Eric Gist

D & L Inc.

Ladder Disposal Form

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Information

Document No.
Audit Title
Client / Site
Conducted on
Prepared by
Location
Personnel

Ladder Number?
Type of Ladder?
- 4' step
- 6' Step
- 8' Step
- 10' Step
- 12' Step
- 14' Step
- 20' Extension
- 24' Extension
- 28' Extension
Circumstances that led to damage?
- Bent Rungs
- Hole or Crack in Uprights
- Rivots Missing
- Cross Braces Damaged
- Fell off truck or rack
- Run Over
- Worn Out
Please dispose of all ladders by cutting them with a Sawzall to reduce dust from fiberglass. Cut the ladder in 2' sections, or between every other rung to ensure that no one can use the remaining pieces.
Please take a photo of the cut up ladder with the ladder number showing.
Employee Signature
Supervisor Signature

Eric Gist

D & L Inc.

Ladder Disposal Form

Use this Template

Print as PDF

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