ADVANCED BUILDINGS AND RESTORATIONS LADDER INSPECTION FORM

• NAME OF PERSON INSPECTING LADDER

• DATE OF INSPECTION

  Date

INSPECTIONS

• Is this the correct ladder for the type of work task?

  YES

  NO

  N/A

• Stop work and direct workers on correct type of ladder.

• Is the ladder Industrial Rated to 150kg?

  YES

  NO

  N/A

• All ladders on site need to be industrial rated to 150kg.

• ARE THE TREADS/RUNGS IN GOOD CONDITION - FREE FROM DEFECTS SUCH AS HOLES, CRACKS, ETC

  YES

  NO

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• ARE THE TREADS/RUNGS FREE FROM GREASE, PAINT, MUD OR OTHER SUBSTANCES

  YES

  NO

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• ARE THE TREADS/RUNGS SECURED TO THE STILES

  YES

  NO

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• DOES THE LADDER STAND FIRMLY & EVENLY

  YES

  NO

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• ARE ROPES AND CORDS IN GOOD CONDITION WITHOUT DAMAGE

  YES

  NO

  N/A

• ARE RIVETS, AND OTHER FITTINGS IN GOOD CONDITION WITHOUT CORROSION

  YES

  NO

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• ARE PULLEYS AND HINGES IN GOOD CONDITION WITHOUT DAMAGE

  YES

  NO

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• IS THERE ANY MOVEMENT IN THE TREADS/RUNGS

  NO

  YES

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• ARE ANY TREADS/RUNGS MISSING

  NO

  YES

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• ARE THE STILES WORN OR DAMAGED AT THE TOP OR BOTTOM

  NO

  YES

  N/A

• DO NOT USE LADDER - NOTIFY HSE TEAM

• IS THE LADDER IN A SUITABLE CONDITION FOR USE

  YES

  NO

  N/A

• Notify HSE - DO NOT USE LADDER

• NAME OF RESPONSIBLE PERSON NOTIFIED OF DEFECTS

• DATE NOTIFIED

  Date

• ADDITIONAL COMMENTS IF REQUIRED

• By signing this form, I confirm I have inspected the ladder thoroughly and will not use the ladder if it is damaged/unsafe, in any way. I have notified the HSE team if there are actions or the ladder is unsafe and followed their instructions for tag out of ladder, if required.

  Sign