lifeline/Lanyard: cuts, burns, tears, soiling, or discoloration?
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Locking Mechanism: proper lock up of brake?
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Retraction/Extension: pull out and allow to retract.
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Hooks and Carabiners: physical damage or corrosion?
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Labels/Tags: OSHA/ANSI/CSA in place and legible?
Sign Off:
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Inspector:
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Date:
