FULL BODY HARNESS INSPECTION REPORT

CUSTOMER DETAILS

CUSTOMER

Date

ADDRESS

ORDER NO

CONTACT

TEL NO:

DESCRIPTION OF UNIT

UNIT:

SERIAL NO:

WLL:

LENGTH/SIZE/REACH

PLANT

LOCATION:

PREVIOUS INSPECTION DATE *

NEXT INSPECTION DATE *

EQUIPMENT CONDITION

SERIAL NO/ ID MARKINGSGOODFAIRBAD

SERIAL NO/ ID MARKINGS Remarks

EXPIRY DATEGOODFAIRBAD

EXPIRY DATE Remarks

SHOULDER ADJUSTMENT BUCKLESGOODFAIRBAD

SHOULDER ADJUSTMENT BUCKLES Remarks

LEG AND WAIST BUCKLESGOODFAIRBAD

LEG AND WAIST BUCKLES Remarks

D RINGS (SIDE/FRONT/DORSAL)GOODFAIRBAD

D RINGS (SIDE/FRONT/DORSAL) Remarks

WEBBING (BURNS/CUTS/HOLES/CHEMICALS)GOODFAIRBAD

WEBBING (BURNS/CUTS/HOLES/CHEMICALS) Remarks

STITCHINGGOODFAIRBAD

STITCHING Remarks

LANYARD (DEPLOYMENT INDICATORS)GOODFAIRBAD

LANYARD (DEPLOYMENT INDICATORS) Remarks

GENERAL CONDITIONGOODFAIRBAD

GENERAL CONDITION Remarks

NOTES

NOTES:

Visual InspectionYESNO

RESULTS

RESULTSPASSFAIL

INSPECTOR NAME & SURNAME

POSITION/ TITLE;

CERTIFIED BY

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CUSTOMER REPRESENTATIVE:

CUSTOMER REPRESENTATIVE

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Consent *

THE CUSTOMER ACKNOLEDGES THAT DEFECTIVE EQUIPMENT WILL NOT BE USED UNTIL REPAIRS ARE DONE AND THE UNIT IS INSPECTED AND/OR TESTED

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This Is To Certify That The Below Mentioned Unit has been Examined/Inspected in Accordance With SANS 50813 And Meets Safety Standards In Accordance With The OHS Act And The MHS Act.