Fortnightly Scaffold Inspection Certificate

• Lasail

  Select

• Conducted on

  Date

• Prepared by

• Site Name & Client

• Location
  Address

• Scaffold Base Photos

  Media

• Scaffold Deck #1 Photos

  Media

• Scaffold Deck #2 Photos

  Media

• Scaffold Deck #3 Photos

  Media

• Scaffold Deck #4 Photos

  Media

• Scaffold Deck #5 Photos

  Media

• Scaffold Deck #6 Photos

  Media

• Scaffold Deck #7 Photos

  Media

• Scaffold Deck #8 Photos

  Media

• Scaffold Deck #9 Photos

  Media

• Scaffold Deck #10 Photos

  Media

Handover/Inspection:

• Docket No

Scaffold Inspection

• Lead Hand:

Scaffold Design #:

• undefined

Supporting Structures/Foundations

• Are the Base/sole boards fully supported by the foundation?

  Compliant

  Non-Compliant

  N/A

• Are all working deck boards installed?

  Compliant

  Non-Compliant

  N/A

• Are all sole boards visible for inspection?

  Compliant

  Non-Compliant

  N/A

• # of Wall and Raker ties. (Upload photo of Site register)

  Media

• Have a minimum of 10% of ties been checked per level?

  Yes

  No

  N/A

• Is any part of the scaffold built from other than ground, Spurs/Needles?

  Yes

  No

  N/A

• Are Needles/Spurs installed as per design & swms?

  Yes

  No

  N/A

• Are jacks/Uheads sitting square on footing or support?

  Compliant

  Non-Compliant

  N/A

• are the set hop ups within 300mm above or below slab?

  Yes

  No

  N/A

• Does the supporting structure continue to have adequate strength?

  Compliant

  Non-Compliant

  N/A

• Are ALL kickboards in place and secure?

  Compliant

  Non-Compliant

  N/A

• Is unimesh/ Chain & Shade Installed to ALL live decks?

  Yes

  No

  N/A

• Is safe access and egress provided to all working platforms?

  Yes

  No

  N/A

• Are overlapping boards secured where required in the 2021 QLD COP?

  Compliant

  Non-Compliant

  N/A

• Are Stairs and Ladders installed correctly and has mesh been lapped minimum 200mm?

  Compliant

  Non-Compliant

  N/A

• Is ALL Access/Egress ways clear of hazards? ( building materials, loose scaffold components)

  Compliant

  Non-Compliant

  N/A

• Has the PCBU or other trades got any items stored on the scaffold that need to be removed immediately?

  Yes

  No

  N/A

• Are maximum Loads displayed on Loading bays top and bottom?

  Compliant

  Non-Compliant

  N/A

• Is there sufficient signage or barriers to incomplete scaffold?

  Compliant

  Non-Compliant

  N/A

• Are Specialised scaffold designs erected according to design and swms?

  Yes

  No

  N/A

• Is there a scaffold tag in place and has it been updated to this Inspection?

  Yes

  No

  N/A

• Are any Corrective Actions required? (e.g. request Manager Audit)

  Yes

  No

  N/A

• I certify that I have performed the Monthly inspection and find the scaffold has been erected to and or remains to conform to the prescribed aforementioned standards.

• Signed:

  Sign

• The Scaffold did not pass the inspection and cannot be handed over until corrective action has been completed and the scaffold has been re-inspected

  Pass

  Fail

  N/A

• Client Representative Name:

• Signed:

  Sign

• Do you take receipt and acceptance on behalf of principle contractor?

  Yes

  No

  N/A

• Date:

  Date