Title Page
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Site Address:
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Scaffold Built By:
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Prepared By:
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Title:
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Conducted On:
1 - Scaffold Vacinity
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1.1 - Is there a scaffold tag present at the scaffold entry point?
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1.2 - Is there a scaffold tag provided?
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1.3 - Is there an installation date and inspection date available on scaffold tag?
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1.4 - Has the scaffold exceeded its 30 day inspect action?
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1.5 - Have safeguards against overhead electric lines been provided?
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1.6 - Are there controls for storage, handling and using hazardous substances?
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1.7 - Are scaffolds erected a safe distance away from trenches or excavations?
2 - Supporting Structure
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2.1 - Is the supporting structure in a safe condition?
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2.2 - Are all measures to strengthen the supporting structure satisfactory?
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2.3 - Is the risk of the supporting structure being overloaded from other sources satisfactorily controlled?
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2.4 - Is the scaffold built on solid ground?
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If built on soft ground are soleboards used to properly distribute load?
3 - Soleboards and Baseplates
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3.1 - Are there enough soleboards?
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3.2 - Are the soleboards of suitable material and in a serviceable condition?
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3.3 - Are the soleboards secure?
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3.4 - Are there enough baseplates?
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3.5 - Are the baseplates secure?
4 - Scaffold Structure
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4.1 - Are the lift heights correctly secured?
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4.2 - Are the ledgers correctly secured?
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4.3 - Is the bracing satisfactory?
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4.4 - Is the scaffold stable?
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4.5 - Are the ties correctly positioned and correctly fixed?
5 - Platforms
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5.1 - Does the scaffold have the required number of working platforms?
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5.2 - Are the working platforms at the required locations?
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5.3 - Are the platforms and supporting scaffold constructed for the relevant duty live loads?
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5.4 - Are there brick guards surrounding top level and any level above 2m?
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5.5 - Are the platform dimensions suitable for the intended work?
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5.6 - Is there satisfactory edge protection?
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5.7 - Are the platforms correctly constructed?
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5.8 - Are planks secure against wind exposure?
6 - Entry and Exit
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6.1 - Is there safe entry and exit to every scaffold platform?
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6.2 - Are portable ladders of an industrial grade, serviceable and correctly installed?
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6.3 - Are entries, exits and access platforms correctly installed?
7 - Protective Mesh Sheeting
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7.1 - Is there protective mesh sheeting on side where there is existing houses?
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7.2 - Are fixing ties secure?
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7.3 - Are there rips or tears?