Woodruff Lanyard 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:

• Type of Lanyard

  Select Flat Web single Flat web Y Internal Shock Bungee Single Internal Shock Bungee Y Internal Shock Non-Bungee Cable lanyard Cable Y-lanyard Other

  • Flat Web single
  • Flat web Y
  • Internal Shock Bungee Single
  • Internal Shock Bungee Y
  • Internal Shock Non-Bungee
  • Cable lanyard
  • Cable Y-lanyard
  • Other

Hardware

• Function of Connector Locking Gate

  Pass

  Fail

  N/A

• Body of Hook or Rivets

  Pass

  Fail

  N/A

• Corrosion

  Pass

  Fail

  N/A

• Pitting

  Pass

  Fail

  N/A

• Nicks

  Pass

  Fail

  N/A

• Hardware Notes

Webbing

• Broken, Missing, or Loose Stitching

  Pass

  Fail

  N/A

• Termination (stitch or splice or swage)

  Pass

  Fail

  N/A

• Webbing Length

  Pass

  Fail

  N/A

• Deterioration

  Pass

  Fail

  N/A

• Cuts

  Pass

  Fail

  N/A

• Burns

  Pass

  Fail

  N/A

• Holes

  Pass

  Fail

  N/A

• Paint Damage

  Pass

  Fail

  N/A

• Webbing Notes

Shock Pack

• Integrity of Cover

  Pass

  Fail

  N/A

• Signs of Deployment

  Pass

  Fail

  N/A

• Signs of Damage

  Pass

  Fail

  N/A

• Shock Pack 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