Fall Protection Equipment Use Form
This form provides the complete checklist for your fall protection equipment. The checklist is used for the inventory of your equipment ensuring the safety of your machine.
Fall Protection Equipment Use Form
This form provides the complete checklist for your fall protection equipment. The checklist is used for the inventory of your equipment ensuring the safety of your machine.
Date
Name
Specific Area Equipment Will Be Used
Inventory - Check Items To Be Used
Equipment inventory being used must be inspected and checked off prior to use as per below:
Harness being used?
if the answer is "oneOf [Yes]"
Harness
Lanyard being used?
if the answer is "oneOf [Yes]"
Lanyards
Tie-Off Adaptor being used?
if the answer is "oneOf [Yes]"
Tie-Off Adaptors
Rope Grabs / Carabiner being used?
if the answer is "oneOf [Yes]"
Rope Grabs / Carabiner
SRL being used?
if the answer is "oneOf [Yes]"
Self-Retracting Lifelines (SRL)
Lifeline being used?
if the answer is "oneOf [Yes]"
Lifelines
Trained and understand proper use of FPE (Fall Protection Equipment).
Notified Supervisor of use
Equipment is good for use
Signature
Click here to sign
Source: Delong - Clinton (Community Member)