Your DetailsName* First Last Email* Select your course Confined Space Training Work Safely at Heights EquipmentDescription* Serial number* Remove from service date* Next inspection date* Complies with Australian Standard AS 1891.1* Yes No N/A WebbingSelect Serviceable Condition: Yes, No or N/ACuts or tears* Yes No N/A Abrasion damage especially where there is contact with hardware* Yes No N/A Excessive stretching* Yes No N/A Damage due to contact with heat, corrosives, or solvents* Yes No N/A Deterioration due to rotting, mildew, or ultraviolet exposure* Yes No N/A Activation of fall indicators if fitted* Yes No N/A D-ringsSelect Serviceable Condition: Yes, No or N/AExcessive ‘vertical’ movement of the straight portion of the D-ring where it is retained by the webbing, so that the corners between the straight and curved sections of the D become completely exposed.*NOTE: Excessive vertical movement of the ring in its mounting can allow the nose of larger snap hooks to become lodged behind the straight portion of the D, in which position the snap hook can often accidentally ‘roll out’ of the D under load. Yes No N/A Cracks, especially at the intersection of the straight and curved portions* Yes No N/A Distortion or other physical damage of the D-ring* Yes No N/A Excessive loss of cross-section due to wear* Yes No N/A Buckles and AdjustersSelect Serviceable Condition: Yes, No or N/ADistortion of other physical damage* Yes No N/A Cracks and forging laps where applicable* Yes No N/A Bent tongues* Yes No N/A Open rollers* Yes No N/A SewingSelect Serviceable Condition: Yes, No or N/ABroken, cut or worn threads* Yes No N/A Damage or weakening of threads due to contact with heat, corrosives, solvents or mildew* Yes No N/A Fault ReportInsert DetailsSign & DateSignature*Date of repair DD slash MM slash YYYY
