Working at Heights Equipment Inspection Checklist
Use this form to inspect working-at-heights equipment before use and record its condition, any defects, and the final decision.
Inspector and Inspection Details
Inspector Name
*
First Name
Last Name
Job Title or Role
*
Company or Department
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Work Site / Location
*
Inspection Reference or Equipment Tag / Asset ID
*
Equipment Inspection Checklist
Type of Equipment Being Inspected
*
Harness
Lanyard
Lifeline
Anchor Point
Fall Arrest Block
Scaffold Access Equipment
Ladder
Platform
Guardrail
Other
Inspection Condition Checks
*
Rows
Pass
Fail
N/A
Visible damage
1
2
3
Wear
4
5
6
Corrosion
7
8
9
Stitching/strap condition
10
11
12
Hardware/fasteners
13
14
15
Connectors/hooks
16
17
18
Labels/tags legibility
19
20
21
Expiration or service status
22
23
24
Cleanliness/contamination
25
26
27
Stability/secure installation
28
29
30
Overall suitability for use
31
32
33
Defects Found
Immediate Action Taken
*
Approved for use
Removed from service
Quarantined
Repaired
Escalated
Applicable Equipment Checks
Harness attachments
Anchor integrity
Lanyard length/condition
Lifeline tension/condition
Fall arrest block function
Scaffold access components
Ladder feet/rungs
Platform surface/edges
Guardrail integrity
Other
Additional Notes
Outcome and Follow-up
Final Inspection Result
*
Pass
Pass with Notes
Fail
Removed from Service
Corrective Actions Required
Maintenance or Repair Reference
Follow-up Inspection Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Final Comments or Recommendations
Inspector Confirmation
Submit Inspection
Submit Inspection
Should be Empty: