Fall Protection Equipment Inspection Checklist INFC Safety

INSTRUCTIONS FOR USE: An annual inspection by a competent inspector must be performed for each piece of
fall protection equipment. Using one of the checklists below, fully inspect each piece of equipment. If the
equipment fails the inspection, it must be destroyed and discarded. After completing the inspection:
1. Indicate on the equipment inspection tag the date of inspection and the initials of the inspector.
2. Indicate on the Fall Protection Equipment Inventory the date of inspection and the name of the
inspector. If equipment fails inspection indicate the date the equipment was destroyed and discarded.
3. Indicate on the Equipment Safety Inspection Matrix the date all inspections are complete and the login
of the inspector. When all equipment is inspected, indicate the inspection is complete on the
Equipment Safety Inspection Matrix and upload it to the Safety Compliance Calendar.
Full Body Harness Inspection Self-Retracting Lifeline Inspection Lanyard Inspection
Manufacture Date Manufacture Date Manufacture Date
Model Number Model Number Model Number
Serial Number Serial Number Serial Number
Lot Number Lot Number Lot Number
1. Hardware: Inspect for _____ Accepted 1. Impact Indicator: Inspect _____ Accepted 1. Hardware (includes snap _____ Accepted
damage, distortion, sharp indicator for activation (rupture hooks, adjusters, keepers,
edges, burrs, cracks, and _____Rejected of red stitching, elongated _____Rejected thimbles, and D-Rings): _____Rejected
corrosion (includes D-Ring) indicator, etc…) Inspect for damage,
distortion, sharp edges, burrs,
cracks, corrosion, and proper
operation
2. Webbing: Inspect for _____ Accepted 2. Screws / Fasteners: Inspect _____ Accepted 2. Webbing: Inspect for cuts, _____ Accepted
cuts, burns, tears, abrasion, for damage and ensure all burns, tears, abrasion, frays,
frays, excessive soiling, and _____Rejected screws and fasteners are tight _____Rejected excessive soiling, and _____Rejected
discoloration discoloration
3. Stitching: Inspect for _____ Accepted 3. Housing: Inspect for _____ Accepted 3. Stitching: Inspect for pulled _____ Accepted
pulled or cut stitches distortion, cracks and other or cut stitches
_____Rejected damage. Inspect anchoring loop _____Rejected _____Rejected
for distortion and damage

4. Labels: Inspect to ensure
all labels are securely held
in place and are legible
Comments:
_____ Accepted 4. Lifeline: Inspect for cuts, _____ Accepted 4. Synthetic Rope: Inspect for _____ Accepted
burns, tears, abrasion, frays, pulled or cut yarns, burns,
_____Rejected excessive soiling, discoloration, _____Rejected abrasion, knots, excessive _____Rejected
and broken wires (see Impact soiling, and discoloration
Indicator Section)
5. Locking Action: Inspect for _____ Accepted 5. Wire Rope: Inspect for _____ Accepted
proper lock-up of brake broken wires, corrosion, kinks,
mechanism _____Rejected and separation of strands _____Rejected
6. Retraction / Extension: _____ Accepted 6. Energy Absorbing _____ Accepted
Inspect spring tension by Component: Inspect for
pulling life line out fully and _____Rejected elongation, tears, and _____Rejected
allowing it to retract fully (no excessive soling
slack)
7. Hooks / Carabineers: Inspect _____ Accepted 7. Labels: Inspect to ensure all _____ Accepted
for physical damage, corrosion, labels are securely held in
proper operation, and markings _____Rejected place and are legible _____Rejected
8. Reserve Lifeline: Inspect _____ Accepted
reserve lifeline retention
systems for deployment _____Rejected
Labels: Inspect to ensure all _____ Accepted
labels are securely held in place
and are legible _____Rejected
Comments: Comments:

Overall Disposition _____ Accepted Overall Disposition _____ Accepted Overall Disposition _____ Accepted

_____Rejected _____Rejected _____Rejected

Inspection Date Inspection Date Inspection Date
Inspector Name Inspector Name Inspector Name
Fall Protection Equipment Inspection Checklist INFC Safety