Questionaire :Personal Fall Protection Date :

Instruction : Circle the correct answer.

Name : ________________ Section : ____________ Emp/No : ____________
1) Some of the fall protection equipment has retractable lines to arrest a fall.
a) Yes b) No
2) The proper wearing and anchoring of a harness will save life during a fall.
a) Yes b) No
3) Staging Supervisors need not wear safety harnesses as they only supervise.
a) Yes b) No

Name : ________________ Section : ____________ Emp/No : ____________

1) Some of the fall protection equipment has retractable lines to arrest a fall.
a) Yes b) No
2) The proper wearing and anchoring of a harness will save life during a fall.
a) Yes b) No
3) Staging Supervisors need not wear safety harnesses as they only supervise.
a) Yes b) No

Name : ________________ Section : ____________ Emp/No : ____________

1) Some of the fall protection equipment has retractable lines to arrest a fall.
a) Yes b) No
2) The proper wearing and anchoring of a harness will save life during a fall.
a) Yes b) No
3) Staging Supervisors need not wear safety harnesses as they only supervise.
a) Yes b) No

Name : ________________ Section : ____________ Emp/No : ____________

1) Some of the fall protection equipment has retractable lines to arrest a fall.
a) Yes b) No
2) The proper wearing and anchoring of a harness will save life during a fall.
a) Yes b) No
3) Staging Supervisors need not wear safety harnesses as they only supervise.
a) Yes b) No

Supervisor/Foreman/Officer/Engineer ;

Name : ________________ Section : ____________ Emp/No : ____________

Signature : _______________