Table 2 – Inspection and Maintenance Log
Inspection Date: Inspected By:
Components: Inspection: (See Section 1 for Inspection Frequency) User
Competent
Person
1
Variable Davit System
(Figure 2)
Inspect the entire system for damage, deformation, corrosion, and rust. Look
for cracks, bends, dents, or wear that could affect strength and operation of the
system.
Inspect all fasteners for damage or corrosion. Tighten as necessary.
Inspect all moving parts for chips, cracks, breaks, or worn areas that can cause
malfunction during operation.
Verify that all adjustment points (pins, bolts, tri-screws, adjusting screws, etc.)
are in full functional condition and are adjusted properly.
Anchor Connection
Points
Ensure Anchor Connection Points are free of corrosion, cracks, or other
imperfections that my cause malfunction during operation.
Retrieval Devices Ensure Winches and Self-Retracting Devices are securely pinned in place and
that mounting brackets and adapter brackets are secure. Mounting brackets and
adapter brackets should be free of cracks, bends, corrosion, etc.
Labels
(Figures 10 and 11)
Verify that all labels are present and fully legible.
PFAS and Other
Equipment
Additional Personal Fall Arrest System (PFAS) equipment, winches, Self-
Retracting Devices (SRDs), etc. that are used with the system should be
inspected per the manufacturer’s instructions.
Serial Number(s): Date Purchased:
Model Number: Date of First Use:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
Corrective Action/Maintenance: Approved By:
Next inspection due:
Date:
1 Competent Person: One who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary,
hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them.
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