Fall Protection Daily Pre-Use Inspection Sheet
Competent Worker must complete checklist prior to use at start of each shift
Site Address/Location
*
Please Select
MJ Dixon Head Office - 2600 Edenhurst Dr., Suite 200, Mississauga, ON
20-02 - City of Toronto - Mount Dennis Childcare Centre - 1234 Weston Rd., Toronto, ON
21-06 - UTSC Library Ph 1 - 1265 Military Trail, Scarborough, ON
21-07 - 27 Rutherford Rd. S., Brampton, ON
22-01 - Seaton Paramedic Station & Training Centre
22-02 - 255 Spadina Rd., Toronto, ON
22-02 - 843 Palmerston Ave., Toronto, ON
22-02 - 765 Queen St. E., Toronto, ON
22-02 - 301 Broadview Ave., Toronto, ON
22-02 - 840 Gerrard St. E., Toronto, ON
22-02 - 235 Cibola Ave., Toronto, ON
22-03 - York Region - York Admin Centre 4th Fl. - 17250 Yonge St., Newmarket, ON
23-01 - 1859 Kingston Rd., Toronto, ON
23-01 - 116 Dorset Rd., Toronto, ON
23-01 - 1313 Woodbine Ave., Toronto, ON
23-01 - 1904 Queen St. E., Toronto, ON
23-01 - 23 Bluffers Park (7 Brimley Rd. S.), Toronto, ON
23-01 - 313 Pharmacy Ave., Toronto, ON
23-01 - 351 Birchmount Rd., Toronto, ON
23-01 - 3600 Danforth Ave., Toronto, ON
23-01 - 87 Main St., Toronto, ON
23-02 - York Paramedic 32 - 53 Jacob Keffer Parkway, Vaughan, ON
23-03 - GBC Athletics Varsity Lounge - 160 Kendal Ave., Toronto, ON
24-01 YRAC Reno & Millwork - 17250 Yonge St., Newmarket, ON
24-02 VicU Goldring Student Centre - 150 Charles St. W., Toronto, ON
24-03 COT Youth Shelter - 25 Canterbury Pl., Toronto, ON
24-04 Waypoint Toanche Bldg. 3rd Fl. - 500 Church St. Penetanguishene, ON
24-05 - Vaughan Fire Stn 7-12 - 9511 Weston Rd., Vaughan, ON
25-01 - UofT Robarts Library - 130 St. George St., Toronto, ON
25-02 - YRP Helicopter Hangar - 350 Garfield Wright Blvd, East Gwillimbury, ON
25-03 - UofT Health & Wellness at Koffler - 214 College Street, Toronto, ON
25-04 - SHN General Hospital Satellite Imaging Renovation - 3030 Lawrence Ave. E., Scarborough, ON
25-05 - UofT - Study of Religion Dept. - 170 St. George St., Toronto, ON
26-01 - Peel Police 21 Division - 10 Peel Centre Dr., Brampton, ON
26-02 - York Paramedic 33 - 2960 Teston Road, Vaughan, ON
26-03 - York Region - York Admin Package E - 17250 Yonge St., Newmarket, ON
26-04 - TDSB - William G Miller PS - 60 Bennett Rd., Scarborough, ON
26-04 - TDSB - Sir Oliver Mowat CI - 5400 Lawrence Ave. E., Scarborough, ON
26-05 - Peel Police Emil V. Kolb Centre - 180 Derry Rd. E., Mississauga, ON
Date
*
-
Year
-
Month
Day
4 digit year, 2 digit month, 2 digit day
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Subcontractor
*
Worker Name
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Full Body Harness
*
Rows
OK
N/A
Webbing
Stitching
Buckles
Grommets
Strap Keepers
D-Ring
Locking Snap Hooks
*
Rows
OK
N/A
Hook
Lock
Springs
Lanyard
*
Rows
OK
N/A
Webbing
Stitching
Jacket
End Loops
Stretching
Connection
Knots
Rope Grab
*
Rows
OK
N/A
Fails
Springs
Gate
Locking Pin
Safety Latch
Teeth
Lifeline
*
Rows
OK
N/A
Rope Matches Grab
Polypropylene or Equal
Length
Rope Condition
Discolouration
Anchor Attachment
Stretching
Edge Protection
Retractable
*
Rows
OK
N/A
Housing
Lifeline
Swivel Connector
Braking
Anchor
*
Rows
OK
N/A
Capacity
Deformation
One per Lifeline
Comments:
Signature
*
Submit
Should be Empty: