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  • FBH Inspection Form @2021. Rev.2

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    This document is an inspection form for personal protective equipment, specifically a full body harness. It lists 21 points that are checked on the harness, including webbing, stitching, hardware, labels/tags, and components like carabiners and snap hooks. It also checks two types of helmets and their chin straps. The inspector fills out their name, date, model/type of harness, serial number, and production date, and indicates pass or fail for each check point along with any notes.

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    FBH Inspection form @2021. rev.2

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    This document is an inspection form for personal protective equipment, specifically a full body harness. It lists 21 points that are checked on the harness, including webbing, stitching, hardware, labels/tags, and components like carabiners and snap hooks. It also checks two types of helmets and their chin straps. The inspector fills out their name, date, model/type of harness, serial number, and production date, and indicates pass or fail for each check point along with any notes.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    4 views1 page

    FBH Inspection Form @2021. Rev.2

    Uploaded by

    data.h3i.nexwave
    This document is an inspection form for personal protective equipment, specifically a full body harness. It lists 21 points that are checked on the harness, including webbing, stitching, hardware, labels/tags, and components like carabiners and snap hooks. It also checks two types of helmets and their chin straps. The inspector fills out their name, date, model/type of harness, serial number, and production date, and indicates pass or fail for each check point along with any notes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PERSONAL PROTECTIVE EQUIPMENT INSPECTION FORM

    Name Inspector :
    Tanggal Inspeksi :

    Full Body Harness Model :


    Full Body Harness Type :
    Full Body Harness Serial Number :
    Tanggal di Produksi :

    Pass (P / √)
    Point yang di check or Catatan
    Fail (F / x)
    Webbing - check for cuts (cek dari terpotong/goresan), frayed edges (ujung yg terurai), burns (terbakar), chemical deterioration
    (kerusakan akibat bahan Kimia), holes (lubang), discoloration (adanya perubahan warna akibat tertentu) or excessive soiling (kotoran
    yang berlebihan seperti tanah)
    1. Shoulder straps (Pengikat pundak)
    2. Chest straps (Pengikat dada)
    3. Back/front straps (Pengikat B/D)
    4. Leg straps (pengikat Paha)

    Stiching (Jahitan) - Check for cut (terpotong) or pulled (tertarik) stitching


    5.Shoulder straps (Pengikat Pundak)
    6.Chest straps (Pengikat Dada)
    7.Waist/backpads straps ( Penopang
    Pungung)
    8.Back/front straps (Pengikat B/D)
    Hardware - check of sharp edges (daerah yg tajam),cracks (retak), bending (Bengkok) or corrosion (Karat)
    9. Back/front D-ring
    10. Side D-rings
    11. Keepers
    12. Buckles
    Labels & Tags - Check to make sure that all labels have appropriate ANSI/EN/SNI markings, are legible and are
    securely attached
    13. Tags & labels
    14. Expired date
    Hardware - check of sharp edges, burrs, cracks, bending or corrosion
    15. Carabiner
    16. Snap hook
    Double Lanyard Absorber - Check to make sure that have appropriate ANSI/EN/SNI standard
    17. Absorber, Loop, rope & Jahitan
    18. Snap hook, Loop & Jahitan
    work positioning lanyard - Check to make sure that have appropriate ANSI/EN/SNI standard
    19. Adjustable mecanism
    20. Snap hook, rope, Loop & Jahitan
    1. Helm Bekerja di Ketinggian
    21. Kondisi Helm
    22. Tali Dagu 4 titik
    2. Helm Keselamatan Umum
    23. Kondisi Helm
    24. Tali Dagu 2 titik
    @ Nokia - PE PS&S Indonesia 2021

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