INSPECTION FORM Vertical Lifeline Serial #

Owner/Company:

Date of First Use:

Inspector:

Date of Manufacture:

Date of Inspection:

LABELS & MARKINGS

Pass

Fail

Label (Intact & Legible) Appropriate ANSI/OSHA/CSA Markings Inspections are Current / Up-to-Date Date of First Use CONNECTORS

Pass Fail

Function of Connector Locking Gate Body of Hook Corrosion

Connector

Pitting/Nicks SHOCK PACK (IF SUPPLIED)

Pass Fail

Termination

Integrity of Cover Damage / Fraying / Broken Stitching Signs of Deployment LIFELINE (ROPE OR WIRE ROPE) Broken / Missing / Loose Stitching

Shock Pack Pass Fail

Label

Termination (Stitch, Splice, or Swage) Impact Indicator Cuts / Burns / Holes Melting Cable Sepa rating / Bird Caging NOTES

FOR MORE INFORMATION CONTACT US AT: 1-800-494-1840 or visit our website: maltadynamics.com

Lifeline

Vertical Lifeline - Inspection Form.pdf

Signs of Deployment. SHOCK PACK (IF SUPPLIED) Pass Fail. Page 1 of 1. Vertical Lifeline - Inspection Form.pdf. Vertical Lifeline - Inspection Form.pdf. Open.
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