Chain Block Inspection Report Form
Document your chain block safety inspection with this clear and minimal report.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location
*
Chain Block ID / Serial Number
*
Visual Condition (corrosion, cracks, damage)
*
Pass
Fail
N/A
Chain Wear and Lubrication
*
Pass
Fail
N/A
Hooks and Safety Latches
*
Pass
Fail
N/A
Function Test (lifting/lowering operation)
*
Pass
Fail
N/A
Additional Comments or Observations
Inspector Signature
*
Submit Inspection Report
Submit Inspection Report
Should be Empty: