Fall_Protection_Inspection_Sheets

Full Body Harness Inspection Checklist / Log Crew A C Days B D Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Hardware: (includes D-rings, buckles, keepers, and back pads) Inspect for damage, distortion, sharp edges, burrs, cracks and corrosion Webbing: Inspect for cuts, burns, tears, abrasion, frays, excessive soiling, and discoloration. Stitching: Inspect for pulling or cut stitches. Accepted / Rejected Accepted Supportive Details or Comments Rejected Accepted Rejected Accepted Labels: Inspect, make certain all labels are securely held in place and legible Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: Lanyards Inspection Checklist / Log Crew A C Days B D Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Hardware: (includes snap hooks, D-ring, keepers, carabiners, adjusters, & thimbles). Inspect for damage, distortion, sharp edges, burns, cracks, corrosion and proper operation. Accepted / Rejected Accepted Supportive Details or Comments Webbing: Inspect for cuts, burns, tears, abrasion, frays, excessive soiling, and discoloration. Stitching: Inspect for pulling or cut stitches. Rejected Accepted Rejected Accepted Synthetic Rope: Inspect for pulled or cut yarns, burns, abrasion, knots, excessive soiling and discoloration. Wire Rope: Inspect for broken wires, corrosion, kinks, and separation of strands. Energy Absorbing Component: Inspect for elongation, tears, and excessive soiling. Labels: Inspect, make certain all labels are securely held in place and legible Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: Hooks / Carabiners Inspection Checklist / Log Crew A C Days B D Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Physical Damage: Inspect for cracks, sharp edges, burrs, deformities and locking operation. Excessive Corrosion: Inspect for corrosion which effects the operation and/or strength. Markings: Inspect, make certain marking(s) are legible. Accepted / Rejected Accepted Supportive Details or Comments Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: Tie-Off Adaptors Inspection Checklist / Log Crew A C Days B D Barrick Goldstrike Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Hardware: (includes D-rings). Inspect for damage, distortion, sharp edges, burrs, cracks and corrosion Webbing: Inspect for cuts, burns, tears, abrasion, frays, excessive soiling, and discoloration. Stitching: Inspect for pulling or cut stitches. Accepted / Rejected Accepted Supportive Details or Comments Rejected Accepted Rejected Accepted Labels: Inspect, make certain all labels are securely held in place and legible Wire Rope: Inspect for broken wires, corrosion, kinks, and separation of strands. Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: Anchorage Plates Inspection Checklist / Log Crew A C Days B D Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Physical Damage: Inspect for cracks, sharp edges, burrs, deformities. Accepted / Rejected Accepted Supportive Details or Comments Excessive Corrosion: Inspect for corrosion which effects the operation and/or strength. Fasteners: Inspect for corrosion, tightness, damage, and distortion. If welded, inspect weld for corrosion, cracks, and damage. Markings: Inspect, make certain marking(s) are legible. Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: Self Retracting Lifelines Inspection Checklist / Log Crew A C Days B D Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Impact Indicator: Inspect indicator for activation (rupture of red stitching, elongated indicator, etc.) Screws / Fasteners: Inspect for damage and make certain all screws and fasteners are tight. Housing: Inspect for distortion, cracks, and other damage. Inspect anchoring loop for distortion and damage Lifelines: Inspect for cuts, burns, tears, abrasion, frays, excessive soiling and discoloration, broken wires (see impact indicator section) Locking Action: Inspect for proper lock-up of brake mechanism. Retraction / Extension: Inspect spring tension by pulling lifeline out fully and allowing to retract fully (lifeline must be taut, no slack). Hooks / Carabiners: Inspect for physical damage, corrosion, proper operation, and markings (see separate checklist/log for hooks/carabiners.) Accepted / Rejected Accepted Rejected Accepted Rejected Accepted Supportive Details or Comments Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Reserve Lifeline: Inspect reserve lifeline retention system for deployment Labels: Inspect, make certain all labels are securely held in place and legible Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: Inspection Checklist / Log Inspection Checklist / Log Crew A C Days B D Open Pit Process Underground Name: Model: Serial Number: Chip Number: Tag Number: Manufacture Date: Lot Number: Chip Scanned YES NO Comments: General Factors Accepted / Rejected Accepted Supportive Details or Comments Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Rejected Accepted Overall Disposition Rejected Inspected By: Date Inspected: