• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Inspection Details

  • Date of Inspection:

  • Inspector Name and License Number:

Scaffold Erectors' Details:

  • Company Erecting Scaffold:

  • Erectors' Name and License Number:

  • COID Letter of Good Standing Current and Available?

  • Medical Fitness Certificates Inspected for all Employees?

  • SHE Induction done by all Employees?

Inspection Criteria:


  • Surface level

  • Sole plates in place

  • Base plates in place

  • Jack used


  • Structure sound

  • Sufficient ties used

  • Ties tightened


  • Complete lines

  • Sufficient types

  • Correct fitting


  • Boards properly supported

  • Boards used are sturdy

  • Toe boards are used

  • Handrails in place

  • Platforms not overloaded


  • Lads in place

  • Ladders secured

  • 900mm above platform

  • Sound condition

  • Properly supported


  • Vertical

  • Sound condition

  • Correctly spaced


  • Correctly spaced

  • Firmly fixed

  • Sound condition

  • Transen (short ledger)


  • Correct castors

  • Height ration

  • Braced

  • Brakes

Suspended Platform

  • Sound equipment

  • Not overloaded

  • Secure outriggers

  • Lifting gear

  • Wire ropes

  • Shackles

  • Safety belt available


  • Placed as required


  • Inspector:

  • Erector:

  • Manager:

Is Scaffold SAFE or NOT SAFE for use?

  • Declared Safe/Not Safe for Use:

  • Photo of Scaffold:

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.