Elevated Work Platforms

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Location / Area:

• Area Supervisor:

Inspection Information

• Approved SWMS in place and communicated

  Yes

  No

  N/A

• EWP checked and authorised for use ON site

• Daily inspections of items listed in its log book or checklist completed and controls tested by the operator

  Yes

  No

  N/A

• Log book kept and retained on the working platform

  Yes

  No

  N/A

• Personnel operating Elevating Work Platforms (EWP) suitably trained and assessed as competent e.g. Elevating Work Platforms <11m Yellow Card or acceptable equivalent / Boom type Elevating Work Platform boom length 11 metres or more relevant High Risk Licence

  Yes

  No

  N/A

• Suitable barricades erected and adequate warning signage displayed "Danger Men Working Overhead"

  Yes

  No

  N/A

• Barricaded area prevents access to other workers in the area and protects the area underneath the working platform

  Yes

  No

  N/A

• EWP set up on firm and level ground

  Yes

  No

  N/A

• Outriggers extended (if applicable to type of EWP)

  Yes

  No

  N/A

• EWP not operating within 'zone of influence' of the edge of an excavation/trench/open precast concrete cable trench or drain without providing approved shoring or cover plates

  Yes

  No

  N/A

• EWP not operating closer than six (6) metres to power lines unless such lines have been isolated

  Yes

  No

  N/A

• EWP free of debris, waste, or unnecessary materials and equipment

  Yes

  No

  N/A

• Precautions in place to prevent tools or equipment from falling out of the working platform

  Yes

  No

  N/A

• Weather conditions suitable for EWP operation in accordance with manufacturer's instructions

  Yes

  No

  N/A

• Safe Working Load (SWL) marked on EWP and SWL of the working platform not exceeded

  Yes

  No

  N/A

• Safety Observer/Spotter available at all times to provide additional guidance when EWP is travelling

  Yes

  No

  N/A

• Fall arrest / restraint system worn and attached to a suitable anchorage point (boom type working platform)

  Yes

  No

  N/A

• Personnel required to use fall protection equipment trained in its specific use

  Yes

  No

  N/A

• EWP inspected by a qualified mechanic / fitter at least every 3 months

  Yes

  No

  N/A

Corrective Actions

• Action

• Action

• Action

• Action

• Action

Inspection Team

• Name:

• Name:

• Name:

• Name:

• Name: