Woodruff Fall Protection Equipment Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Fall Protection Equipment Information

• Select type of equipment to be inspected:

  Select Harness Lanyard Carabiner SRL Anchor Point Vertical Lifeline Horizontal Lifeline Rope Grab Other

  • Harness
  • Lanyard
  • Carabiner
  • SRL
  • Anchor Point
  • Vertical Lifeline
  • Horizontal Lifeline
  • Rope Grab
  • Other

• Manufacturer

• Model #:

• Asset ID:

• Serial Number:

• Date of Manufacture

• Date of First Use

• Name of Competent Inspector:

Hardware

• Signs of damage to hardware

  Yes

  No

  N/A

• Corrosion

  Yes

  No

  N/A

• Component works as manufacturer intended

  Pass

  Fail

  N/A

• Hardware Notes

Labels/Tags

• Appropriate ANSI/OSHA Markings (ANSI Z359/ANSI A10.32-12, OSHA 1910 & 1926 Subpart M)

  Yes

  No

  N/A

• Legible Label

  Yes

  No

  N/A

• Label/Tag Notes