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Checklist Inspeksi Harness

Checklist Harness Inspection

Location :
Department :
Bulan & Tahun :

Polyamide lanyard
D-Ring back pad

Shoulder Strap
Dorsal D-Ring

Lock Hook
Carabiner
Back Pad

Stiching

Buckle

Hook

TTD
No. Tanggal No. ID

Di Periksa Oleh 1 2 3 4 5 6 7 8 9 10
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
NB : √ = Baik X = Rusak
1
3 2 10 10 8
6 6 9

4
4

5 5

6
6

6 7 7
6

Form - 006 - EHSS - Checklist Harness Inspection Rev. 00

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