Title Page
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Document No.
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Customer
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Address
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Conducted on
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Prepared by
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Location
TASK
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TASK
- VOID PROTECTION
- MOBILE SCAFFOLD
- HANG ON PLATFORM
- FIRST FLOOR EDGE PROTECTION
- QUICKALLY
- TEMP STAIR
- POOL VOID
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Are all Hazards/Risks identified in the Safe Work Method Statement. A hard copy is located in each truck and digitally.
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Identify Potential hazards and control Measures put in place prior to commencing work
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Please detail Potential Hazards and control measures put in place.
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Do I have the correct PPE/ TOOLS to complete the task safley
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New Install / Saftey Check / Removal
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Are internal voids proteted?
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Install ELITE void system and complete VOID handover certificate before comencing.
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Are all balconies protected with FALLGUARD Prior to accessing?
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Install FALLGUARD and complete FALLGUARD handover certificate
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Are there any Lost or damaged Items?
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List Lost or damaged Items
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Are internal voids proteted?
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Install ELITE void system and complete VOID handover certificate before comencing.
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Are all balconies protected with FALLGUARD Prior to accessing?
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Install FALLGUARD and complete FALLGUARD handover certificate
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Are internal voids proteted?
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Install ELITE void system and complete VOID handover certificate before comencing.
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Are all balconies protected with FALLGUARD Prior to accessing?
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Install FALLGUARD and complete FALLGUARD handover certificate
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Are All hangers correctly fitted and secured?
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Are Trusses installed and fixed securely?
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If HANG-ON has been installed PRE TRUSS are back braces and top plate corner braces installed as per installation manual?
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Are all Hand rails secured (clipped) ensuring overlapping past post (minimum 100mm) and all corner posts installed.
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Are all boards secured as per instruction manual?
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Is there safe Access to Elevated Work area
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Do a Site walk around and ensure All Excess gear taken from site?
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Has scaffold tag been fitted with correct information at access point?
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Take a Photo of Scaffold Tag
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Take photo of each Elevation
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Are internal voids proteted?
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Install ELITE void system and complete VOID handover certificate before comencing.
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Are all balconies protected with FALLGUARD Prior to accessing?
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Install FALLGUARD and complete FALLGUARD handover certificate
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Are internal voids proteted?
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Install ELITE void system and complete VOID handover certificate before comencing.
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Are all balconies protected with FALLGUARD Prior to accessing?
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Install FALLGUARD and complete FALLGUARD handover certificate
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Are All hangers correctly fitted and secured?
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Are Trusses installed and fixed securely?
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If HANG-ON has been installed PRE TRUSS are back braces and top plate corner braces installed as per installation manual?
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Are all Hand rails secured (clipped) ensuring overlapping past post (minimum 100mm) and all corner posts installed.
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Are all boards secured as per instruction manual?
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Is there safe Access to Elevated Work area
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Do a Site walk around and ensure All Excess gear taken from site?
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Has scaffold tag been fitted with correct information at access point?
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Take a Photo of Scaffold Tag
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Take photo of each Elevation
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Have i read and understood my SWMS for this task.
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DO NOT commence work until SWMS is read and understood for this task and all potential hazards are identified and control measures put in place
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Are all Hazards/Risks identified in the Safe Work Method Statement. A hard copy is located in each truck and digitally.
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Identify Potential hazards and control Measures put in place prior to commencing work
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Do I have the correct PPE/ TOOLS to complete the task safley
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Activity
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SAFE WORKING LOAD OF VOID PLATFORM
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Are all Void Supports within allowable spans as per the installation Manual (max 2.5m)
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Have Center supports been installed
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Are all Panels in place maintaining maximum 225mm to all working faces?
- Yes
- No
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Is there a maximum 100mm distance on designated walk off to floor?
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Is there a ladder bracket fitted preventing movement of ladder and maintaining a 4 :1 ratio and minimum 900mm protruding past top of void?
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Has scaffold tag been fitted with correct information on ladder?
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Take Photo from top of void
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Take photo of underside of void
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Take photo of ladder
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Take photo of scaff tag
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Ladder Removed from site
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Is all gear accounted For
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List Missing/Damaged Items
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Ladder Removed from site
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SAFE WORKING LOAD OF VOID PLATFORM
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Are all Void Supports within allowable spans as per the installation Manual (max 2.5m)
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Have Center supports been installed
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Are all Panels in place maintaining maximum 225mm to all working faces?
- Yes
- No
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Is there a maximum 100mm distance on designated walk off to floor?
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Is there a ladder bracket fitted preventing movement of ladder and maintaining a 4 :1 ratio and minimum 900mm protruding past top of void?
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Has scaffold tag been fitted with correct information on ladder?
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Take Photo from top of void
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Take photo of underside of void
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Take photo of ladder
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Take photo of scaff tag
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Have i read and understood my SWMS for this task.
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DO NOT commence work until SWMS is read and understood for this task and all potential hazards are identified and control measures put in place
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Are all Hazards/Risks identified in the Safe Work Method Statement. A hard copy is located in each truck and digitally.
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Identify Potential hazards and control Measures put in place prior to commencing work
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Do I have the correct PPE/ TOOLS to complete the task safley
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Erection/Modification/Dismantle
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Is all Equipment accounted for.
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Detail all missing/Damaged Components
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SAFE WORKING LOAD OF MOBILE SCAFFOLD
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Type of scaffolding
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Is the scaffolding over 2m Deck Height
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Outriggers Need to be fitted
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Is the Scaffolding 3m Deck Height
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Outriggers Need to be fitted
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Is there a ladder bracket fitted preventing movement of ladder and maintaining a 4 :1 ratio?
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Has scaffold tag been fitted with correct information on ladder?
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Take photo of scaffolding
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Take photo of ladder
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Take photo of scaff tag
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SAFE WORKING LOAD OF MOBILE SCAFFOLD
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Type of scaffolding
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Is the scaffolding over 2m Deck Height
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Outriggers Need to be fitted
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Is the Scaffolding 3m Deck Height
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Outriggers Need to be fitted
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Is there a ladder bracket fitted preventing movement of ladder and maintaining a 4 :1 ratio?
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Has scaffold tag been fitted with correct information on ladder?
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Take photo of scaffolding
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Take photo of ladder
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Take photo of scaff tag
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Have i read and understood my SWMS for this task.
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DO NOT commence work until SWMS is read and understood for this task and all potential hazards are identified and control measures put in place
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Are all Hazards/Risks identified in the Safe Work Method Statement. A hard copy is located in each truck and digitally.
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Identify Potential hazards and control Measures put in place prior to commencing work
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Do I have the correct PPE/ TOOLS to complete the task safley
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Install / Modification / Removal
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Is all Gear Accounted for
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List all lost/Damaged Components
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Are internal voids proteted?
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Install ELITE void system or Hand rail around Void.
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Are All Brackets fixed Securely to structurally sound frames, beams and trusses?
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Are all Hand rails secured (clipped) ensuring overlapping past post (minimum 100mm) and all corner posts installed.
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Is there safe Access to Elevated Work area
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All Excess gear taken from site?
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Has scaffold tag been fitted with correct information at access point?
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Take photo of each Elevation
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Installed By
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Have i read and understood my SWMS for this task.
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DO NOT commence work until SWMS is read and understood for this task and all potential hazards are identified and control measures put in place
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Are all Hazards/Risks identified in the Safe Work Method Statement. A hard copy is located in each truck and digitally.
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Identify Potential hazards and control Measures put in place prior to commencing work
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Do I have the correct PPE/ TOOLS to complete the task safley
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Erection/ MODIFICATION/ DISMANTLE
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IS there any Lost or damaged Equipment
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List Equipment
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TYPE OF SCAFFOLDING
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SWL OF SCAFFOLDING (INCLUDING MEN AND MATERIALS)
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DATE OF HANDOVER
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NAME OF COMPETENT PERSON
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SIGNATURE OF COMPETENT PERSON
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PHOTOS OF SCAFFOLDING INCLUDING ACCESS POINT. SCAFFOLD TAG AND EACH ELEVATION
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Installed By