Utility Belt Security Check Log Form
Log and verify the condition and contents of each utility belt during security inspections.
Inspector Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Belt ID or Serial Number
*
Checklist: Are all required items present?
*
Handcuffs
Radio
Flashlight
Baton
Pepper Spray
Gloves
Other
Overall Condition of Belt
*
Satisfactory
Needs Attention
Notes or Comments
Inspector Signature
*
Submit Log
Submit Log
Should be Empty: