‫الــفـــريــــق الســتــشــــارات الســـالمــــة‬

TEAM SAFETY CONSULTANTS L.L.C

EXAMINATION AND TEST OF BACK – UP LANYARD

Job No.: Certificate/ Report No.:
Client Name and Address:
Type Of Inspection INITIAL PERIODIC
Ref. Standard/ Regulation BS EN 354:2010, BS EN 795-B:2012
Location: TSC Test Method No TSC/TM/01
TSC Test Equipment No TSC/EQ/07
Roll Year
Name of Manufacturer I.D. / Serial No. Model No. / Reference No. Length SWL
No. Manufactured

10

Date of Previous Test: Date of Inspection: Date of Issue: Date of Expiry:

Name and position of person who EQUIPMENT STATUS:

Carried out the inspection and test:

SATISFACTORY
NOT SATISFACTORY

______________________
Inspection Engineer

TSC-F-91W(Rev.1) (22/01/2023) Page 1 of 2

 TEAM SAFETY CONSULTANTS L.L.C, TRADE LICENSE NO. 500714, AL-GARHOUD, P. O. BOX: 112349, DUBAI -UAE,
TEL: 04-2828868,FAX: 04-2865265 EMAIL: info@tsc-uae.ae, WEBSITE: https://www.tsc-uae.ae/

Continuation of Job No.: Certificate/Report No.:

REMARKS AND RECOMMENDATIONS

TSC-F-91W(Rev.1) (22/01/2023) Page 2 of 2