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Idiomas disponibles
25.0 INSPECTION FORM
Product lifetime is indefinite as long as it passes pre-use and Competent Person inspections. User must inspect prior to each
use. Competent Person other than the user must complete formal inspection at least annually.
Manufacturer:
Model Number:
Description:
Serial Number:
Lot Number:
Date of Manufacture:
LABELS & MARKINGS
Label (Intact and Legible)
Appropriate ANSI / OSHA / CSA Markings
Inspections are Current / Up-to-Date
Date of First Use
HARDWARE
(If Applicable)
Signs of Deformity
D-Ring / Connection Points
Hook Gate / Rivets (if applicable)
Corrosion / Pitting / Nicks
ANCHORAGE CONNECTOR
Termination (Stitch, Splice, or Swage)
Deterioration / Corrosion
Cuts / Burns / Holes
Integrity of Welds / Rivets
Paint Contamination
Stitching / Wire Condition
Heat Corrosion / UV Damage
Separation / Bird-Caging
NOTES
225 Wilshire Avenue SW, Concord NC 28025
PASS
FAIL
NOTE
PASS
FAIL
NOTE
PASS
FAIL
NOTE
If equipment fails inspection
IMMEDIATELY REMOVE FROM SERVICE
2023 Copyright Safewaze
INSPECTION FORM
Company:
Name of Inspector:
Signature:
Date of Inspection:
In-Service Date:
Anchor
Galvanized Steel
Material:
Zinc-Plated Steel
CABLE ANCHOR
Connection
Point
Termination
Label
Cable
ROOF ANCHOR
Connection
Point
Welds &
Rivets
Labels
•
800-230-0319
•
ANCHORS
Stainless Steel
Aluminum
Other:
CROSS ARM STRAP
Label
Webbing
POST ANCHOR
www.safewaze.com
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