SAFEWAZE 021-4055 Premier Sliding Beam Anchor Instruction Manual

User Manual

021-4055

Premier Sliding Beam Anchor
Instruction Manual

ANSI Z359.18-2017 Type A, OSHA 1910.140, OSHA 1926.502
This manual is intended to meet the manufacturer’s instructions as required by ANSI Z359 and should be used as part of an employee training program as required by OSHA.

User Information

Date of First Use:___
Serial#:____
Trainer:____
User:__

220-00055

WARNING

This product is part of a personal fall arrest, work positioning, or rescue system. The manufacturer’s instructions must be provided to users of this equipment. The user must follow the manufacturer’s instructions for each component of the system. The user must read and understand these instructions before using this equipment. Manufacturer’s instructions must be followed for proper use and maintenance of this equipment. Alterations to this product, misuse of this product, or failure to follow instructions may result in serious injury or death.

These instructions must be provided to any person utilizing this equipment. The worker must read and understand the manufacturer’s instructions for this, and all other components of the complete Fall Protection System. It is expected that all personnel be fully trained in the safe installation and use of this equipment. These instructions must be followed for the proper use, maintenance, and inspection of this equipment. These instructions must be kept and made available to worker’s at all times. Any alteration, misuse, or use of this equipment outside the scope of the manufacturer’s instructions, may result in serious injury or death. A comprehensive Fall Protection Plan must be kept on file and available to all employees at all times.

Inspect all components of this system prior to each use and at least annually. Inspect in accordance with the user instructions. If this equipment is exposed to the forces of a Fall Arrest or Impact Force, the equipment must be removed from service and inspected by a Competent Person prior to being used again.

This product is part of a complete fall protection system. A PFAS is typically composed of a Full Body Harness, Anchorage, and a Connecting Device. Connecting Devices used with Safewaze Beam Anchors are Energy Absorbing Lanyards (EALs) or a Self Retracting Lifelines (SRLs).

Personnel must always maintain 3 points of contact during climbing operations. If utilizing components from different manufacturers, ensure that all components are compatible and meet all applicable standards, codes, and requirements. Before using this equipment, consult with a Competent and/or Qualified Person.

Consult your doctor if there is reason to doubt your fitness to safely absorb the shock from a fall arrest. Age and fitness seriously affect a worker’s ability to withstand falls. Pregnant women or minors must not use this equipment. Failure to heed this warning may result in serious injury or death.

Never exceed the maximum allowable capacity of your fall protection equipment. Never exceed the maximum free fall distance of your fall protection equipment.

Do not use this system or any other part of a PFAS that fails pre-use or other scheduled inspections. For any questions or concerns regarding the use of this equipment for an application not specified in this manual, contact Safewaze technical support.

Additional precautions should be used when working in environments of high heat, electrical hazards, chemical hazards, explosive or combustible chemicals, toxic materials, sharp edges, or where equipment used above could topple onto a user below or their fall protection equipment.

Use of a body belt for fall protection applications is not permitted. Only use an approved Full Body Harness.

Make considerations for eliminating or minimizing all swing fall hazards. Swing falls occur when the anchor is not directly above the location where a fall occurs. Always work as close to in line with the anchor point as possible. Swing falls significantly increase the likelihood of serious injury or death in the event of a fall.

Contact Safewaze if you have questions regarding compatibility of this equipment that are not covered in this manual. Do not alter or misuse this equipment. Some subsystem components could affect the performance and the operation of this equipment. Do not anchor this product to moving machinery, or hazards that have chemical, electrical or gaseous characteristics. Failure to comply with this warning could result in serious injury or death.

Do not misuse this equipment.

Equipment designated for fall protection must never be used to lift, hang, support or hoist tools or equipment unless specifically certified for such use.

Operational temperature for Safewaze anchors: -30°F (-34°C) to 130°F (54°C)

Anchors that are exposed to fall arrest forces MUST IMMEDIATELY be removed from service and destroyed.

Do not throw away these instructions!
Read and understand these instructions before using equipment!

