KStrong Inspection Forms

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INSPECTION FORM SELF-RETRACTING DEVICES

Unrivaled Safety.

Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture: Lifeline Material: ________________ Length:

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

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Unrivaled Safety.

Web

Stainless Steel

Galvanized Steel

Pass Fail Note

LABELS & MARKINGS

Attachment Point

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented Cover / Shrink Tube (Don’t Cut or Remove) Damage / Fraying / Broken Stitching Impact Indicator (Signs of Deployment) SHOCK PACK (IF PRESENT)

Housing

Pass Fail Note

Screws

Pass Fail Note

HOUSING

Attachment Point Nuts / Bolts / Rivets / Screws Evidence of Damage (Dents / Cracks / Rust)

Shock Pack (If Present)

Termination / Swage or Stitching

Pass Fail Note

LIFELINE (WEB OR CABLE)

Impact Indicator

Termination (Stitch, Splice, or Swage) Cuts / Fraying / Broken Stitching Excessive Wear Cable Separating / Bird-Caging Entire Length Retracts Smoothly Test Braking / Locking Function Connector (Self-Closing & Locking) Impact Indicator Hook Body / Rivets Corrosion Pitting / Nicks CONNECTORS

Connector

APP M O B I L E

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NOTES

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

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MOBILE APP

Inspection Form Revision Date: 9 th September, 2021

customercare@kstrong.com

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INSPECTION FORM ANCHORAGE CONNECTORS

Unrivaled Safety.

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

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Unrivaled Safety.

Cable Sling Anchor

Cross Arm Strap

Pass Fail Note

LABELS & MARKINGS

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented

Cable

Webbing

Connector

Pass Fail Note

HARDWARE (IF APPLICABLE)

Signs of Deformity D-Ring / Connection Points Hook Gate / Rivets (if applicable) Corrosion / Pitting / Nicks

Label

Parapet Anchor

Pass Fail Note

ANCHORAGE CONNECTOR

Anchorage Connector

Termination (Stitch, Splice, or Swage) Deterioration / Corrosion Cuts / Burns / Holes Integrity of Welds / Rivets Paint Contamination Stitching / Wire Condition Heat Corrosion / UV Damage Separation / Bird-Caging

Rubber Grips

Griping Disk

APP M O B I L E

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Tightening Handles

Locking Pin

NOTES

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

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MOBILE APP

Inspection Form Revision Date: 9 th September, 2021

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customercare@kstrong.com

MOBILE APP

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INSPECTION FORM HARNESS

Unrivaled Safety.

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Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

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Unrivaled Safety.

Kapture™ Epic Harness

Pass Fail Note

LABELS & MARKINGS

Shoulder Straps

Labels (Intact & Legible) Appropriate Standards markings visible Inspections Are Current / Up-to-date Date of First Use Documented Impact Indicator (Signs of Deployment)

Chest Strap Adjustment Buckles Waist Belt Side D-rings

Pass Fail Note

Shoulder Adjustment Buckles Leg & Waist Buckles / Other Hardware D-Rings (Dorsal, Side, Shoulder, or Sternal) Corrosion / Pitting / Nicks HARDWARE (BUCKLES & D-RINGS) Cover / Shrink Tube (Don’t Cut or Remove) Damage / Fraying / Broken Stitching Impact Indicator (Signs of Deployment) SHOCK PACK (IF PRESENT)

Leg Straps

Kapture™ Essential Harness

Pass Fail Note

Dorsal D-Ring

Impact Indicators

Pass Fail Note

WEBBING

Back Strap

APP M O B I L E

Shoulder / Chest / Leg / Back Straps Cuts / Burns / Holes Paint Contamination Excessive Wear Heat / UV Damage

Labels

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NOTES

Pass Fail Note

STITCHING

Shoulder / Chest / Leg / Back Straps

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

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MOBILE APP

Inspection Form Revision Date: 9 th September, 2021

customercare@kstrong.com

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INSPECTION FORM HORIZONTAL LIFELINES

Unrivaled Safety.

Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

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Webbing Lifeline

Kernmantle Lifeline

Cable Lifeline

Unrivaled Safety.

