Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
General Checks
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Do you have a Nationally recognised Working at Heights qualification? IF NO - DO NOT CONTINUE
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Have you completed the required permits for Working at Heights?
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Have you completed a Take-5 risk assessment?
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Does the harness bag contain the correct harness and sling required for your task?
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Can you find a suitable replacement? IF THE ANSWER IS NO - DO NOT CONTINUE
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Is the harness the correct size for you?
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Have you tried to adjust it correctly? IF ANSWER IS YES - DO NOT PROCEED
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Is the harness and sling within the Test & Tag date (RGBY system)? IF THE ANSWER IS NO - DO NOT CONTINUE
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Is the equipment more than 10yrs old? IF THE ANSWER IS YES - DO NOT CONTINUE
Harness
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Is the webbing in good condition, free from cuts and tears? IF NO - DO NOT CONTINUE
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is the stitching in good condition, without loose threads or frayed edges? IF NO - DO NOT CONTINUE
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Are the D-rings in good condition, free from excessive movement, no cracks, sharp edges or damage? IF NO - DO NOT CONTINUE
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Are the buckles and adjusters in good condition, free from damages or distortion? IF NO - DO NOT CONTINUE
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Are the snap hooks and karabiners in good condition, free from wear, excessive movement or damage? IF NO - DO NOT CONTINUE
Slings and Lanyard
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Is the rope / webbing in good condition, free from abrasion, fraying, deterioration or damage IF NO - DO NOT CONTINUE
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Is the rope (fibre 3-strand twisted) in good condition, free from fraying, deterioration, kinking/hockling or damage IF NO - DO NOT CONTINUE
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Is the rope (kernmantle) in good condition, free from fraying, deterioration, kinking/hockling or damage IF NO - DO NOT CONTINUE
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is the energy absorber / shock pack in good condition, free from activation, damage and dirt/grease? IF NO - DO NOT CONTINUE
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Is the rope / wire grabs / lad safe and free from excessive wear, sharp edges and damage? IF NO - DO NOT CONTINUE
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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
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Did you answer NO to any of the previous sections?
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Why did you continue the checklist?
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Do you feel confident that all equipment you have checked is in safe condition and free from damage?
Sign off
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Person completing checklist
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Signature
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Date & time