IMPORTANT

Never exceed the stated maximum capacity of your fall protection equipment.

Never use equipment that has failed pre-use or other type of inspection. Equipment must be removed from service if inspection reveals any defects or damage.

User must ensure compatibility of components if using fall protection equipment produced by more than one manufacturer.

Never alter or modify fall protection equipment. Unauthorized modification or alteration of fall protection equipment can result in serious injury or death.

It is essential that the users of this type of equipment receive proper training and instruction including detailed procedures for the safe use of such equipment in their work application. ANSI/ASSP Z359.2, Minimum Requirements for a Comprehensive Managed Fall Protection Program, establishes guidelines and requirements for an employer’s managed fall protection program including policies, duties and training; fall protection procedures; eliminating and controlling fall hazards; rescue procedures; incident investigations; and evaluating program effectiveness.

Record identification information before using this product. Identification information may be found on the equipment label (See Figure 7). This information should be recorded in the “Inspection Form” located at the back of this manual (Section 25.0).

Questions regarding the use, care, or suitability of this equipment for your application? Contact Safewaze.

USER INSPECTION, MAINTENANCE AND STORAGE OF EQUIPMENT

Users of personal fall arrest systems shall at a minimum, comply with all manufacturer instructions regarding the inspection, maintenance and storage of the equipment. The user’s organization shall retain the manufacturer’s instructions and make them readily available to all users. See ANSI Z359.2, Minimum Requirements for a Comprehensive Managed Fall Protection Program, regarding user inspection, maintenance and storage of equipment.

1. In addition to the inspection requirements set forth in the manufacturer’s instructions, the equipment shall be inspected by the user before each use and additionally by a competent person, other than the user, at interval of no more than one year for:
   • Absence or illegibility of markings.
   • Absence of any elements affecting the equipment form, fit or function.
   • Evidence of defects in, or damage to, hardware elements including cracks, sharp edges, deformation, corrosion, chemical attack, excessive soiling, abrasion, alteration, needed or excessive lubrication, excessive aging and excessive wear.

2. Inspection criteria for the equipment shall be set by the user’s organization. Such criteria for the equipment shall equal or exceed the criteria established by this standard or the manufacturer’s instructions, whichever is greater.

3. When inspection reveals defects in, damage to, or inadequate maintenance of equipment, the equipment shall be permanently removed from service or undergo adequate corrective maintenance by the original equipment manufacturer or their designate before return to service.

MAINTENANCE AND STORAGE

1. Maintenance and storage of equipment shall be conducted by the user’s organization in accordance with the manufacturer’s instructions. Unique issues, which may arise due to conditions of use, shall be addressed with the manufacturer.
2. Equipment, which is in need of, or scheduled for, maintenance shall be tagged as unusable and removed from service.
3. Equipment shall be stored in a manner as to preclude damage from environmental factors such as temperature, light, UV, excessive moisture, oil, chemicals and their vapors or other degrading elements.

1.0 INTRODUCTION

Thank you for purchasing a Safewaze Anchorage Connector. This manual must be read and understood in its entirety and used as part of an employee training program as required by OSHA or any applicable state agency. This manual and any other instructional material must be available to the user of the equipment. The user must understand how to safely and effectively use these anchors, and all fall protection equipment used in conjunction with the anchors.

2.0 PURPOSE

This product is part of a personal fall arrest, fall restraint, work positioning, or rescue system.

Safewaze Fall Protection equipment must be installed and used only by individuals trained in its proper application.

IMPORTANT: The 022-4055 Premier Sliding Beam Anchor is designed for connection of Fall Protection Equipment ONLY! Do not connect lifting equipment or engage in material lifting operations with this Anchorage Connector!

3.0 APPLICABLE SAFETY STANDARDS

When used according to instructions, Safewaze Anchors meet all applicable ANSI Z359.18 standards and OSHA regulations for fall protection. Safewaze anchorage connectors have been tested in compliance with ANSI/ASSE Z359.7. It should be cautioned that ANSI compliance and testing covers only the hardware and does not extend to the anchorage and substrate to which the anchorage connector is attached. Applicable standards and regulations depend on the type of work being done, and may include state-specific regulations. Refer to local, state, and federal (OSHA) requirements for additional information concerning the governing of occupational safety regarding Personal Fall Arrest Systems (PFAS).

