Body Harness and Lanyard Inspection
Project:
*
Date
*
-
Month
-
Day
Year
Use the calendar to select
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:
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Inspection Rating
Comments
Manufacturer's Serial Number
Yes
No
Harness Webbing and/or Leather
Yes
No
All Stitching
Yes
No
Rivets and Eyelets
Yes
No
D-Ring(s) and Buckle(s)
Yes
No
Lanyard and Deceleration Device
Yes
No
Hook and Safety Latch / Carabineers
Yes
No
Certification or Data Tag
Yes
No
Body Harness
Yes
No
Would you like to upload an image and draw/indicate any issues or deficiencies?
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: