The document is a daily inspection record for life lines used in construction projects. It details the project information, checklist items for lifeline installation and inspection, and requirements for safety and compliance. The completed record must be signed by the inspector and reviewed by the HSE manager.

1. LIFE LINE INSPECTION RECORD
(To be completed on daily basis)
Page 1 of 1 Form # HSEQ- LLIR (Rev 2 Mar 23)
Project Information
Project Name: Level/ Floor:
Location: Grid line:
Company name : Date:
Life line check point Line No. Line No. Line No. Line No:
Life line to be installed by competent erector and inspected prior use
Wire rope free from damage / broken wires
Minimum 12 mm diameter wire rope with breaking strength of 89 kN
Wire rope not corroded/ rusted
No kinks available
No reduction in diameter
No birdcage available
Both vertical pipes at ends provided at diagonal bracing
Platform secured with ladders
3 bull dog clips provided at end joints and properly clamped
No joints available in life line
No deformity on formwork scaffold
Safe Distance between two life lines is maintained.
Away from electrical lines
Valid third party certificate available for installed lifeline
Others ( Specify)
Remarks:
This checklist to be completed for both Shift
Inspector Name: Signature:
Reviewed By HSE Manager / In charge Signature: