GBE - Portable Ladder Platform Weekly Check and Test

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Equipment

• Date: Time:

  Date

• Model/Serial No

Critical Checks

• If any of the following critical components are found to be defective the equipment is to be Locked and Tagged out and reported immediately. it shall not be operated until the fault has been rectified.

• Manufacturers labels present and legible

  Yes

  No

  N/A

• No indication that the podium should not be in service such as DO NOT USE sign

  Safe

  At Risk

  N/A

• Podium is correct height for planned work

  Yes

  No

  N/A

• No evidence of unusual damage, wear, deterioration, corrosion, sharp edges or burrs

  Safe

  At Risk

  N/A

• All bolts, nuts or connections tight.

  Yes

  No

  N/A

• No loose steps, rungs or hardware

  Safe

  At Risk

  N/A

• Steps are free of obstacles, grease, oil & dirt

  Yes

  No

  N/A

• No cracks in welds or other metal parts

  Safe

  At Risk

  N/A

• Locking mechanism and castors intact & operable

  Yes

  No

  N/A

• Guard handrails secure

  Yes

  No

  N/A

• Podium is stable when erected

  Yes

  No

  N/A

Signature

• Add signature

  Sign

• Select date

  Date