fall arrest harness inspection report - lsci · fall arrest harness inspection report...

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Lancaster Safety Consulting, Inc. 100 Bradford Road, Suite 100 Wexford, PA 15090 Phone: (888) 403-6026 Fax: (724) 776-1007 www.LancasterSafety.com Page 1 of 1 Fall Arrest Harness Inspection Report Department/Location: ____________________________________________________________ Equipment: ________________________________________________ ID No.: ___________ Item Satisfactory Needs Action Follow Up 1. Harness Inspection (Belts and Rings) 2. Harness Inspection (Buckles and 3. D-Ring) 4. Harness Inspection (Tongue Buckle) 5. Harness Inspection (Friction Buckle) 6. Lanyard Inspection (Snaps) 7. Lanyard Inspection (Thimbles) 8. Steel Lanyard 9. Web Lanyard 10. Rope Lanyard 11. Shock Absorbing Packs Please provide additional comments/recommendations below for all items noted in the "Needs Action" column. Document completion of recommendations and/or "Needs Action" items in "Follow Up" column. Comments/Recommendations: __________________________________________________________ ____________________________________________________________________________________ Inspected By: ______________________________________________ Date: _____________ Reviewed By: ______________________________________________ Date: _____________

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Page 1: Fall Arrest Harness Inspection Report - LSCI · Fall Arrest Harness Inspection Report Department/Location: ... Harness Inspection (Buckles and 3. D -Ring) 4. Harness Inspection (Tongue

Lancaster Safety Consulting, Inc.

100 Bradford Road, Suite 100 Wexford, PA 15090 Phone: (888) 403-6026 Fax: (724) 776-1007 www.LancasterSafety.com Page 1 of 1

Fall Arrest Harness Inspection Report

Department/Location: ____________________________________________________________

Equipment: ________________________________________________ ID No.: ___________

Item Satisfactory Needs Action Follow Up

1. Harness Inspection (Belts and Rings)

2. Harness Inspection (Buckles and

3. D-Ring)

4. Harness Inspection (Tongue Buckle)

5. Harness Inspection (Friction Buckle)

6. Lanyard Inspection (Snaps)

7. Lanyard Inspection (Thimbles)

8. Steel Lanyard

9. Web Lanyard

10. Rope Lanyard

11. Shock Absorbing Packs

Please provide additional comments/recommendations below for all items noted in the "Needs Action" column.

Document completion of recommendations and/or "Needs Action" items in "Follow Up" column.

Comments/Recommendations: __________________________________________________________

____________________________________________________________________________________

Inspected By: ______________________________________________ Date: _____________

Reviewed By: ______________________________________________ Date: _____________