4.0 WORKER CLASSIFICATIONS

Understand the definitions of those who work in proximity of or may be exposed to fall hazards.

Qualified Person: “Qualified Person” means one who, by possession of a recognized degree, certificate, or professional standing, or who by extensive knowledge, training, and experience, has successfully demonstrated his ability to solve or resolve problems relating to the subject matter, the work, or the project.

Competent Person: “Competent Person” means 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.

Authorized Person: “Authorized Person” means a person approved or assigned by the employer to perform a specific type of duty or duties or to be at a specific location or locations at the job site.

It is the responsibility of a Qualified or Competent person to supervise the job site and ensure safety regulations are complied with.

5.0 FALL CLEARANCE

Fall Clearance: There must be sufficient clearance below the anchorage connector to arrest a fall before the user strikes the ground or an obstruction. When calculating fall clearance, account for a MINIMUM 2′ safety factor, deceleration distance, user height, length of lanyard/SRL, and all other applicable factors. (See Figure 1)

It is important to make sure that adequate clearance is available. Free Fall, Maximum Arrest Distance, Height of Worker, and current clearance above the next fall hazard must all be considered in the Fall Clearance calculation.

5.1 DETERMINE REQUIRED FALL CLEARANCE

Determining fall clearance is critical in understanding the correct connecting device to use. The lower the clearance height, the less options available to connect to the anchor point with. To Determine Fall Clearance several factors must be considered:

Length of Anchorage connector (LA)

Length of Connecting device (LC)

Maximum Arrest Distance of connecting device (MAD)

Height of Worker (HW)

Safety Factor (SF) – (Includes harness stretch, typically 2′)

Distance from Anchor Point to next closest obstruction (DAP)

Using the above information Fall Clearance (FC) can be determined with the following formula FC (from anchor point)=LA+LC+MAD+HW+SF

FIGURE 1- DETERMINE REQUIRED FALL CLEARANCE

For all applications: worker weight capacity range
(including all clothing, tools, and equipment) is 130-310 lbs. per ANSI Z359.18-2017
Weight capacity per OSHA is up to 420 lbs.

***Diagram shown is an example fall clearance calculation ONLY.

Fall Clearance Diagram

1. Required distance from Anchorage (18′ total)
2. Lanyard Length (6′ Total)
3. Deceleration distance (4′ total)
4. Worker Height (6′ average)
5. Safety factor (2′ total)

5.2 SWING FALLS

An anchorage point located in a position that is not directly over the user’s fall location results in a swing fall (See Figure 2). Swing falls may result in the user striking an object with enough force to cause serious injury. Greater clearance is needed to ensure safety during a swing fall as vertical fall distance will be greater than a fall originating directly below the anchorage point.

FIGURE 2 – SWING FALLS

6.0 LIMITATIONS & REQUIREMENTS

When installing or using this equipment always refer to the following requirements and limitations.

– A competent person shall train users on this equipment in accordance with OSHA and ANSI.
– Never exceed a free fall distance of 6 ft. A free fall of more than 6 ft could cause excessive arrest forces that could result in serious injury or death.
– Safewaze anchors have a maximum capacity of:
ANSI 310 lbs (140.6 kg) including tools, clothing, etc…, OSHA up to 420 lbs. (190.51 kg) including tools, clothing, etc…
– Anchorages for attachment of Personal Fall Arrest System shall support a minimum of 5,000 lbs or be designed with a safety factor of two by a Qualified Person.
– All Safewaze full body harnesses must IMMEDIATELY be removed from service if subjected to fall arrest forces.
– Safewaze full body harnesses shall be inspected by the end user prior to each usage and by a Competent Person other than the user at least annually. These annual inspections shall be documented.