Horizontal Lifeline Kit (Kernmantle rope, Carabiners, Rope Tensioner, & O-rings)

Pass Fail Note

LABELS & MARKINGS

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented

Tensioner

Lifeline

Label

Pass Fail Note

HARDWARE

Connector (Self-Closing & Locking) Hook Gate / Tensioner / Rivets Corrosion Pitting / Nicks

Connectors

O-Rings

Cable Horizontal Lifeline System (Cable, Web Tensioner, Impact attenuator, & O-rings)

Pass Fail Note

Confirm Proper Lifeline Threading Broken / Missing / Loose Stitching Termination (Stitch, Splice, or Swage) Excessive Wear (Fraying or Broken Strands) Cuts / Burns / Holes Kinks Separation / Bird-Caging MATERIAL (ROPE OR CABLE) Cover / Shrink Tube (Don’t Cut or Remove) Damage / Fraying / Broken Stitching Impact Indicator (Signs of Deployment) SHOCK PACK (IF PRESENT)

Pin

Connector Tensioner

Handle

O-Rings

APP M O B I L E

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Snap Hook

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

NOTES

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MOBILE APP

Inspection Form Revision Date: 9 th September, 2021

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customercare@kstrong.com

MOBILE APP

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INSPECTION FORM LANYARDS

Unrivaled Safety.

Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

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Wire

Web

Restraint lanyard

Single leg lanyard

Unrivaled Safety.

Double leg lanyard

Shock Absorbing Lanyards

Pass Fail Note

LABELS & MARKINGS

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented

Snap Hook

Shock Absorber

Scaffold Hook

Pass Fail Note

CONNECTORS

Webbing

Connector (Self-Closing & Locking) Hook Gate / Rivets Corrosion Pitting / Nicks

Double Leg Lanyard (Internal shock & non-shock)

Pass Fail Note

Broken / Missing / Loose Stitching Termination (Stitch, Splice, or Swage) Webbing Length Cuts / Burns / Holes Paint Damage Cable Separating / Bird-Caging MATERIAL (WEB OR CABLE) Cover / Shrink Tube (Don’t Cut or Remove) Damage / Fraying / Broken Stitching Impact Indicator (Signs of Deployment) SHOCK PACK (IF PRESENT)

Connector

Scaffold Hook

APP M O B I L E

Webbing Rope

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Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

NOTES

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MOBILE APP

Inspection Form Revision Date: 9 th September, 2021

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customercare@kstrong.com

MOBILE APP

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INSPECTION FORM VERTICAL LIFELINES

Unrivaled Safety.

Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

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Kernmantle Rope

Twisted Rope

Unrivaled Safety.

Vertical Lifeline (Rope, shock absorber, positioning device & connectors)

Pass Fail Note

LABELS & MARKINGS

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented

Connector

Pass Fail Note

HARDWARE

Connector (Self-Closing & Locking) Hook Gate / Rivets Corrosion Pitting / Nicks

Rope Grab

Shock Absorber

Pass Fail Note

Broken / Missing / Loose Stitching Termination (Stitch, Splice, or Swage) Excessive Wear (Fraying or Broken Strands) Cuts / Burns / Holes Kinks Separation / Bird-Caging MATERIAL (ROPE OR CABLE) Cover / Shrink Tube (Don’t Cut or Remove) Damage / Fraying / Broken Stitching Impact Indicator (Signs of Deployment) SHOCK PACK (IF PRESENT) Locks on lifeline automatically Moves freely when disengaged No visible damage, rust or corrosion ROPE GRAB (IF PRESENT)

Rope

APP M O B I L E

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Pass Fail Note

NOTES

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

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MOBILE APP

Inspection Form Revision Date: 9 th September, 2021

customercare@kstrong.com

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INSPECTION FORM MICRON SERIES

Unrivaled Safety.

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

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Unrivaled Safety.

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented LABELS & MARKINGS Cover / Shrink Tube (Don’t Cut or Remove) Damage / Fraying / Broken Stitching Impact Indicator (Signs of Deployment) SHOCK PACK (IF PRESENT)

Pass Fail Note

Attachment Point

Housing

Pass Fail Note

Screws

Shock Pack

HOUSING

Pass Fail Note

Attachment Point Nuts / Bolts / Rivets / Screws Evidence of Damage (Dents / Cracks / Rust)

Load Indicator

Connectors

LIFELINE (WEB OR CABLE)

Pass Fail Note

Connector (Self-Closing & Locking) Impact Indicator Hook Body / Rivets Corrosion Pitting / Nicks Termination (Stitch, Splice, or Swage) Cuts / Fraying / Broken Stitching Excessive Wear Cable Separating / Bird-Caging Entire Length Retracts Smoothly Test Braking / Locking Function CONNECTORS

APP M O B I L E

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NOTES

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

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MOBILE APP

Inspection Form Revision Date: 29 th April, 2022

customercare@kstrong.com

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INSPECTION FORM TRIPOD

Unrivaled Safety.

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Manufacturer: Model #: Description: Unique Identification number - UID #: Date of Manufacture:

Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

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Unrivaled Safety.

Tripod Head

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented LABELS & MARKINGS

Pass Fail Note

Tripod Legs

TRIPOD HEAD

Pass Fail Note

Retrieval Block

Pulleys in place and rotate freely Locking Pins function and secured in place Eyebolt Attachments points in place Nuts, Bolts & Wire lanyards Securely attached No Visible damage

Winch

TRIPOD LEGS

Pass Fail Note

Legs Telescopic in and out freely Legs Extended and locked into position Pins lock into place Type 3 & Winch brackets easily attach to Tripod mounting Brackets Tripod set in position and firmly on surface Legs Locked in place Attachment Pins & wire lanyards undamaged Legs Straight with no signs of deformation or distortion Mounting Brackets secure Adjustable Webbing Strap and Karabiner free of damage Rubber Foot Pads pivot freely FUNCTION

Note: Refer separate Checklists for Retrieval Block and Winch

APP M O B I L E

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NOTES

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

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MOBILE APP

Inspection Form Revision Date: 20 th December, 2021

customercare@kstrong.com

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INSPECTION FORM TYPE 3 RESCUE RETRIEVAL

Unrivaled Safety.

Manufacturer: Model #: Description: Serial #: Lot #: Length: Stainless Steel

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

Date of Manufacture:

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Unrivaled Safety.

Galvanized Steel

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented LABELS & MARKINGS Attachment point Swivels Nuts, Bolts, Rivets & Screws Secured No Visible damage to casing HOUSING

Pass Fail Note

Attachment Point

Screws

Housing

Pass Fail Note

WIRE CABLE

Pass Fail Note

Retrieval Handle

Pin

Cuts, Fraying, or Broken wires Excessive wear Damage to Termination of Wire

CONNECTOR

Pass Fail Note

Swivel Steel Snap Hook

Self Closing & locking Impact Indicator not deployed

Impact Indicator

Hook Body Rivets Corrosion or Pitted

APP M O B I L E

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FUNCTION RESCUE MODE

Pass Fail Note

NOTES

Pin freely Pulls out & engages Rescue Mode Cable Extracts & Retracts when handle is Rotated

FUNCTION SRL MODE

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

Pin Pulls out / Push handle to engage SRL Mode Cable Freely moves in & out when pulled and released Test Braking / Locking Function

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MOBILE APP

Inspection Form Revision Date: 30 th Dec, 2021

customercare@kstrong.com

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INSPECTION FORM WINCH

Unrivaled Safety.

Manufacturer: Model #: Description: Serial #: Lot #:

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Unrivaled Safety.

Owner/Company: Date of Inspection: In-Service Date: Inspector’s Name: Signature:

Date of Manufacture:

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Length: Cable

Unrivaled Safety.

Stainless Steel

Galvanized Steel

Galvanized Steel Wire Rope

Labels (Intact & Legible) Appropriate Standards Markings Visible Inspections Are Current / Up-to-date Date of First Use Documented LABELS & MARKINGS Attachment point Swivels Nuts, Bolts, Rivets & Screws Secured No Visible damage to casing HOUSING

Pass Fail Note

Pass Fail Note

Handle

Mounting Bracket

Casing

WIRE CABLE

Pass Fail Note

Cuts, Fraying, or Broken wires Excessive wear Damage to Termination of Wire

APP M O B I L E

Self Closing & locking Hook Body Rivets Corrosion or Pitted CONNECTOR

Pass Fail Note

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NOTES

FUNCTION

Pass Fail Note

KStrong Compass™ App Intelligently Track & Inspect All Your Assets from Any Location

Cable Extracts & Retracts when handle is Rotated Other

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MOBILE APP

Inspection Form Revision Date: 30 th Dec, 2021

customercare@kstrong.com

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