APPENDIX B – EQUIPMENT INSPECTION CHECKLISTS

Full Body Harness Equipment Inspection Checklist

Date Inspected:
Yes No
E-Training Complete:
Hands On Training Complete:
Location/Facility:
Inspected by:
Description:
Equipment Type:
Manufacturer:
Model #:
Serial #:
Factory Order #/Lot #/Batch #:
Date of Mfg.:
How is equipment stored:
Other:
Component Potential Defects Pass Fail
Back D-Ring Corroded, Bent, Cracked, Pitted, Rusted
Waist D-Ring (if applicable) Corroded, Bent, Cracked, Pitted, Rusted
Sternum D-Ring (if applicable) Corroded, Bent, Cracked, Pitted, Rusted
Straps Burns, Holes, Deterioration, Cuts, Frays
Webbing & Stitching Frayed, Cracked, Cut, Burnt
Buckles Bent, Torn Tongue Holes
Label Damaged, Missing Information
Final Appraisal Pass Fail
Overall Pass or Fail
 Lanyard Equipment Inspection Checklist
Date Inspected:
Yes No
E-Training Complete:
Hands On Training Complete:
Location/Facility:
Inspected by:
Description:
Equipment Type:
Manufacturer:
Model #:
Serial #:
Factory Order #/Lot #/Batch #:
Date of Mfg.:
How is equipment stored:
Other:
Component Potential Defects Pass Fail
Connectors Corroded, Bent, Cracked, Pitted, Rusted
Shock Pack Damage, Signs of Deployment
Webbing & Stitching Frayed, Cracked, Cut, Holes, Deterioration
Label Damaged, Missing Information
Final Appraisal Pass Fail
Overall Pass or Fail
 Lifeline Equipment Inspection Checklist
Date Inspected:
Yes No
E-Training Complete:
Hands On Training Complete:
Location/Facility:
Inspected by:
Description:
Equipment Type:
Manufacturer:
Model #:
Serial #:
Factory Order #/Lot #/Batch #:
Date of Mfg.:
How is equipment stored:
Other:
Component Potential Defects Pass Fail
Housing (Self-Retracting) Anchorage Point, Damage, Missing Bolts/Screws
Connectors Impact Indicator, Corrosion, Pitting, Nicks
Lifeline Frayed, Cut, Worn, Kinked, Caging
Shock Pack Damaged, Signs of Deployment
Label Damaged, Missing Information
Final Appraisal Pass Fail
Overall Pass or Fail