MONTHLY CHECKLIST FOR SAFETY HARNESS Company name: Hydro one pte ltd 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Name & Signature of Competent Inspector: _________________________________________ Date: __________________________________________ CAN USE Tags & labels Snap Hook Carbineer Buckle Attachment D-rings Back straps Shoulder straps Stitching Back straps Leg straps Body Harness Serial Number Chest straps NO Shoulder straps Webbing Lanyard condition Next inspection date:_________________ Shock Energy Absorber NOT OK (can’t use) Leg straps × Chest straps OK (can use) / Inspection Date: ________________