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Safety Belt Inspection Checklist 1 of 1

Date:
Contractor Name: Safety Belt No.:
CHECKPOINTS
SR SR
CHECK ITEM PHOTOS Y/N Y/N CHECK ITEMS PHOTOS Y/N Y/N
NO NO
Harness is full Includes D-rings and its
body with double insulation.
lanyard (separate keepers and back pads
1 lanyard fixed in D- 6 Inspect for damage,
ring) distortion, sharp edges,
burrs, cracks and
corrosion.
Lanyard length is 1.8 Inspect for cuts, burns,
not more than abrasion, excessive
2 1.8m 7 soiling and discoloration.

Safety harness is Hook in the lanyard is in

made of Polyester working condition and
3 with polyamide 8 with out damage
Fibre rope

Harness is ISI Stitching: Inspect for

certified and pulled or cut stitches.
4 tested by 9 No Image
manufacturer.

No damage in the Remarks:

lanyard and
5 lanyard joints.

Frequency: Once in a 15 Days

Frequency: Once in a 15 Days

Inspected By Checked Reviewed By

Format No.: EHS-F15-R00

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Safety Belt Inspection Checklist 1 of 1

Name

Signature

Date

Format No.: EHS-F15-R00