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Lifting Plan For Presentation in Bahasa

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Inspection form

Manufacturer:

Model #:
lanyards
Owner / Company:

Lanyard Name of Inspector:


Description: Configuration:
Single leg lanyard
Signature:
Serial #: double leg lanyard
Internal Shock absorber Date of Inspection:
Lot #: external Shock absorber
cable web In-Service Date:
Date of Manufacture:

Single leg Lanyard


labels & markings Pass fail Note (external shock)
Label (Intact & Legible)
Connectors
Appropriate ANSI/OSHA/CSA Markings
Inspections are Current / Up-to-Date Termination
Date of First Use
Shock Absorber
Connectors Pass fail Note
Connector (Self-Closing & Locking) Label
Hook Gate / Rivets
Webbing
Corrosion
Cable
Pitting / Nicks

Material (web or Cable) Pass fail Note


Broken / Missing / Loose Stitching
double leg Lanyard
(internal shock & non-shock)
Termination (Stitch, Splice, or Swage)
Connectors
Webbing Length
Cuts / Burns / Holes Termination

Paint Damage
Cable Separating / Bird-Caging
Label

shock pack (if present) Pass fail Note


Cover / Shrink Tube (Don’t Cut or Remove)
Webbing
Damage / Fraying / Broken Stitching
Impact Indicator (Signs of Deployment)

Notes

Docket # L001

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