Inspection Date:
Component:
SRD
(Figure 16)
End Connectors
(Figure 17)
Web Lifeline
(Figure 18)
Energy Absorber
(Figure 19)
Serial Number(s):
Model Number:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
1 Competent Person:
One who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary,
hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them.
Table 3 – Inspection and Maintenance Log
Inspection:
(See Section 2 for Inspection Frequency)
Inspect for loose fasteners and bent or damaged parts.
Inspect the Housing (A) for distortion, cracks, or other damage.
Inspect the Swivel (B) and Swivel Eye (C) for distortion, cracks, or other
damage. The Swivel should be attached securely to the SRL, but should pivot
freely. The Swivel Eye or Integral Connector should rotate freely in the Swivel.
The Web Lifeline (D) should pull out and retract fully without hesitation or
creating a slack line condition.
Ensure the SRD locks up when the Lifeline is jerked sharply. Lockup should be
positive with no slipping.
All labels must be present and fully legible (see Figure 20).
Inspect the entire SRD for signs of corrosion.
Table 2 identifies the End Connectors that should be included on your
Nano-Lok SRD model. Inspect all Snap Hooks, Carabiners, Rebar Hooks,
Interfaces, etc. for signs of damage, corrosion, and proper working condition.
Where present: Gates should open, close, lock, and unlock properly, and
Locking Buttons and Locking Pins should function correctly.
Inspect webbing; material must be free of cuts (A), frays (B), or broken fibers.
Check for tears, abrasions, heavy soiling (C), mold, burns (D), or discoloration.
Inspect stitching; Check for pulled or cut stitches. Broken stitches may be an
indication that the device has been impact loaded and must be removed from
service.
Verify that the integral Energy Absorber has not been activated. An open cover
or torn cover (A), webbing pulled out of the cover, torn or frayed webbing (B),
ripped stitching, etc. are indicators of an activated Energy Absorber.
Inspected By:
Date Purchased:
Date of First Use:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
18
Competent
User
Person
1