CLIENT & LOCATION

  • Project

  • Job Number

  • Conducted on

  • Prepared by

  • Location
  • What-3-Words

  • Specific Location & Name

  • Client Name

  • Reason for visit

  • Sector

Client Submitted Information

  • Are there structural drawings available ? ?

  • What Format ?

  • Has the client or their client submitted Design Brief?

Scaffold Principles

  • Is the scaffold Internal / External / Both

  • Specified Materials

  • Will Extendable Transoms be used?

  • Cladding

  • Does the scaffold require a temporary roof?

  • Type of roof?

  • Type of Scaffold

  • Describe scaffold

  • Load Class

  • Type of Ties

  • Independent Board Gauge

  • Boarded Lifts

  • Specified Access

  • Are prefabricated beams required?

  • What beams are to be used?

  • Ground Specification

  • What is the ground condition if not stated

  • Base material of main structure

  • Does the scaffold involve roof work?

  • What is the roof material

  • Is the pitch of the roof greater than 10°

  • Does the scaffold require a fan?

  • What Class of Fan ?

Scaffold Details

  • Description of Scaffold(s)

  • Images

  • Main Dimensions (Height Length Width)

  • Structure Dims & Sketches

Design Risk Assessment

  • Are there any related risks

  • Describe Risk

  • Provide Images (If Possible)

undefined

  • Is the project affiliated to Network Rail?

  • Does a FORM C have to be completed

  • Is a CAT 3 Check Required

Sign Off

  • Completed By

  • Date & Time

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.