Title: HMS Document Number:

Fall Protection Equipment Inspection Checklist CL-GL-HAL-HSE-0604

Approver:
Owner: Rev Date: Rev No: Page:
Director, Global HSE/SQ Management Systems
Global HSE 29.NOV.2021 2 1 of 2

Fall Protection Equipment Inspection Checklist

Fall protection equipment shall be visually inspected before each use by the user for damage and wear. Any item found
damaged or defective is to be removed from service, replaced, marked as being unusable and destroyed.

Equipment Inspected by: SAID ZEGHIDI Inspection Date: 08/06/2023

Facility/Worksite: HMD Work/Project: DRIFT & SCRATCHER

Inspect Equipment Serviceable If NOT Serviceable Check () all that apply
Check () One
Harnesses/Belts/Lanyards/Ropes
Yes No Cleaned Replaced Removed Destroyed
Wear X
Mold/Mildew X
Distortion and free from:
Broken Fibers
Pulled Stitches X
Discoloration X
Cuts X
Tears X
Scrapes X
Damage from: X
Fire/Heat
Acid X
Or other Corrosives X
Hardware Cracks X
Sharp Edges X
Burrs X
Additional manufacturer X
recommended inspection points
Snap hooks close properly and lock X
tightly
Buckles work properly X
Lifeline anchors and mountings are X
not loose or damaged
Comments:

Printed versions of this document are considered

UNCONTROLLED.
This is the minimum Halliburton Company Standard. If local, country, or contractual requirements exceed this standard then those
requirements
must be followed.
 Title: HMS Document Number:
Fall Protection Equipment Inspection Checklist CL-GL-HAL-HSE-0604
Approver:
Owner: Rev Date: Rev No: Page:
Director, Global HSE/SQ
Global HSE 29.NOV.2021 1 1 of 2
Management Systems

Revision Date Rev. No Revised By Summary of Key Changes

29-NOV-2021 2 Cliff Salawage Adjusted Format
06.DEC.2018 1 Buddy Rozell Biennial review: Administrative format update
02-DEC-2016 0 Ed Devol Initial Release
For questions, comments or previous versions of HSE documents please send using the Global HSE Support Request Form.

Printed versions of this document are considered

UNCONTROLLED.
This is the minimum Halliburton Company Standard. If local, country, or contractual requirements exceed this standard then those
requirements
must be followed.