You are on page 1of 1

Inspection form

harnesses 1.800.466.6385
customer.service@puresafetygroup.com

Manufacturer:
Owner / Company:
Model #:
Harness
Configuration: Name of Inspector:
Description:
Chest Strap: PT TB
Signature:
Serial #: Leg Straps: PT TB
waist belt: yes no Date of Inspection:
Lot #:
In-Service Date:
Date of Manufacture:

Seraph construction harness


labels & markings Pass fail Note
(pt chest, tb waist, & tb legs)
Label (Intact & Legible)
Shoulder Straps
Appropriate ANSI/OSHA/CSA Markings
Chest Strap
Inspections are Current / Up-to-Date
Adjustment
Date of First Use Buckles

Impact Indicator (Signs of Deployment)

HARDWARE (BUCKLES & D-RINGS) Pass fail Note


Shoulder Adjustment Buckles Side D-Rings

Leg & Waist Buckles / Other Hardware Waist Belt

D-Rings (Dorsal, Side, Shoulder, or Sternal)


Leg Straps
Corrosion / Pitting / Nicks

Webbing Pass fail Note Velocity harness


(PT chest & legs)
Shoulder / Chest / Leg / Back Straps
Cuts / Burns / Holes Dorsal D-Ring
Paint Contamination
Labels
Excessive Wear
Heat / UV Damage Back Strap
Impact
stitching Pass fail Note Indicators

Shoulder / Chest / Leg / Back Straps

Notes

Docket # H001

You might also like