Fall Protection Equipment Information

  • Select type of equipment to be inspected:

  • Manufacturer

  • Model #:

  • Asset ID:

  • Serial Number:

  • Date of Manufacture

  • Date of First Use

  • Name of Competent Inspector:

Hardware

  • Back D-Ring

  • Sternum D-Ring

  • Waist D-Ring

  • Shoulder Adjustment

  • Chest & Back Buckle Hardware

  • Chest Carabiner

  • Leg Straps

  • Hardware Notes

Webbing

  • Impact Indicator intact

  • Shoulder Straps

  • Chest & Back Straps

  • Waist Straps

  • Deterioration

  • Leg Straps

  • Cuts

  • Burns

  • Holes

  • Paint Damage

  • Webbing Notes

Stitching

  • Shoulder Strap

  • Chest & Back Straps

  • Waist Straps

  • Leg Straps

  • Stitch Notes

Labels/Tags

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

  • Legible Label

  • Label/Tag Notes

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