Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

General Checks

  • Do you have a Nationally recognised Working at Heights qualification? IF NO - DO NOT CONTINUE

  • Have you completed the required permits for Working at Heights?

  • Have you completed a Take-5 risk assessment?

  • Does the harness bag contain the correct harness and sling required for your task?

  • Can you find a suitable replacement? IF THE ANSWER IS NO - DO NOT CONTINUE

  • Is the harness the correct size for you?

  • Have you tried to adjust it correctly? IF ANSWER IS YES - DO NOT PROCEED

  • Is the harness and sling within the Test & Tag date (RGBY system)? IF THE ANSWER IS NO - DO NOT CONTINUE

  • Is the equipment more than 10yrs old? IF THE ANSWER IS YES - DO NOT CONTINUE

Harness

  • Is the webbing in good condition, free from cuts and tears? IF NO - DO NOT CONTINUE

  • is the stitching in good condition, without loose threads or frayed edges? IF NO - DO NOT CONTINUE

  • Are the D-rings in good condition, free from excessive movement, no cracks, sharp edges or damage? IF NO - DO NOT CONTINUE

  • Are the buckles and adjusters in good condition, free from damages or distortion? IF NO - DO NOT CONTINUE

  • Are the snap hooks and karabiners in good condition, free from wear, excessive movement or damage? IF NO - DO NOT CONTINUE

Slings and Lanyard

  • Is the rope / webbing in good condition, free from abrasion, fraying, deterioration or damage IF NO - DO NOT CONTINUE

  • Is the rope (fibre 3-strand twisted) in good condition, free from fraying, deterioration, kinking/hockling or damage IF NO - DO NOT CONTINUE

  • Is the rope (kernmantle) in good condition, free from fraying, deterioration, kinking/hockling or damage IF NO - DO NOT CONTINUE

  • is the energy absorber / shock pack in good condition, free from activation, damage and dirt/grease? IF NO - DO NOT CONTINUE

  • Is the rope / wire grabs / lad safe and free from excessive wear, sharp edges and damage? IF NO - DO NOT CONTINUE

  • Is the sheathed and non-sheathed - flat / round webbing slings in good condition, free from damaged stitching, heat distortion or cuts? IF NO - DO NOT CONTINUE

Final Checks

  • Did you answer NO to any of the previous sections?

  • Why did you continue the checklist?

  • Do you feel confident that all equipment you have checked is in safe condition and free from damage?

Sign off

  • Person completing checklist

  • Signature

  • Date & time

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.