Model Number (Serial Number):
Date Purchased:
;
This product must be inspected by the user before each use. Additionally, a Competent Person other than the user must
inspect this equipment at least once each year.
Component
Harness Hardware
(Table 1)
Webbing & Stitching
(Figure 16)
Stitched Impact Indicators
(Figure 17)
Labels (Figure 15)
Fall Protection Equipment
;
If the product fails an inspection procedure, then the product fails overall inspection. If the product fails inspection, remove
it from service immediately. Clearly tag the product "DO NOT USE". See Section 5 for more information.
Inspection Type:
Inspected By:
Signature:
Additional Notes:
Figure 17 - Webbing
A
B
Table 2 – Inspection and Maintenance Log
Inspection Procedure
Inspect all harness hardware for damage, including all attachment
elements, buckles, adjusters, and other elements. Each of these
items must not be damaged, broken, or distorted. Each item must
also be free of any sharp edges, burrs, cracks, worn parts, or
corrosion. PVC-coated hardware must be free of cuts, rips, tears,
and holes in the coating to ensure non-conductivity. Ensure all
buckles and adjusters operate smoothly.
Inspect the webbing of the harness across all areas. All webbing
material must be free of cuts (A), fraying (B), heavy soiling (C),
and welding burns (D). Check for tears, abrasions, mold, burns,
discoloration, and broken fibers. Check for pulled or cut stitches.
Broken stitches may indicate that the harness has been impact
loaded and must be removed from service.
Verify all Impact Indicators are intact. Impact Indicators are
sections of webbing lapped back on themselves and secured with
a specific stitch pattern. This stitch pattern is designed to release
when the harness arrests a fall or is exposed to equivalent force.
If an Impact Indicator has been activated (indicated), then the
harness must be removed from service and destroyed.
All labels are present and fully legible.
Additional Fall Protection equipment that is used with the product
is installed and inspected per the manufacturer instructions.
User
Competent Person
C
D
Date of First Use:
···
···
···
···
Overall Inspection Result:
Date of Inspection:
Next Inspection Due:
···
Figure 18 - Impact Indicators
Inspection Result
Pass
Fail
Pass
ü
X
Fail