7.0 CAPACITY

Safewaze Sliding Beam Anchors are designed for the following weight capacities: (Maximum capacities include clothing, tools, and equipment)

ANSI Z359:   130-310 lbs max
OSHA:           Up to 420 lbs max

8.0 ANCHORAGE

It must be ensured the anchorage(s) to which the Safewaze anchorage connector is connected to:

• i) can withstand 5,000 pounds without failure, except that lower strengths are acceptable when permitted by applicable legislation
• ii) are certified by a professional engineer as having the required strength for fall arrest or travel restraint, as applicable; or
• iii) Safewaze may provide specifications of allowable materials including the minimum shapes, sizes, and geometry of structural elements to which the anchorage connector may be fastened. A qualified person shall approve these specifications

Anchorages selected for fall arrest systems shall have a strength capable of sustaining static loads applied in the directions permitted by the system of at least:

1. 5,000 lbs. (22.2 kN) for non-certified anchorages, or
2. Two times the maximum arresting force for certified anchorages.

When more than one fall arrest system is attached to an anchorage, the strengths set forth in (1) and (2) above shall be multiplied by the number of systems attached to the anchorage.

From OSHA 1926.502 and 1910.66
Anchorages used for attachment of personal fall arrest systems shall be independent of any anchorage being used to support or suspend platforms, and capable of supporting at least 5,000 lbs (22.2 kN) per user attached, or be designed, installed, and used as part of a complete personal fall arrest systems which maintains a safety factor of at least two, and is under the supervision of a qualified person.

9.0 INSPECTION FREQUENCY

Either the Authorized Person (User), or the Rescuer must inspect this equipment before each use. Annual inspections must be completed by a Competent Person other than the user. Results must be documented.

10.0 RESCUE PLAN

When using this equipment, employers must create a rescue plan, and provide the means to implement the plan. This plan must be communicated to equipment users, authorized persons, and rescuers. Rescue operations require specialized equipment beyond the scope of this manual. See ANSI Z359.4-2013 for specific rescue information.

11.0 COMPATIBILITY OF COMPONENTS

Unless otherwise noted, Safewaze equipment is designed for use with Safewaze approved components and subsystems only. Substitutions or replacements made with non-approved components or subsystems may jeopardize compatibility of equipment and may affect safety and reliability of the complete system.

IMPORTANT: Read and follow manufacturer’s instructions for associated components and subsystems in your personal fall arrest system.

12.0 COMPATIBILITY OF CONNECTORS

Connectors are compatible with connecting elements when they have been designed to work together in such a way that their sizes and shapes do not cause their gate mechanisms to inadvertently open regardless of how they become oriented. Connectors (hooks, carabiners, and D-rings) must be capable of supporting at least 5,000 lbs. (22.2 kN). Do not use equipment that is not compatible. Non-compatible connectors may unintentionally disengage (See Figure 3). Connectors must be compatible with the anchorage or other system components (See Figure 4). Connectors must be compatible in size, shape, and strength. Self-locking snap hooks and carabiners are required by ANSI Z359 and OSHA guidelines. Contact Safewaze if you have any questions about compatibility.

NOTE: SOME SPECIALTY CONNECTORS HAVE ADDITIONAL REQUIREMENTS. CONTACT SAFEWAZE WITH QUESTIONS.

FIGURE 3 – UNINTENTIONAL DISENGAGEMENT

1 – Non-compliant part
2 – gate presses against non-complaint part
3 – gate opens
4 – parts disengage

Using a connector that is undersized or irregular in shape (1) to connect a snap hook or carabiner could allow the connector to force open the gate of the snap hook or carabiner. When force is applied, the gate of the hook or carabiner presses against the non-compliant part (2) and forces open the gate (3). This allows the snap hook or carabiner to disengage (4) from the connection point.

13.0 MAKING CONNECTIONS

Snap hooks and carabiners used with this equipment must be double locking and/or twist lock. Ensure all connections are compatible in size, shape and strength. Do not use equipment that is not compatible. Ensure all connectors are fully closed and locked.

Safewaze connectors (snap hooks and carabiners) are designed to be used only as specified in each product’s user instructions. See Figure 4 for examples of inappropriate connections. Do not connect snap hooks and carabiners:

• To a D-ring to which another connector is attached.
• In a manner that would result in a load on the gate (with the exception of tie-back hooks). NOTE: Large snap hooks must not be connected to objects which will result in a load on the gate if the hook twists or rotates, unless the snap hook complies with ANSI Z359.12 and is equipped with a 3,600 lbs. (16 kN) gate. Check the marking on your snap hook to verify its compatibility.

FIGURE 4 – INAPPROPRIATE CONNECTIONS

14.0 SPECIFIC ANCHOR APPLICATIONS

Personal Fall Arrest: Safewaze Anchors are designed as an anchor point to support a maximum of 1 Personal Fall Arrest System (PFAS) when utilized for fall protection applications. The structure to which the anchor is attached must withstand loads applied in the directions permitted by the system of at least 5,000 lbs. Maximum allowable free fall is 6′.

Restraint: Safewaze Anchors are authorized for use in Restraint applications. The structure to which the anchor is attached must withstand loads applied in the directions permitted by the system of at least 1,000 lbs NO free fall is permitted. Restraint systems may only be used on surfaces with slopes up to 4 / 12 (vertical / horizontal). For Restraint applications, the allowable attachment points to harness are Dorsal D-ring, Chest D-ring, Side D-rings, and Shoulder D-rings.

Work Positioning: Safewaze Anchors are authorized for use in Work Positioning applications. Work Positioning allows a worker to be supported during suspension while freeing both hands to conduct work operations. The structure to which the Anchor is attached must withstand loads applied in the directions permitted by the system of at least 3,000 lbs. Maximum allowable free fall is 2′. For positioning applications, the allowable attachment points to harness are the Side D-rings.

Rescue/Confined Space: Safewaze Anchors are authorized for use in Rescue/Confined Space applications. Rescue systems are utilized to safely recover a worker from a confined location or after exposure to a fall. Composition of rescue systems can vary based upon the type of rescue involved. The structure to which the Anchor is attached must withstand loads applied in the directions permitted by the system of at least 3,000 lbs. NO free fall is permitted. For rescue applications, the allowable attachment points to harness are Dorsal D-ring, Chest D-ring and Shoulder D-rings.

All above referenced applications have a worker weight capacity range of:
ANSI 310 lbs. / OSHA Up to 420 lbs. (including all clothing, tools, and equipment).

