close
lumiform

Lumiform

Mobile audits & inspections
Get AppGet App

Health & Safety Equipment Inspection

Rated 4.8/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before
  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 5,000 expert-proofed templates
Share now

Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 4.8/5 stars on Capterra
App StorePlay Store

Health & Safety Equipment Inspection

What type of engineer is this?

PPE (personal issue) CLIMBING

Body Harness

Serial Number

Manufactures Date

Small Karabiners - qty x5

Verify Qty

Large Karabiners

Cows Taill

Serial Number

Manufacturers Date

Rope Grab

20mm Re-usable Eyebolts

Verify Qty

12mm Eyebolts

Verify Qty

15m Kermantle Rope

Serial Number

Manufacturers Date

10m Kermantle Rope

Serial Number

Manufacturers Date

5m Kermantle Rope

Serial Number

Manufacturers Date

Goggles

Hard Hat

Manufacturers Date

Safety Boots

Retractable Safety Line

Serial Number

Manufacturers Date

Adjustable Webbing Strap - Various lengths

Verify Qty

Continuous Loop Webbing Slings

Verify Qty

10m Blue Web Strap with Ratchet

Other Safety Equipment

Extension Ladder Size

Fit for Purpose

Extension Roof Ladder

Combination Ladders/Step Ladders

Microlite

Laddermate

Ladder Spike

Crawl Board(s)

Chimney Kit/Strop

Serial Number

Manufacturers Date

Soft Slings (part of chimney kit)

Knee Pads

Gloves

Ear Protection

Eye Protection

Hi-Viz Vest

Dust Mask

Gravel Bag

Ladder Clamps

Voltage/Metal and Stud Detector

Cones x2

Hazards Analysis Form

SAT/DAT Equipment

Alternate ladder size

Fit for Purpose

8 Rung Roof Ladder Ext Piece x2 (DAT)

Conservatory Bearer Bar x2 (DAT)

Ladder Lock x2 (DAT)

Ridgegear Multi Task Comfort Harness - RGH16

Serial Number

Manufacturers Date

Camp Silver Star Helmet

Serial Number

Manufacturers Date

Ridgegear 11mm Kermantle rope x 50mtrs - RGA12R

Serial Number

Manufactures Date

Ridgegear Rocker - RGA14 - Lockable (back up device)

Serial Number

Camp 10mm Delta Maillon

Verify Qty

Camp Safety AXEL (pn 1686) belay device

Petzl 1mtr x 10mm wire rope (protected) min SWL 250kgs

Serial Numbers

30mtr x 7mm Static ACC. Cord

Camp Rope protectors

Verify Qty

Camp Single pulley blocks - fixed sheave for 11mm rope

Verify Qty

Camp Kit bags - 30ltr rucksack

Notes, Coaching and Comments

Have you made a record of any/all items that need replacing?

Please list items that need replacing/ordering and supply reasons and photographs where applicable.

(check name not set)

Add media

ENGINEERS DECLARATION - I confirm

That the above equipment has been issued to and is used by me.

That no other equipment is used without authorisation, and a full inspection has been carried out by the SHS - PPE & Equipment Examiner.

Engineer's Signature

PERSON CARRYING OUT THE INSPECTION

TM's Signature

NOTE - if any items are found defective they are to be isolated and replaced as soon as possible