Inspection Checklist

Model Number:		Serial Number:
Date:		Inspector (Name / Signature):
Date of Manufacture:		Date of Purchase:
Date of First Use:		Date Due for Next Periodic Inspection:

#	Description	Good—Safe for Use	Good—Safe for Use	Good—Safe for Use	Good—Safe for Use	Good—Safe for Use	Damaged, Worn, Altered, Missing—Remove from Service	Comments
1	Load indicator
2	Nozzle / Nozzle Rod
3	Housing / Fasteners
4	Handle (If Present)
5	Labels
6	Energy absorber pouch (V-TEC® EDGE SRLs Only)
7	Lifeline
8	Snaphook
	Lock on (ensure device locks)

V-TEC SRL / V-TEC Synthetic SRL	V-TEC EDGE SRL