15.0 ANCHOR COMPONENTS

FIGURE 5 – ANCHOR COMPONENTS

021-4055

Anchor Components

|

Material

---|---

A

| Support Bar | Aluminum
B| Clamps|

Aluminum

C

| D-ring| Stainless Steel / Plated Steel
D| Jaws|

Plated Steel

E

| Adjustment Levers | Steel
F| Label Cover|

Polyester

16.0 INSTALLATION

TABLE 1 – SUITABLE I-BEAM DIMENSIONS

Suitable Beam Dimensions

021-4055

| 3-1/2” to 14” Width|

Up to 1-1/4” Flange Thickness

021-4055 ← – – – – 3-1/2″ to 14″ – – – – →

1. 1-1/4″ Max Flange Thickness

FIGURE 6 – INSTALLATION
021-4055

Dwg. 1                                          Dwg. 2

Dwg. 3                                           Dwg. 4

Dwg. 5

1. The 021-4055 is for use in a horizontal orientation only. It is not designed for use in vertical applications.
2. The work location should be free of debris, and other materials or equipment that could interfere with the proper operation of this equipment.
3. Inspect the steel beam to which the anchor will be attached. User should inspect for the following hazards. These hazards include, but are not limited to, excessive corrosion, cracks, severe rust, excessive paint, spray applied fire proofing, electrical hazards, etc…
4. The 021-4055 can be installed on beams 3-1/2″ to 14″ in width, with a maximum flange thickness of 1-1/4″. User must inspect the 021-4055 prior to each use. If damage or defects such as, but not limited to, excessive corrosion, deformation of any component, improper function of the adjustment levers, fall protection connection point damaged or missing, chemical or excessive heat exposure are present, the anchor MUST BE REMOVED FROM SERVICE.
5. After inspection of the installation location, adjust the Beam Anchor in to fit the beam dimensions. Ensure the steel I-Beam is within the acceptable dimensions for the Beam Anchor being utilized (See Table 1). Width adjustment is made by depressing the Adjustment Levers on each Clamp Assembly and sliding the assemblies in or out to fit beam dimensions (See Figure 6, Dwg.1 and Dwg. 2).
6. With the anchor properly fitted to the I-Beam, the user can connect their fall protection device to the anchor (See Figure 6, Dwg. 3).
7. The 021-4055 is designed to slide along the beam in unison with the user’s movement. It can be used in overhead or foot level tie off applications (See Figure 6, Dwgs. 4 & 5).

17.0 APPLICATION LIMITS

Precautions should be taken in the design and installation of a PFAS in order to avoid hazards such as thermal, chemical, or electrical hazards. Avoid moving machinery, sharp and/or abrasive edges, and any other hazard that could damage or degrade components of the PFAS.

18.0 MAINTENANCE, CLEANING, & STORAGE

18.1 MAINTENANCE

Remove the Safewaze anchor from use if subjected to fall arrest forces or inspection reveals an unsafe or defective condition. If unsafe or defective condition is found, dispose of the anchor as recommended in Section 23.0.

18.2 CLEANING

Anchor can be cleaned with water and mild soap if necessary. User should remove all dirt, possible corrosives, and contaminants from the anchor prior to, and after each use. Never use any type of corrosive substance to clean the anchor. Excess water should be blown out with compressed air. Hardware can be wiped off with a clean, dry cloth.

18.3 STORAGE

When not in use, store the anchor in a cool dry area where it will not be exposed to extreme light, extreme heat, excessive moisture, or possibly corrosive chemicals or materials. Anchor should be hung on a rack or peg or stored flat on a shelf.

19.0 INSPECTION

• Safewaze Anchors shall be inspected prior to each use by the user, and at least annually by a Competent Person other than the user. Annual inspections shall be documented. Severity of conditions during use may necessitate increased frequency of documented inspections.
• Anchors that fail inspection MUST be removed from service.
• Prior to each use, inspect the anchor for deficiencies or damage, including, but not limited to, sharp edges, rough edges, deformations, corrosion, pits, burrs, chemical exposure, extreme heat exposure, kinked, bird nested, or otherwise damaged cable, and damaged, missing or illegible labels. If any deficiencies or defects are found, the anchor must IMMEDIATELY be removed from service.
• The anchor must be inspected at least annually by a Competent Person other than the user.
• Competent person inspections must be recorded in the inspection log included in this manual and on the inspection grid label on the anchor.

20.0 WARRANTY

Safewaze warrants its products are free from defects in materials and construction under normal use and service. Liability is not accepted for abuse, modification, improper use, destructive activity, and contaminated exposure.

21.0 UNSAFE OR DEFECTIVE CONDITIONS

Equipment inspectors must be trained to look for damage to components of the Beam Anchor. If inspection reveals an unsafe or defective condition remove the Beam Anchor from service. Refer to the Inspection Form (Section 25.0) of this manual for inspection specifications.

22.0 PRODUCT LIFE

The working life of Safewaze anchors are determined by work conditions, care and inspection provided. As long as the anchor passes inspection, it may remain in service.

23.0 DISPOSAL

Dispose of the Safewaze anchor if it has experienced fall arrest forces or inspection reveals an unsafe or defective condition. Before disposing of the anchor, ensure it is marked as damaged and unsafe for use.

