Body Harness and Lanyard Inspection
Project:
*
Date
*
-
Month
-
Day
Year
Date
Location:
*
Job #:
*
Body Harness - Serial #:
*
Lanyard - Serial #:
*
Instructions:
All parts of the body harness and its attachments must be inspected for wear and damage.
Inspect and document daily.
Maintain the completed inspection report so that it is readily available to the Safety representative.
Inspection Detail:
*
Passed
Repair/Replace
N/A
Manufacturer's Serial Number
Harness Webbing and/or Leather
All Stitching
Rivets and Eyelets
D-Ring(s) and Buckle(s)
Lanyard and Deceleration Device
Hook and Safety Latch / Carabineers
Certification or Data Tag
Body Harness
Calc 1
For each deficiency, please describe what needs to be repaired/replaced
*
Would you like to upload an image and draw/indicate the issue or deficiency?
Yes
Upload an image of the deficiency by clicking the Camera+ icon, and markup/write text as required:
Additional Remarks:
Worker Name:
*
First Name
Last Name
Worker Email:
*
example@example.com
Worker Signature:
*
Supervisor Name:
First Name
Last Name
Supervisor Email:
example@example.com
Supervisor Signature:
Submit
Should be Empty: