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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