24.0 LABELING

FIGURE 7 – LABELING

225 Wilshire Ave SW
Concord, NC 28025
USA
800-230-0319
www.safewaze.com

XXXXXXX
S/N

PREMIER SLIDING BEAM ANCHOR:
PART#: 021-4055

Fits beams 3-1/2″ to 14″ width, with flanges up to 1-1/4″
Capacity: ANSI 130-310 lbs (140.61 kg) OSHA Up to 420 lbs (190.5 kg)

MUST FOLLOW ALL MANUFACTURER’S
INSTRUCTIONS INCLUDED WITH THIS EQUIPMENT

DO NOT REMOVE THIS LABEL

MUST BE INSPECTED BEFORE EACH USE.
MUST BE INSPECTED BY A COMPETENT PERSON AT LEAST ANNUALLY FROM MFG DATE.
ANY UNIT THAT HAS BEEN SUBJECTED TO FALL ARREST FORCES MUST BE REMOVED FROM SERVICE.
MINIMUM BREAKING STRENGTH: 5,000 lbf / 22.25 kN

Materials: Stainless Steel, Alloy Steel, and Aluminum Alloy

Meets: ANSI Z359.18-2017, OSHA 1910.140, OSHA 1926.502

021003

MFG. DATE

MONTH

| YEAR
---|---
01| 02|

03

| 04|
05|

06

|

07

| 08|
09|

10

|

11

|

12

|

WARNING:
Compliant fall protection and emergency rescue systems help prevent serious injury during fall arrest. Avoid contact with sharp edges and abrasive surfaces. Only make compatible connections. Avoid all physical hazards, including, but not limited to, thermal, electrical and chemical sources. Failure to follow all warnings or misuse of equipment could result in serious injury or death. For proper equipment usage, see user’s instructions, visit www.safewaze.com or call SAFEWAZE at 800-230-0319.

INSPECTION LOG

MONTH

|

YEAR

---|---
|
|
|
|
|
|

021004

25.0 INSPECTION FORM

Product lifetime is indefinite as long as it passes pre-use and Competent Person inspections. User must inspect prior to each use. Competent Person other than the user must complete formal inspection at least annually.

INSPECTION FORM
ANCHORS

Manufacturer: __
Model Number:
Description: __
Serial Number:
Lot Number: ___
Date of Manufacture: _

Company: _
Name of Inspector: __
Signature: __
Date of Inspection: __
In-Service Date: _
Anchor   Galvanized Steel  Stainless Steel  Aluminum
Material: Zinc-Plated Steel    Other: ____

LABELS & MARKINGS| PASS
| FAIL
 | NOTE

---|---|---|---
Label (Intact and Legible) | | |
Appropriate ANSI / OSHA / CSA Markings | | |
Inspections are Current / Up-to-Date | | |
Date of First Use | | |
HARDWARE (If Applicable)|

PASS
 

| FAIL
 | NOTE

---|---|---|---
Signs of Deformity | | |
D-Ring / Connection Points | | |
Hook Gate / Rivets (if applicable) | | |
Corrosion / Pitting / Nicks | | |
ANCHORAGE CONNECTOR| PASS
| FAIL
| NOTE

---|---|---|---
Termination (Stitch, Splice, or Swage) | | |
Deterioration / Corrosion | | |
Cuts / Burns / Holes | | |
Integrity of Welds / Rivets | | |
Paint Contamination | | |
Stitching / Wire Condition | | |
Heat Corrosion / UV Damage | | |
Separation / Bird-Caging | | |

CABLE ANCHOR             CROSS ARM STRAP

1. Connection Point
2. Termination
3. Label
4. Cable
5. Webbing

ROOF ANCHOR               POST ANCHOR

1. Connection Point
2. Welds & Rivets
3.  Labels

NOTES

225 Wilshire Avenue SW, Concord NC 28025 • 800-230-0319 • www.safewaze.com

If equipment fails inspection
IMMEDIATELY REMOVE FROM SERVICE

Safewaze
225 Wilshire Ave SW
Concord, NC 28025

PHONE: 1-800-230-0319
FAX: 1-704-262-9051

WEB:Safewaze.com
EMAIL:info@Safewaze.com

Copyright Safewaze

References

• Fall Protection and Safety Equipment | Safewaze Inc.
• Fall Protection and Safety Equipment | Safewaze Inc.

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