Elite Access Solutions (Handover Certificate)

• Conducted on

  Date

• Prepared by

• Principal Contractor / Client

• Location
  Address

Disclaimer

• This Scaffold detailed has been erected in alignment with its technical drawings, scaffold code of practice and is suitable for its intended purpose at the time of handover. Scaffold inspections every 30 days maximum or immediately following any incident which may affect the adequacy of the scaffold

Risk Assessment and Pre-Start

• Risk Assessment Completed ?

  Yes

  No

  N/A

• Pre-Start Completed ?

  Yes

  No

  N/A

Scaffold Vicinty

• Has public protection been provided?

  Yes

  No

  N/A

• Have safeguards against overhead electric lines been provided?

  Yes

  No

  N/A

• Is there control over vehicle movement?

  Yes

  No

  N/A

• Is there control over crane operations?

  Yes

  No

  N/A

• Are there controls for storage, handling and using hazardous substances?

  Yes

  No

  N/A

• Are scaffolds erected a safe distance away from trenches or excavations?

  Yes

  No

  N/A

Supporting Structure

• Is the supporting structure in a safe position?

  Yes

  No

  N/A

• Does the supporting structure have satisfactory strength?

  Yes

  No

  N/A

• Are there controls to prevent deterioration of the supporting structure?

  Yes

  No

  N/A

• Are all measures to strengthen the supporting structure satisfactory?

  Yes

  No

  N/A

• Is there a risk of the supporting structure being overloaded from other sources satisfactory controlled?

  Yes

  No

  N/A

• Is the scaffold built on solid ground? If built on saft ground, are sole boards used to properly distribute the load?

  Yes

  No

  N/A

Soleboards and Baseplates

• Are there enough soleboards?

  Yes

  No

  N/A

• Are the soleboards of suitable material and in a serviceable conditions?

  Yes

  No

  N/A

• Are the soleboards secure?

  Yes

  No

  N/A

• Are there enough baseplates?

  Yes

  No

  N/A

• Are the baseplates of the correct type?

  Yes

  No

  N/A

• Are the baseplates serviceable and of suitable dimensions?

  Yes

  No

  N/A

• Are the baseplates secure?

  Yes

  No

  N/A

Scaffold Structure

• Are the standards bearing firmly?

  Yes

  No

  N/A

• Are the standards plumb or as designed?

  Yes

  No

  N/A

• Are the longitudinal standard spacings correct?

  Yes

  No

  N/A

• Are the transverse standard spacings correct?

  Yes

  No

  N/A

• Are the joints in standards correctly positioned and secured? Special duty or Hung Scaffolding

  Yes

  No

  N/A

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• Are the ledgers level or as disigned?

  Yes

  No

  N/A

• Are the ledgers continuous or as deisgned?

  Yes

  No

  N/A

• Are the lift heights correct?

  Yes

  No

  N/A

• Are the horizontal ledger spacings correct?

  Yes

  No

  N/A

• Are the ledgers correctly secured?

  Yes

  No

  N/A

• Are the joints ledgers joints correctly positioned and secured - tube or coupler scaffold?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are there enough transoms or putlogs?

  Yes

  No

  N/A

• Are the transoms or putlogs correctly positioned and secured?

  Yes

  No

  N/A

• Is the bracing satisfactory?

  Yes

  No

  N/A

• Is the scaffold stable?

  Yes

  No

  N/A

• Are the ties correctly positioned and correctly fixed?

  Yes

  No

  N/A

• Has Mixing of components been approved in writing by a competent person?

  Yes

  No

  N/A

Platforms

• Does the scaffold have the required number of working platforms?

  Yes

  No

  N/A

• Are the working platforms at the required locations?

  Yes

  No

  N/A

• Are catch platforms currently positioned?

  Yes

  No

  N/A

• Are the platforms and supporting scaffold constructed for the relevant duty live loads?

  Yes

  No

  N/A

• Are the platform dimensions suitable for the intended works?

  Yes

  No

  N/A

• Is there satisfactory edge protection?

  Yes

  No

  N/A

• Are the platforms correctly constructed?

  Yes

  No

  N/A

• Are planks secured against wind?

  Yes

  No

  N/A

Entry and Exit

• Is there safe entry and exit to every scaffold platform?

  Yes

  No

  N/A

• Are temporary stairways correctly installed?

  Yes

  No

  N/A

• Are portable ladders industrial grade, serviceable and correctly installed?

  Yes

  No

  N/A

• Are entries, exits and access platforms correctly installed?

  Yes

  No

  N/A

Containment Sheeting

• Has the scaffold been designed for wind loading on containment sheeting?

  Yes

  No

  N/A

• Has the retention of rainwater and its affects on increasing weight been considered?

  Yes

  No

  N/A

• Are all fixing ties secure?

  Yes

  No

  N/A

• Are there rips and tears?

  Yes

  No

  N/A

• Are the overlap joints satisfactory?

  Yes

  No

  N/A

Mobile Scaffolds

• Is the supporting surface hard and flat?

  Yes

  No

  N/A

• Is the area of operation free from overhead electric lines or other hazards?

  Yes

  No

  N/A

• Are floor penetrations covered?

  Yes

  No

  N/A

• Are the castor wheel locks in working order? The should be locked at all times except during movement of scaffold.

  Yes

  No

  N/A

General Fitness for Purpose

• Is there provisions for material handling?

  Yes

  No

  N/A

• Are the clearances between the scaffold and adjacent structures correct?

  Yes

  No

  N/A

• Is there protection from falling debris?

  Yes

  No

  N/A

• Has the scaffold been safely designed to support attachments?

  Yes

  No

  N/A

• Are approaches and platforms effective lighting?

  Yes

  No

  N/A

Project Details

• Project/Reference Number

• Description of work area handed over

• Intended use of scaffold

• Duty Classification?

• Number of working decks?

• Top working platform height?

• Working bay(3.0m, 2.4m, 1.8m, 1.2m, .8m )

• Plant Design Registration Number? (If Applicable)

  Yes

  No

  N/A

Installation

• Has the Scaffold been built in accordance with AS/NZS 1578(1-5) and AS/NZS 4576?

  Compliant

  Non-Compliant

  N/A

Re-Inspection

• Has it been explained to client that Scaffold inspections required every 30 days, or immediately following any incident which may affect integrity of Scaffold?

  Yes

  No

  N/A

Photos of completed works

• Site photos of completed works and sign off tag

  Media

Sign off

• AES Representive Name

  Sign

• Certificate Number

• Date and Time

  Date

• Acceptance on behalf of Client

  Yes

  No

  N/A

• Client Representive Name

  Sign

Standard Clause Covering Orders

• 1. It is to be noted that the Terms of Hire and Terms and conditions of Sale found overleaf will apply to any Variation Work

• 2. This signed docket will be taken to supersede any conditions relative to additional work contained in the purchase order (Head Contract) of the client at the commencement of the contract works.

• All hire materials supplied for variation work to commence from date of delivery and finished when material is returned back yard.