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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
Web Lanyards (Figure 14.1)
Rope Lanyards (Figure 14.2)
Connectors
(Figure 15)
Energy Absorber (Figure 16)
Impact Indicator - Tubular
Web Lanyards (Figure 17)
Labels (Figure 13)
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:
Table 2 – Inspection and Maintenance Log
Inspection Procedure
Inspect the webbing for Cuts (A), Frays (B), broken fibers, tears, abrasion,
Heavy Soiling (C), mold, Burns (D), and discoloration. Inspect the lanyard
stitching for pulled or cut stitches, since broken stitches may indicate that
the product has been impact-loaded and must be removed from service.
Inspect rope for Abrasion (A), Cut Strands (B), Pulled Strands (C), Melting
(D), Compression (E), Inconsistent Diameter (F), and Discoloration (G).
Inspect all connectors for signs of damage and corrosion. Verify that all
connectors are working properly. Where present: Gates (A) should open,
close, lock, and unlock properly; Swivel Eyes (B) should rotate without
interference; and locking buttons and pins should function correctly.
Verify that the integral energy absorber has not been activated. There
should be no webbing pulled out of the Cover (A). The cover should be
secure and free of Tears (B) or other damage.
Inspect tubular web lanyards for deployment of the impact indicator. If the
stitching is torn, revealing the Impact Indicator Label (A), then the lanyard
has been exposed to impact force and must be removed from service.
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
Date of First Use:
···
···
···
···
Overall Inspection Result:
Date of Inspection:
Next Inspection Due:
···
Inspection Result
Pass
Fail
Pass
Fail
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