CHECKLIST FOR SAFETY HARNESS INSPECTION SAFETY HARNESS MONTHLY INSPECTION RECORD Company Name: ____________________________________________ Trade:_____________________ Supervisor-in-charge

(Name): _________________________________ Colour code :

1st registration

Monthly inspection
Checked Items Shock
1 ) Harness Condition

Serial No. Serial No.

3) Buckle Attachment

Badge NO

6) Lanyard Condition

5 ) Shoc k E ne rgy A bs or ber

Employee Name

4) Karabiner

ECC ID

Harness

Absorber

7) Snap hook

Body

Remarks: (V) Satisfactory/Yes, (X) Not Satisfactory/No, (NA) Not Applicable

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Check for cracks, dents, deformation, deteoriration, corrosion, stitches, rivets {original), shock absorber packaging, landyard wear & tear.

Inspected by :
Supervisor in charge

Date :
(Name & Signature)

Confirmed by :
HSE Section

Date :
{Name & Signature)

8) Certification Tag (PSB Test)

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2) Dorsal Anchorage point