Honeywell - Miller Product Inspection Guide

R scrip R scrip Serial # Wire Wire De De

ope Lanyards tion: ope Lanyards tion:

Model Model D

#: #:

:

ate of Manufac ate Inspected: ate of Manufac ate Inspected: PASS: ❑ Initia PASS: ❑ Initia

INSPECTION CHECKLIST - FALL PROTECTION EQUIPMENT Serial # : Inspect or: Inspector Signature:  FAIL: ____ ✔ Initial_____ Inspect or: Inspector Signature:  FAIL: ____ ✔ Initial_____ R E FROM SERVIC

D D ✔ ✔

Model #: Inspection Checklist – Fall Protection Equipment R scrip #: Wire De ope Lanyards tion: Model Serial # ate of Manufacture: : D Inspect ate Inspected: or: D Inspector Signature:  FAIL: ____ ✔ Initial_____ ✔ EMOV E R E FROM SERVIC EMOV E Date of Manufacture: Date Inspected:

RETURN TO RETURN TO

SE SE

Description:

Serial #:

8 FAIL: o Initial_________ REMOVE FROM SERVICE EMOV list – Fall Protection Equipment #: s Model Date of Manufacture: Date Inspected: Inspector: Inspector Signature: E R E FROM SERVIC

PASS: ❑ Initial_________

4 PASS: o Initial_________

RETURN TO

SERVICE

RETURN TO SERVICE

PASS: ❑ Initial_________

_

____

✔

RVIC

RETURN TO

E

SERVICE

Description LANYARD IT EM # IT EM #

Fail 8 DESCRIPTION – LANYARD DESCRIPTION – LANYARD

FAIL  FAIL 

PASS ✔ PASS ✔

COMMENT COMMENT

Item #

Pass 4

Comments

Broken Wires Rust/Corrosion/Pitting Deformations Heat Damage Fittings/Thimbles Splices Labeling (tags) SNAPHOOK Hook Body Hook Nose Gate (keeper) Lock Eye Hinge Spring (inside gate) DESCRIPTION – LANYARD Deformations Heat Damage Fittings/Thimbles Splices Labeling (tags) SNAPHOOK Hook Body Hook Nose Gate (keeper) Lock Eye Hinge COMMENTS Broken Wires Rust/Corrosion/Pitting

PASS ✔ Broken Wires Rust/Corrosion/Pitting FAIL  Broken Wires Rust/Corrosion/Pitting Deformations Heat Damage Fittings/Thimbles Splices Labeling (tags) SNAPHOOK Deformations Heat Damage Fittings/Thimbles Splices Labeling (tags) SNAPHOOK Hook Body Hook Nose Gate (keeper) Lock Eye Hook Body Hook Nose Gate (keeper) Lock Eye

IT EM #

COMMENTS

–

FAIL 

PASS ✔

n/Pitting

les )

Product Inspection Guide

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