Harness Inspection Survey
Complete this survey to ensure all harnesses meet safety and compliance standards before use.
Inspector Full Name
*
First Name
Last Name
Inspector Email Address
*
example@example.com
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Harness Identification Number or Code
*
Location of Inspection (Site/Area)
*
Harness Type
*
Please Select
Full Body Harness
Chest Harness
Positioning Harness
Other
Harness Condition Checklist
*
Rows
Pass
Fail
N/A
Webbing/Straps: No cuts, frays, or burns
1
2
3
Buckles and D-Rings: Free from corrosion, cracks, or deformation
4
5
6
Stitching: Intact and not loose or broken
7
8
9
Labels/Tags: Present and legible
10
11
12
Hardware: No sharp edges or distortion
13
14
15
Connectors: Working properly
16
17
18
Adjusters: Functioning correctly
19
20
21
Overall Harness Condition
*
1
2
3
4
5
Is the harness safe for use?
*
Yes
No
Additional Comments or Observations
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: