Serial Number(s):
Model Number:
Inspected By:
Component:
Inspection:
Work Positioning Lanyard
Inspect for bent or damaged parts.
(Figure 1)
The Rope should adjust without hesitation or binding.
Ensure device locks up when lifeline is jerked sharply. Lockup should be positive with no slipping.
The labels must be present and fully legible (see "Labels").
Look for signs of corrosion on the entire unit.
Rope
Inspect rope for cuts, kinks, bird-caging, welding splatter, chemical contact areas, or severely abraded
areas.
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Corrective Action/Maintenance:
Table 3 – Inspection & Maintenance Log
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
Approved By:
Date:
13
Date Purchased:
Date of First Use:
Inspection Date:
Before
Each Use
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Next Inspection Due:
Competent
Person