Inspector Name :

YOYO ARRESTOR Inspection Number :

Date of Inspection :
INSPECTION STANDARD
INSPECTION
INSPECTION RESULT
METHOD REASON FOR NOT
No INSPECTION ITEM STANDARDS
NOT COMPLY
VISUAL FUNCTION COMPLY
COMPLY
1 Marking Legible ( Nampak ) ●

2 load rating clear,readable (jelas,terbaca) ●

3 Carabiner lock tight (mengunci dengan rapat) ● ●

4 Cover Good Condition ●

5 Nuts & Bolting Completed ●

6 Hole Anchor Point Available & Not broken ●

7 Wire Condition Good Condition ●

8 Lock Suspended Function ● ●

9 Rubber Pad Not Broken ( Tidak Rusak & utuh) ●

10 Hook not crack,bent (tidak retak,bengkok) ● ●

INSPECTION STATUS : PASS HOLD REJECT

SPECIAL NOTE FROM INSPECTOR

Inspected by, Approved by,

(Name&Signature) (Name&Signature)